I'm nervous about my Fibroscan next week

[MarkD6701]

Three & half years ago I was diagnosed with non-cirrhotic portal hypertension due to blood clots (Myeloproliferative Neoplasm). I'd had a fibroscan then with a score of 4.6.

However, this Easter I developed obstructive jaundice and my liver readings were up. My Jaundice went away after a couple of weeks.

I then had an endoscope to check my varices & they were barely noticeable. I've also had MRI, CT, Ultrasound and they can't detect gallstones.

What's making me nervous is that even though my varices & portal hypertension are minor my liver enzymes are still a bit elevated and obstructive jaundice is associated with liver disease.

Is it possible to have fibrosis & even cirrhosis with barely minor varices and portal hypertension?

[kurtymac]

Hey Mark, hope everything goes well next week. It's pretty hard to offer any advice regarding cirrhosis possibilities given your history. Non-cirrhotic PHT can lead to cirrhosis if the issue ISNT treated. As the 3 main hepatic veins are damaged, this is seen in a multiple types of liver disease, Budd Chari, ect. Do you have polycythemia Vera that caused this? The good thing is your MRI was clear. Normally, a new clot will show up on MRI and CT with contrast. I assume given your history they do your scans with contrast. Varicies with your situation isn't a good indicator of staging liver disease. When I had a drug induced liver injury I had minor varcies but lots of pressure in the portal system. So high that it actually tore my linea Alba. Now I have clear scans, clear fibroscan, no PHT. Fibroscan is nerve racking, but go in there with an open mind. Don't expect good or bad and hopefully you get a good tech. My tech helped ease my mind a lot and when I got the scan they came out much better than anticipated. AST and ALT can be elevated when the liver isn't happy. However, if Albumin is normal, Globulin is below 3.3, INR is normal then I'd say your might have some damage but not be cirrhotic.

[Hidden]

Keep the faith you're going to get another great fibroscan score.

The fact that your jaundice resolved swiftly is an optimistic sign substantial damage did not occur during this brief time.

Your multiple imaging studies coming back clean is another good sign.

Ask your doc about "Lecithin" (aka phosphatidylcholine) found in egg yolks as possibly beneficial regarding keeping bile thin and flowing well. An ounce of prevention is worth a pound of cure!

[Isabelle2]

Hi Mark

I know the worst part is waiting. Waiting for the appointment, waiting for results, then the follow up with the specialist. I sincerely hope it’s fine but if it isn’t then at least it’s good to know so that the doctors can give you the treatment you need. Please let us know how you get on.

Isabelle xx

[MarkD6701]

The thing is with my liver is that I was originally diagnosed with cirrhosis in Dec 2014 as the findings showed course heterogeneous texture leading them to believe it was cirrhotic. However the Fibroscan came up at 4.6. I was then diagnosed with NCPH.

When I was ill at Easter with obstructive Jaundice the subsequent ultrasound & CT scan led them to think it was cirrhotic once again although my own doc thinks that could be NRH they are seeing. Hence why I'm nervous about my latest fibroscan. Even though my liver readings were a bit high they have settled a bit and my obstructive jaundice only lasted about two and half weeks before disappearing entirely. All the tests for gallstones were negative.

As I have a Myeloproliferative neoplasm (Pre-fibrotic myelofibrosis) I'm on Clexane as well as Hydroxycarbamide (that kills blood cells) so I'd be very surprised & amazed if I ever got any new blood clots due to low blood counts.

What worries me slightly is that something still isn't right with my liver with raised levels but my latest endoscope (3 weeks ago) showed the portal hypertension & varices were hardly existent, almost to the extent they had disappeared entirely. But if there is progression of fibrosis I don't know what they can do as i'm teetotal and exercise regularly. Plus I'm on drugs to stop any further clots in the portal vein and anywhere else.

[MarkD6701]

Had my fibroscan and it came back kpa 6.9 so I'm very relieved.

The first reading was 30.5 which was a bit of a shock but then the median kept coming down and the nurse stopped taking readings when it had got down to 6.9.

As the range is from 2.5 to 7 for F0/F1 I'm not sure whether she just stopped once it was within the healthy range.

My Cap was 211 which seems to be ok as well. I've got to speak to the Gastroenterologist next week and my LFT's are pretty much back to normal as well. It may be the case that I have NRH, but I'll see what he says.