Cirrhosis/ Child Pugh

[Rugby50]

What does Child Pugh A score mean had cirrhosis for one year ago after collapsing 3 months after had fibroscan 75kPa and ultrasound which came back severe advanced cirrhosis forward know repeat tests 36kPa ultrasound same consultant says I am child Pugh score A , so my knowledge is limited but that sounds good also found out last week I know have diabetes .

[AyrshireK]

Explanation of Child Pugh Scoring system at:- en.wikipedia.org/wiki/Child...

You are definitely at the better end of the spectrum, as you'll see it's a mathematical calculation based on various blood results. Don't fret at all about it talking about prognosis etc. Too many people get hung up on all these scores and what they potentially represent, best to just live life .

Katie

[Richard-Allen]

Hello Rugby,

Once again dear Katie has beaten me to it.

There is an interesting (just been updated) NHS article about the scoring here: sps.nhs.uk/wp-content/uploa...

Although this scoring system was first devised over in America, it is used over here too as a way of assessing the amount of liver damage and an early indication as to whether a liver transplant may be in order. Like Katie has said, you are at the good end of the scale. So, this may just require further 6-six monthly checkups.

An MRI scan may be carried out to just to check for any possible tumours, but this is nothing to worry about, it’s just a routine check.

As the scaring on the liver continues, the liver can become insulin resistant.

We have several specialist genes in our body called the CRTC2 gene (also known as the Switch gene). These genes keep an eye on the amount of blood glucose there is in the body. If the muscles need extra sugar, like having to run for the bus or doing something energetic, then the CRTC2 sends a message to the liver, to dump more glucose into the body. When we’ve caught the bus and sit down, the CRTC2 then sends another signal to the pancreas. The pancreas in turn then sends out insulin into the body. It is believed that insulin acts as a signal to the liver to stop dumping sugar.

If the liver has become insulin resistant, then this message to stop dumping sugar doesn’t get through.

So, levels change in type 2 diabetes and this makes the hyperglycemia worse. What’s most interesting is that the signals that act through this molecule are linked to a protein called calcineurin which is activated and causes the liver to make more sugar. The calcineurin levels increase in insulin-resistant states. CRCT2 is found in many cells including immune cells, heart and placenta and some studies suggest in liver cells too. Also down-regulated in some cancers

I’d also like to point out that for most people who develop diabetes and who later go on to have a liver transplant may still have diabetes post-transplant. Calcineurin is also found in immune cells and is linked to growth and functional responses. So some anti-rejection medications used after transplant, target calcineurin to dampen down anti-graft immune responses. Tacrolimus and cyclosporin are calcineurin inhibitors. So, if a person was type 2 diabetic pre-transplant, there is a good chance they’ll still be diabetic post-transplant.

I hope this helps in the understanding as to what is going on.

Good luck.

Richard

[jacobsmum24 in reply to Richard-Allen]

I know this is far from an exact science and definitely best not to dwell on the numbers but was a bit surprised by the mortality table in the NHS article. Everything I have read previously suggested Child Pugh A patients had an average lifespan of 15-20 years but this suggests that only a quarter will actually reach ten years. Has cirrhosis prognosis been revised downwards ?

[Rugby50 in reply to Richard-Allen]

Hi liver -Lifestyle -Guru I appreciate everyone’s input but you seem to have a lot of knowledge are you from clinical background anyway just a few things so I collapsed 12 months ago vomiting new and old blood and also from back passage was hospitalised where I was told I have cirrhosis I was treated for this down the alcoholic route anyway discharged with meds was really unwell up to Christmas , seen gastro consultant again in January 2020 said everything ok So I decided to phone British Liver Trust as recommended by a friend they told me to see go and demand to see Hepatologist or Liver specialist which they did so I’m know under liver specialist at QE Birmingham in Feb had blood which weren’t right at fibroscan which was 75kPa so gave me some more tests which showed advanced cirrhosis forward to know had fibroscan 36 kPa and ultra sound , what bothers me more I’m extremely tired and week not eating only weetabix and fortijuce my feet and fingers hurt and keep loosing balance I was informed I had diabetes on last visit type 2 but needs investigating I was fit and well delivering beer a year ago extremely heavy work and know all I do is sleep sorry for going on to you I said this to consultant but I think she sees it day in day out also before I let you go she says I’m child score A which Ive read about from yourselves but surely I should feel better than I do or is this part and parcel of liver disease.

[Rugby50 in reply to Richard-Allen]

5 hours ago

Hi liver -Lifestyle -Guru I appreciate everyone’s input but you seem to have a lot of knowledge are you from clinical background anyway just a few things so I collapsed 12 months ago vomiting new and old blood and also from back passage was hospitalised where I was told I have cirrhosis I was treated for this down the alcoholic route anyway discharged with meds was really unwell up to Christmas , seen gastro consultant again in January 2020 said everything ok So I decided to phone British Liver Trust as recommended by a friend they told me to see go and demand to see Hepatologist or Liver specialist which they did so I’m know under liver specialist at QE Birmingham in Feb had blood which weren’t right at fibroscan which was 75kPa so gave me some more tests which showed advanced cirrhosis forward to know had fibroscan 36 kPa and ultra sound , what bothers me more I’m extremely tired and week not eating only weetabix and fortijuce my feet and fingers hurt and keep loosing balance I was informed I had diabetes on last visit type 2 but needs investigating I was fit and well delivering beer a year ago extremely heavy work and know all I do is sleep sorry for going on to you I said this to consultant but I think she sees it day in day out also before I let you go she says I’m child score A which Ive read about from yourselves but surely I should feel better than I do or is this part and parcel of liver disease.

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