My initial diagnosis is F3-F4 alcohol-related fibrosis (but they were leaning more towards F4 cirrhosis with 17.8 kPa reading). My antibody markers were continuously high in the past 1.5 years. My doctor suggests liver biopsy to determine if this can be related to AIH at the same time telling me that it is highly unlikely.
The first question is - Is it common to do biopsies as a means of diagnosing this disease? Unfortunately, "doctor knows what he is doing" attitude almost brought me to the end of my life at some point and since then I'm very cautious about everything that is being suggested. I know that there are a lot of people with AIH here. Was this the primary way that you were diagnosed? Thank you!!!
Secondly, how invasive the procedure is (he mentioned a needle) and I guess I am just looking for the experiences of people who have gone through it. He asked for the permission to put this my schedule and it will be performed in the next week.
He also said that the procedure would determine the stage of the fibrosis as well. Do I understand it correctly, that even though it's a golden standard it still has a 10% inaccuracy possibility?
Thank you
Written by
Margolia
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Liver biopsy is almost always required to confirm a diagnosis of AIH since it looks at the liver on a cellular level to see which bits are affected. Diagnosis of AIH is very much a case of eliminating all other causes then lots of jigsaw bits need to come together.
Liver biopsy is done on of two ways - a needle biopsy through your side which should be relatively painless .... they numb the entry site with a little local anaesthetic and take a few small samples. The other method is the transjugular route where the go in through the neck - this is most commonly used if someone has potential bleeding issues. My hubby has had both done in the past and neither caused him any problems.
Make sure you use the loo before your procedure and take something with you to pass a few hours as you often need to lie down for a few hours post procedure to prevent bleeding.
Thank you very much for this very informative response. I didn't realize that biopsy was that important in diagnosing AIH. I am leaning towards doing this procedure though I will ask them just in case if they can do a sedation.
When I had ascites, I was not sedated when they drained it but I was not in my, let's say, best condition and I didn't care much, though I remember it was unpleasant. So, I'll see if I can get the same sedation as I had during my gastroscopy in May.
I'll make sure I'll get something to read with me. I appreciate you taking your time to explain everything. Thank you!
I had a Liver biopsy May 2022, apart from an ache in the right shoulder shortly after, which went away after ten minutes, and was perfectly normal side effect in many but not all patients. It went well, I was told it was normally a day case routine with observation for four hours then you are allowed home, but I have a complicated neurological disorder so they kept me in the Liver unit over night. I had had a Fibroscan which suggested Cirrhosis, but the conclusion after biopsy was your diagnosis so far F3 - F4 with Bridging, not good, but not as bad as the consultant had originally expected.
It's better than F4 for sure! Nice! Why there is a pain in a shoulder? How long were you not able to wet the incision spot? I go to a swimming pool few times a week, just wondering. Thank you!
I was extremely lucky to have a specialist Liver nurse on my observation, she said when the extremely small fiber type needle goes in and takes a sample, referred pain ache is common as although it's only a tiny sample it is nevertheless invasive, but because it's only a slight nip it sometimes aches in the right shoulder above the liver, for 5 to ten minutes, out of five of us in recovery only two of us experienced it, it was just for a few minutes. As for the incision site, a little sore for a day or so but nothing to write home about, had a bath that evening on the ward.
Thank you, that was helpful. My doctor told me that I will get a local anesthesia during this biopsy. Did you have the same? If so, can you let me know how uncomfortable was the procedure itself after the pain-killing injection?
Yes I had a local anaesthetic, you feel very little during the procedure, a slight stinging sensation, if anything, as I've said referred shoulder pain is only temporary and not acute (dull ache) and doesn't happen with everyone.
Thank you very much! I appreciate it. I was a little bit worried. So, based on what you said it doesn't warrant any unnecessary sedation. That's good to know. 🤝🙂
Mre! It’s an mri with elasography of the liver. It’s done with and without contrast and gives the best picture of the entire liver and stiffness and surrounding organs. My hepatologist felt this would be better than the biopsy even since that also has levels of different reading. My fibroscan had a 17.5 kpa reading. I was diagnosed with cirrhosis due to that. But then my hepatologist ordered the MRE and it can back within normal limits!!
Congratulations!!! Great news. In my city we only have a Fibroscan option and there is a waiting time of ~6-7 months for it. I wish I could pay for it to monitor my condition but there is no such service. Closest one is 500 km away.
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