auto hep

[Eternity6]

please could someone advise I’m confused. To be honest these don’t really mean much to me but written down. Is these good or bad results. I’ve had liver biopsy last week and obviously awaiting those results, but here are the last more recent ones I’m on 5 Mg pred and 50mg aza. I’m not feeling well today. But have only just become unwell. My liver consultant who I saw last week tells me he’s going to put my aza up to 75mg and pred up to 40mg !!!!!! I’m concerned about the very high steriod increase

[AyrshireK]

It looks like your immune globulins are possibly quite high showing that your immune system is still not being tamped down enough, the thioprine tests which is the 6TGN, 6MMPN results indicate there is room to up your azathioprine to try and deal with the over active immune system BUT doctor isn't going to do this until the biopsy comes back to show whether your liver is currently inflamed in the areas where AIH would be expected. (Your ALT etc. arn't too raised so it's not like a massive flare ongoing).

I'd wait till your doctor has the full results and you have a proper discussion regarding why they think the big pred increase is needed. It does seem a huge leap when there isn't active liver inflammation and you are generally well but doctor will have the full picture and you have to make an informed decision based on a discussion with doctor.

You have a right to have this fully explained to you before you agree to any course of treatment but you have to have all the facts too.

Making treatment decisions involves:

Making a list of your options and understanding the differences between them.

Having a shared understanding of the problems and issues with your healthcare team and those close to you.

Discussing the likely outcomes of each option and the risks and benefits involved.

Being clear about what treatments are being proposed and why.

Agreeing on the proposed treatment plan and care.

Best news on that scan report is no cirrhosis evident. You do have some degree of fatty liver disease though and a fairly high BMI so you could aid your liver a bit more with tackling that too if you can so that you don't have two attacks going on with your liver.

I am not an expert on this as we have never seen any of hubbies blood results, some of the AIH Facebook group would be better placed to advise and I think you've been posting there for help too.

Katie

[Eternity6 in reply to AyrshireK]

thank you so very much Katie, that’s a big help , I’m very concerned about the pred being raised such a huge amount as I know how my body reacts to certain meds and a lot of the time I can react badly, I must admit I haven’t a problem in going up slowly but it’s the 40mg that scares me, yes the fact that no cirrhosis has been seen really pleases me, I have recently lost two stone well last year, and do try to exercise as much as can. I’d like a question answered though can I actually refuse to go straight up to 40mg, obviously I want to get well, but I know how my body reacts to things.

[AyrshireK in reply to Eternity6]

Make sure doctor fully explains any rationale behind going up to 40mg - if you were in a flare and inflammation levels were high then you might anticipate a need to go on high steroids for a short term to bring down the inflammation but in the absence of that you definitely need to find out why they think you need such a high dose. You can of course refuse to go to such a high dose, it's your body BUT obviously you need to make sure this is an informed decision. Ask wuestions - could a lower dose work, is pred the only option - you don't have cirrhosis so is budesonide a possible alternative?

Make sure you have a thorough discussion.

Katie

[Eternity6]

thanks soo much Katie, you have helped xx

[Eternity6 in reply to Eternity6]

I want to wish you and your husband well Katie x

[AyrshireK in reply to Eternity6]

Thank you.

[Eternity6]

such a shame Buddythezhu deleted the reply before I could read it

[Hidden]

Am not medically qualified in any way, just from my own experience.

Creatinine - measures kidney function, standard range is between 62-115, so 89 seems good to me.

Albumin 34 seems ok, normal range is 35 to 50, I have had way lower than this, usally when they did my drains I would lose massive amounts of protein out of my muscles, causing muscle deterioration, they would top me up with Human Albumin Solution (HAS), 34 is still good.

Quote from Verywell website "Albumin is the most common protein found in blood plasma. It helps to ensure blood stays in arteries and veins, and helps carry hormones, vitamins, and enzymes throughout the body. Albumin is made in the liver and quickly carried to the bloodstream."

I don't know about the others 😀

[Eternity6 in reply to Hidden]

Thankyou MrHappy