Elevated Fibroscan Results

[PoalaH]

Hi Guys,

I wonder if you have any advice. My liver enzymes were elevated so I was sent for an ultrasound which showed fatty liver. I then went for a Fibroscan which had horrendous results - 67.9 KPA.

I had a phone call with the liver clinic who told me I had NAFLD and cirrhosis. Based purely on the scan. The only advice was to lose weight and they would catch up with me in 4 months. At the time I was 160lb overweight (I’ve lost 45 lb since the scan but have a way to go). I’m shocked that the clinic have diagnosed cirrhosis when I am so overweight and the Fibroscan has been proven to be inaccurate with super obese people.

My Dad has cirrhosis and HCC so this diagnosis has been really stressful. I’m not sleeping worrying about being here for my family.

Would you request a biopsy? I feel like they’ve dropped a bomb and told me to get on with it and I have a ton of questions that I would like to have asked.

I have cut out all processed food, am vegan and don’t drink - is there anything else I should be doing?

Thanks so much for any advice you may have.

X

[AyrshireK]

Being overweight and having any elevation of inflamation markers can throw into doubt the accuracy of your fibroscan result (false high score possibly due to the fibroscan technology not being able to differentiate between inflamed tissue and actual fibrous tissue) and with the ultrasound not revealing cirrhosis then the cirrhosis diagnosis based on the fibroscan alone may be doubtful.

It sounds like you are doing all the right things, if you are able to exercise as well as doing your healthy diet then you might be able to stabilize things and when you have your next check up those liver numbers may well have come down.

They are unlikely to offer a biopsy as a means of diagnosing cirrhosis - it is often a diagnostic tool to see what has caused cirrhosis rather than in order to actually diagnose cirrhosis. They are reluctant to go sticking needles into livers if it can be avoided.

There are other blood tests like the ELF (Enhanced Liver Fibrosis) test which might be run to see if there actually is fibrosis present.

Keep up the healthy lifestyle and you will hopefully reduce all those figures.

Katie

[PoalaH in reply to AyrshireK]

Thank you Katie that helps put my mind at rest.

They have actually given me the ELF test on Monday so I should have results by the end of next week. I called the liver team today and they were adamant that the ultrasound in 4 months will show any cirrhosis but I’m not convinced that ultrasound can show scarring on an overweight person.

Thanks again for taking the time to reply. Xx

[Bikerguy54]

I would push to have a biopsy done because it's the gold standard for an accurate diagnosis. As an encouragement, I was diagnosed with Fatty liver NASH a few years ago and was scared to death. Nonetheless, I became a fanatic with the recommended treatment (Mediterranean style eating, fruits, nuts specifically walnuts, sunflower seeds, & almonds, no sugar products, no alcohol). Coffee, Stevia, red onions are wonderful, and persistent exercise. Like you, I lost 10 percent of my weight initially, 35 lbs and my numbers went down to eventually normal range. As of January this year, my Fibroscan and MRI shows no fatty liver nor fibrosis. It can be reverse so stay at it. Much blessings to you

[PoalaH in reply to Bikerguy54]

that’s so amazing - well done you! It’s stories like this that give me hope thank you. X

[Readlots]

Hi Paola, I had a liver biopsy to confirm autoimmune liver diseases. These were indicated by blood test results and an ultrasound (no fibroscans when I was diagnosed. So if you’ve had blood tests, an ultrasound and a fibroscan, the doctor will be using all of these to make a diagnosis, not just the fibroscan. I don’t think they normally need a liver biopsy unless blood tests indicate there is any question of what’s causing the disease e.g an autoimmune condition.

Unlike Bikerguy I wouldn’t push for a biopsy. They are invasive and not without risk. You can make all of the lifestyle changes and see if that improves things and avoid a biopsy. Even if you have a biopsy and it confirms cirrhosis, you’d still have to make the lifestyle changes anyway.

You’ve done really well losing weight. I was advised to reduce the amount of carbs I eat and not to have alcohol. But you have to do what works for you. It might be worth requesting a referral to a dietician when you see the consultant.

I hope this helps x

[PoalaH in reply to Readlots]

thank you so much. My bloods were only slightly elevated ALT but the GGT was triple the recommended amount. I read my ultrasound report and they definitely couldn’t see fibrosis or cirrhosis they said they could just make out fatty liver so all the diagnosis was based on the Fibroscan really.

I’ve since emailed the liver team with my worries after reading multiple papers on Fibroscan in the obese and the consultant actually agreed with me and are giving me an MRI. I had my bloods done on Monday and now all my numbers are normal except the GGT but this has come down so they are happy that the changes I am making are helping.

I’m so relieved that I am getting the MRI - I just want to know what damage has been done and how reversible it is. My Dad has cirrhosis and CCT so it’s important to put my family’s mind at rest if I can.

X

[mtk0925]

I’m not a doctor, before I type this I’ll say CAN BE SUGGESTIVE of cirrhosis, but AST higher than ALT can be suggestive of cirrhosis. Check your blood work as a SMALL part of the puzzle that we as patients have to work on ourselves as drs say well hmm that suggests that so we’re go with that. With out all the pieces I wouldn’t go on fibro alone

[PoalaH in reply to mtk0925]

hi thanks for replying. I had my bloods done on Monday and the only raised result is now the GGT. My AST has never been raised. Do you think that’s a good sign then? X

[PoalaH]

thank you so much for all your replies Guys. It’s really kind of you to find the time to help. X