Compensated Cirrhosis - Sudden Extreme Increase in Liver Stiffness while Blood Reports Have become Normal

[ZeroInfiniti]

During annual medical tests in Feb 2024:

- Saw elevated Liver Enzymes, Hi bilirubinFibroscan (ordered by Dr) Stage 2 Fatty Liver, LSM 12.8, Early eosphageal varices, normal platelets (low end of normal)

- Compensated Child-A Cirrhosis

- Diabetic, high Cholesterol, hi triglycerides Hypertension: All numbers were high

Taking Medicines for all.

Advised exercise, weight loss, healthy diet (high protein). Saroglitazar (PPAR agonist), Vitamin E.

After 3 months

- Liver Enzymes normal

- Bilirubin almost normal

- Hba1c, Blood pressure, Cholesterol normal , Still high triglycerides

Update:

I got a fibroscan today after being on the medication and healthy lifestyle regimen and hoping to see improvement.

To my utter horror and shock, the liver stiffness is 74 kpa with the Fibroscan. It was 12.59kpa 3 months back with another non Fibroscan Transient Elastography.

The technician tested 2-3 times to confirm the numbers

I am at loss as to what happened. My metabolic numbers have returned to normal/acceptable with my recent tests. How could my liver stiffness go off the chart in 3 months while under treatment?

My view of the possibilities:

- Rapid worsening of the condition

- Some other inflammation of the liver

- Operator measurement problem

I will meet my Doctor soon. Any clues/pointers will be much appreciated

[MINTVCX]

Well I think the answer is here:

"To my utter horror and shock, the liver stiffness is 74 kpa with the Fibroscan. It was 12.59kpa 3 months back with another non Fibroscan Transient Elastography.'

1. You cannot directly compare the result from Fibroscan and "non Fibroscan Transient Elastography". For example if it was SWE please see the scale.

2. The facts are:

- you were diagnosed Compensated Child-A Cirrhosis first based I think not only on Transient Elastography result.

- Basically Fibroscan result was pretty the same - cirrhosis. Depends on your disease if it is 15, 20 or 75 kpa it does not change your situation. Still F4.

I think your doctor will the best option to

clarify your concern. Good luck.

Swe

[ZeroInfiniti in reply to MINTVCX]

The scales are very similar. The concern is that the LSM has increased dramatically while the expectation was that it will improve with the medications and life style modifications

[lusitania84]

I'm certainly not a Dr as most of us here are not. Wouldn't that be nice if there were some on here? I will say that I've seen many reports on here of discrepancies between fibroscans and other more accurate tests such as MRE and/or biopsy. I would be asking for one of those two tests as a confirmation of those results.

[Alterity]

I have been in stage 4 for 23 years. My blood work is never elevated, but slightly. My old dr who retired said when my blood works shows that it is going up, I will be on my last leg because mine just never moves. I have a very hard cirrhosis liver. I lose 48 pounds and they thought I went down to a 2/3 but the biopsy said I was still 4. Now I have gain 20 pounds which I got to get back off. Having trouble again with swelling and other things, but things will yo yo with the liver, most of it depends on what you eat and if it had a hard time digesting and if you have had lots of rest. When I eat wrong the blood pressure goes up and the stabbing gets bad, so all the numbers are going to go up.

[ZeroInfiniti in reply to Alterity]

Thanks a lot for this useful perspective. Wishing you the very best for a healthy life.

[ThyroidDeb]

I was diagnosed at first through blood test and fibroscan as stage 4 cirrhosis and advanced fatty liver. The gastroligist I had was willing to settle with that result and did not believe in transgression. I went for second opinion, this hepotoligist did not believe in the fibroscan and doesn't use it, too many variables that give false readings. He suggested a biopsy which I did, result was stage 1 mild fibrosis and mild fatty liver, zone 3. Vitamin C and Viramin E, E for 3 months then a multivitamin with E continued along with diet and exercise. For the last 3 years my bloods get better and better, this year is the first time nothing was high, a1c 5.3. My hepotoligist moved out of State and I have a new gastroligist and I'm not as happy with him so far. He ran a bunch of blood work that he said can determine fibrosis, that was almost a month ago and I have never heard any results. I called the office for a follow up appointment and was told I didn't need one. Not sure what to think. Good luck, my opinion is don't stop at a fibroscan, I personally don't trust the test or the person doing it. Mine had a lot of trouble trying to get it right, to the point I had sore ribs, result I believe was 19.5 kpa and fatty liver 350 if I remember correctly.

[ZeroInfiniti in reply to ThyroidDeb]

Thanks a lot. Kudos to your persistence in seeking a second opinion and following through with a very vigorous healthy regimen to get all the markers right. Best wishes on maintaining your good health.