Fibroscan results (strange) S0 with F4????

[Trumindsoul]

Guys. i just had a fibroscan based on my elevated liver enzymes (less than double of top range)

Fibroscan results: 143 CAP score, 75 kPa reading, 6.3 IQR/med

Interpretation:

CAP value is consistent with no steatosis, S0

Fibroscan demonstrated kPa consistent with Metavir of F4, suggesting cirrhosis

FIB-4 is consistent with absence of advance fibrosis.

disgestive specialist said, this is inconcluive and he recommends biopsy. I am not conviced i need a biopsy. he did mention MRE. What do you guys think?

Additional info: 6'1", 175 lbs. skinny build with slight belly. non diabetic. only had a history of high cholesterol and triglycerides which has been managed in range in medication Lipitor and fenofibrate.

Bonus question; anyone experienced with fenofibrate? i noticed since i started it back in 2015, my kidney GFR dropped by 30 points and been in 60s for all these years which puts me at stage 2 CKD. I am in process of stopping it for few months and do another kidney tests to see if cretinine levels go down a bit.

[Darlenia]

Oh my...you have an interesting lab report! Some info alludes to cirrhosis, autoimmune issues and so forth while there is also info that seems to offset the findings, etc. My hubby takes meds for high cholesterol and high triglycerides but has never heard of fenofibrate. A quick search indicates that fenofibrate has been implicated in cirrhosis and related. I think it would be wise to switch to something else sooner than later. Ultimately our organs are linked so what happens in one organ can often lead to issues in another. I, personally, think it's probably a good idea to consider a biopsy too. It's good to be proactive. We only have one life to live - it's best to make it as pleasant and as trouble free and as long as possible. I hope you get real answers to your questions soon from your team!

[Trumindsoul in reply to Darlenia]

apologies for being MIA. Fenofibrate has helped a lot to drop the triglyceride leves. Use to be around 600-800 range. Statin got it down to 300 but no more than that. in 2015 i started fenofibrate which got me down in 150-200 range. I researched what you mentioned for the role of fenofibrate in liver injury. the clinical study of over 1200 patient showed 0.6% showed that. but the classic symptoms of that are high AST and ALT (>500). The highest i have ever seen is 90. (once over 12 years of monitoring). others times go in and out of range, which is also proven by < 1 FIB-4 score. what else can give me an indication of liver abnormalities? i am considering MRI/MRE as a secondary option to rule this out if any. at this point i feel it might be a bad scan (false positive). feel free to share your thoughts.

[Trumindsoul in reply to Darlenia]

also if you dont mind, what meds is your hubby using for triglycerides?

[Darlenia in reply to Trumindsoul]

Hubby uses Crestor and it keeps his triglycerides in the normal range; he has never used Fenofibrate. I'm very glad that Fenofibrate is effective in dropping your levels, seemingly without injuring your liver since your AST and ALT seem to be fine. We are so very different! I do see that you have a mystery on your hands - trying to figure out why your labs are what they are. Scans would outline the current status of your liver, whether or not there is damage or changes present and so on. It would be good step. I sense, though, that your doctor might still request a biopsy to see what's behind it all - the driving force - for example an autoimmune condition that can't be seen on a scan . I'd have a heart-to-heart talk with my doctor, laying out views and concerns, and see what he says. It's important to be heard and to be educated. And it makes decision making so much easier for all. You want to live a good life, doctors want that too. Partnering is good. Let us know your outcome!

[Badger2024]

Have you been tested for Hepatitis C? Very good treatment these days. Agree with everything that Darlenia said

[Trumindsoul in reply to Badger2024]

apologies for being MIA. all Hepatitis tests are negative. there is nothing at the moment pointing to any issues. my liver enzymes were only elevated a little bit. mostly in 60-70s which go in and out of range.

[Badger2024 in reply to Trumindsoul]

So my gut feeling (I used to be a gastroenterology nurse) is that your fibroscan was inaccurate. I’ve had one before and know that it is a very basic test. Not actually possible to have cirrhosis and liver enzymes that are borderline normal. I’m totally with you in saying no to a liver biopsy. Not a comfortable procedure and certainly not necessary with your blood results right now. Can’t comment on Fenofibrate as I don’t know anything about it. Please don’t take my opinion as a qualified one and get a second doctor’s opinion perhaps. Hardly anyone is told when they’re stage 2 CKD so good on you for taking the best care of yourself from early on. Nothing to worry about though