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Done With Ultrasound Scan Of Abdomen. Liver Cirrhosis May Affect In Future. Taking Golbi. Advise?

Posted on Tue, 3 Sep 2013

Question: Dear Sir,

My mother's (aged 53 years) ultrasound scan of abdomen indicates" Liver is normal in size.Hepatic paranchyma shows coarse echotexture" with impression given as "chronic liver disease XXXXXXX SGOT(AST) shows 68 u/l and SGPT(ALT) shows 31 U/L .AFP shows 10.6 ng/ML.Her father had liver cirrhosis.Doctor says her present condition may lead to liver cirrhosis in future. Presently she is taking GOLBI 300 twice daily.She is also diabetic. Occasionally she reports stomach upsets..My query is whether her present condition may lead to cirrhosis in future. Is the present medication sufficient and please suggest alternatives to avoid further complications in future

With Regards
XXXX

Answered by Dr. Dr.P.Ratnakar Kini (12 hours later)

Brief Answer:
Need more information to give my opinion.

Detailed Answer:
Hi XXXXXXX
I went through your post.
Coarse echotexture is a feature of chronic liver disease. But it is not diagnostic of chronic liver disease or may indicate it may lead to chronic liver disease.

But I need some more information before I can give my opinion.

1. Why were these tests done?

2. What symptoms is she having?

3. What are the total protein and albumin values?

4. A high AST and AST/ALT ratio of more than 2 is suggestive of alcoholic hepatitis. So I would like to know whether she consumes alcohol.

5. I would like to know her bilirubin and serum alkaline phosphatase value also.

Kindly get back to me with the answers and I would give my opinion.
Regards,
Dr.Ratnakar Kini

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Dr.P.Ratnakar Kini (2 hours later)

Follow up: Dr. Dr.P.Ratnakar Kini (4 minutes later)

Dear Sir,

Answers to your questions.

(1) She reported bloating of stomach with occasional pain.Stomach full with bowel gas.

(2) Bloating with occasional pain

(3)Total protein-8.2 gm/dl
Albumin-2.9 g.dl

(4) No never

(5) Bilirubin

Total Serum-1.65 mg/dl
Direct Serum-0.56 mg/dl
Indirect -1.09 mg/dl

Serum Alkaline Phosphate-166 U/L

Awaiting your response

Regards
XXXX

Answered by Dr. Dr.P.Ratnakar Kini (44 hours later)

Brief Answer:
She might be having early CLD

Detailed Answer:
Hi,
Since her liver shows altered echo texture and her serum albumin level is low, she might be having early cirrhosis.
I recommend a liver biopsy to rule out/confirm early cirrhosis. Further treatment is best decided based on biopsy results.

Let me know if I can assist you further.
Regards,
Dr.Ratnakar Kini

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Above answer was peer-reviewed by : Dr. Prasad