Swollen Leg After Injury. Have Diabetes, Cirrhosis, Hepatitis C, High Blood Sugar. Liver Failure Or Cancer?

Posted on Sun, 26 Aug 2012

Question: My mom has cirrhosis and hep c....recent tests showed creatine 1.6 ....MRI showed nodule on liver 1.5 cm. Her afp jumped from 55 to 182 in one year. Drs are concerned about the 182. It has been 10 years since she found out about cirrhosis and hep c. She hit her leg the other day and it swelled right away! She also has diabetes. The diabetic dr said her sugar is averaging 240. Is there a possibility my mom is experiencing liver failure or cancer?

Answered by Dr. Charles S Narasi (39 minutes later)

Hello XXXXXX,
Sorry to hear about your Mom's condition.
Most likely, her cirrhosis was caused by long
standing effects Hepatitis-C Virus infection. I am
assuming that she never had treatment for Hep-C.
ALP or Alpha-feto-protein can be elevated in any type
of cirrhosis. However the levels are not too high. In
your mother's case, MRI is showing a solitary nodule
or a mass lesion. This combined with increasing levels
of AFP is certainly of great concern. This could be indicative
of liver cancer. I would recommend that you consult a liver
specialist if she already has one and then referral to a liver
center would be preferable.Pittsburg,PA,Cleveland Clinic,Ohio,
Emory Medical Center in Atlanta XXXXXXX have some of the best
centers.
Wish your Mom well.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Charles S Narasi (9 minutes later)

Yes ...she has had two separate inferon treatments several years ago for hep c. Her liver doctor plans to do another afp test on Wednesday to see if it has increased. Do you think he should also do a creatine test since it was out of range on her CBC test?

Answered by Dr. Charles S Narasi (6 hours later)

Hello,XXXXXX,
Glad you read my note. The Creatinine level is important for
determination of kidney function. Advanced liver disease can cause
kidney failure as well and is called "Hepato- Renal Syndrome XXXXXXX
It is good to have that checked also.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Charles S Narasi (37 hours later)

One more thing...
My mom's Albumin is 3.2... Which is low. Her ALP is 162 which is high.
Question...how serious is having a Albumin level that low given that she has cirrhosis?

Question 2: she has had severe chest pain that felt like she is having a heart attack. She is passing it off as gas. Is it possible that her cirrhosis is causing her chest pains. They usually occur at night when she is resting.

Other info that may help
White blood cells count 3.7 low
Protein total 8.5High
Globulin 5.3 high
Albumin/ globulin ratio .6 low
Alp162 high
AST 69 high
ALT 65 high
Hemoglobin 8 high
Platelet 58 Low

Answered by Dr. Charles S Narasi (3 hours later)

Hello XXXXXX,
Thank you for sending me all the lab results. Low albumin and high
globulin levels indicate considerable liver damage. Also low platelet
counts and low white cell count and her low hemoglobin indicating
anemia are all part of the problem. With increasing ALP levels, I am
very concerned about the possibility of liver cancer. Please follow
with your specialist.
Wish the best.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar