What Does My MRI Scan Indicate?

Brief Answer:
Need Autoimmune markers and Biopsy report

Detailed Answer:
Hello XXXX,

Gone through the reports carefully..

The LFT numbers are in acceptable limits.So no need to worry in this aspect.

How's your health ?

MRI Abdomen without contrast is suggesting evidence of bile duct inflammation(Primary sclerosing cholangitis) could be a possibility in this case.

But it would be better to have biopsy and autoimmune marker's test reports to comment well on diagnosis.

Regards.

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Brief Answer:
Urinary tract infection unlikely.

Detailed Answer:
Hello XXXX,

Happy to hear that you are well and improving..

I had noticed the urine culture result in your previous report. But presence of urinary tract infection is unlikely if the examined specimen was a clean catch sample. Usually above 100,000 CFU/ml would need treatment or repeat urine test. If you are symptomatic(like painful/burning urination,increased frequency etc),antibiotics like ampicillin,nitrofurantoin etc can safely be considered. Otherwise, antibiotics may not be necessary at present.

Liver biopsy report indicates the presence of chronic active hepatitis( Grade-moderate to severe,stage-precirrhotic ). This could be probably the sequale of chronic autoimmune hepatitis.Autoimmune markers test reports would also help in confirming the diagnosis.


Regards,

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Brief Answer:
You need not be much worried about the LFT

Detailed Answer:
Hello XXXX,

As long as there is an active inflammatory process, liver enzymes would show up in increased numbers. Its very difficult to bring back the enzymes to normal level if its a chronic liver disease. Only we can get back the enzyme levels to near normal or keep it within acceptable limits with appropriate therapy.

In my opinion, you need not be much worried about the LFT values until you are feeling symptomatically better (or) the numbers in raising tendency say (ALT,AST--above 500IU/L).

Also when comparing this report(dated 09/22/14) with the latest one with MRI(dated 10/27/14)--The liver enzyme titre levels are actually in decreasing tendency i.e could relate to the effect of cactus juice.

You may not need immunosuppressant therapy like steroids for a while. Watching for clinical symptoms and monitoring the liver function with LFT every month might be considered now.But autoimmune marker test report could change my view to some extent. Awaiting for it.

Discuss this with your treating physician and decide further management.

Regards,

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Brief Answer:
Yes

Detailed Answer:
Hello XXXX,

Biopsy report indicates the presence of occasional areas of liver cellular damage (necrosis) with scarring(bridging fibrosis) and mild architectural distortion..But not suggestive of full blown cirrhosis..

MRI suggested the possibility of sclerosing cholangitis aand liver fibrosis too..

Regards

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Brief Answer:
I had seen this report already in previous query.

Detailed Answer:
Hello XXXX,

Hope you are good..

I have compared all your blood reports(from older to latest ones), and found persistent elevation of total bilirubin and globulin fraction bit on higher side. This reports could be correlated with the liver inflammation suggested by biopsy, probably due to autoimmune cause.However the liver enzyme levels (ALT,AST,GGT) is on the decreasing tendency. This could indicate liver damage is not extensive.

1)How's your symptoms? itching,fever,abdominal pain etc ?
2)Any recent reports with Conjugated(direct) and unconjugated(indirect) bilirubin ? ---> Because in reports I could see only total bilirubin..If not available, then no issues..

Regards

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Brief Answer:
Unlikely to be an infection..

Detailed Answer:
Hello XXXX,

The intermittent symptoms could most likely be associated with the subacute presentations of chronic liver inflammation(chronic hepatitis) which you have.I don't think it as an infection related issue.

Did you find any recent reports having conjugated and unconjugated bilirubin levels which i asked for ?


Regards

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