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I Seem To Have Many Side Effects Of Cirrhosis But

Posted on Tue, 22 Sep 2020

Question: I seem to have many side effects of cirrhosis but no pathology in the liver itself. I have high portal BP, an enormous spleen, varices at the entrance to the liver, and esophageal varices. I do not drink and I never had hepatitis and have no hepatitis antibodies. I have had CTs, MRIs, a PET scans, dozens of blood tests, and none show liver pathology. Six years ago I had a liver biopsy that was normal, although my spleen was already enlarged, and my hepatic BP was mildly elevated. I do have a great deal of itching. Has this ever been seen before? My father died of cryptogenic cirrhosis, he also did not drink and never had hepatitis, but he did have al te symptoms of a cirrhotic disease.

Answered by Dr. Dr.P.Ratnakar Kini (3 hours later)

Brief Answer:
Answer given below

Detailed Answer:
Hi,
Thanks for posting your query.
I am Dr.R.K and I am pleased to assist you.
Enlarged spleen and esophageal varices are indicative of portal hypertension.
Liver cirrhosis is just one of the causes of portal hypertension.
There are other causes of portal hypertension as well in which liver can be normal.
You may be having extrahepatic portal venous obstruction causing portal hypertension.
If you have liver biopsy report with you, kindly upload it. I will go through it and give my opinion.
Regards,
Dr.R.K.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Dr.P.Ratnakar Kini (19 hours later)

I do not have a recent biopsy. 6 years ago was the last. At that time they said it was normal but was not a diagnostic size sample.
What tests do you recommend to determine the cause of portal hypertension? My gastro ordered "nuclear imaging of liver and spleen, dynamic and static" and also an MRI of the liver. Should these tests be helpful?

Is there treatment for portal hypertension? In the recent past both a biopsy and a splenectomy were discussed. My platelet count is in the 60 K/uL range.

Answered by Dr. Dr.P.Ratnakar Kini (26 minutes later)

Brief Answer:
Answer given below

Detailed Answer:
Hi,
You can get the following tests done.
1. Transient elastography of liver
2. Portal Venous Doppler scan.

Regards,
Dr.R.K

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Above answer was peer-reviewed by : Dr. Yogesh D