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Suggest Treatment For Stage 4 Primary Biliary Cirrhosis

Posted on Fri, 7 Apr 2017

Question: I have primary biliary cirrhosis stage 4. Blood work was perfect, but one was off. Lab said the alfa feto protein was abnormal. Usually thr lab gives a range of what is normal.
How do I know how far off the alfa feto protein was with no values only abnormal.
Bilirubin,ast,alt,albumin,alkaline phosphates,any and all liver panel was fine.
I read that that the abnormal reading could be liver cancer or other cancers.
Please advise.

Answered by Dr. Dr. Happykumar Kagathara (5 hours later)

Brief Answer:
Abnormal AFP

Detailed Answer:
Hello,
I can understand your concern about abnormal values on blood investigation.
1) Yes, AFP is a tumor marker for liver cancer and abnormal value are predictive of having liver cancer.
2) Generally AFP value twice than higher limit of normal range would be considered as abnormal value with suspicion of liver cancer.
3) Primary biliary cirrhosis itself is a risk factor for development of liver cancer (Although very rare)
4) You must undertake AFP periodically along with LFT though frequency would be less frequent than LFT test.

Hope I answered your query. If you have any further doubts, I would be happy to help you.
Have a nice day!

Above answer was peer-reviewed by : Dr. Remy Koshy

Follow up: Dr. Dr. Happykumar Kagathara (5 hours later)

I got the results on my patient portal. The nurse did not give me the info.,correctly

Results
alt-afp,afp-lL3 [19529]
Range Lo
afp1.4nng/ml 1.6-4.5 L
The afp-L3% value is not calculated when the afp-L3 concentration is below 0.3n/g. In such cases the afp-L3% result field will indicate.NO VALUE Determined 2.
Please respond as soon as you can.I forgot to put in the text Abnormal Flag:L

Then at the end it stated NO VALUE DETERMINED2

Answered by Dr. Dr. Happykumar Kagathara (1 hour later)

Brief Answer:
Normal AFP

Detailed Answer:
Hello,
"No value determine" indicates test result very small that couldn't be detected with machine. Indirectly this means normal test.

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Dr. Happykumar Kagathara (6 hours later)

Dr. just called and said my meld score,was 13.
All other lfts were fine.
How significant is this?
What is the life expectancy with a meld score of13.

Thanks again
Please be prompt if you have time.

Answered by Dr. Dr. Happykumar Kagathara (21 hours later)

Brief Answer:
Good outcome

Detailed Answer:
Hello,
I apologize for late reply.
MELD score can be correlated with life expectancy in term that, 3-moth survival after liver transplant in a patient with MELD score <22 is 90%.
This MELD score can be considered as fair.
Are you listed for cadaver liver transplant allocation program?
If so, then this MELD score suggest a good outcome following transplant. Also liver transplant for PBS has a better outcome than transplant for hepatitis.

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Above answer was peer-reviewed by : Dr. Vaishalee Punj