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High prothrombin time 18.4 n high INR 1.45

Hi friend I had an episode of fewer chills vomiting n diarea and after the sonography revealed coarse echotecture with mild hepatomegely noted with mild edemetous echopattern .My sgpt sgot n alkaline phosphate was 450.ggt was 69.but after treatment all was normal but after 8 months sgpt is higher to 58 n prothrombin time is18.4 second n INR is 1.45 ...N prothrombin ratio is 1.40...Any medicine to recover or diet to control pt n inr....N specify how serious this is.
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Avatar universal
Oh and SGPT-ALT becomes elevated if the heart or liver is damaged.. yours isn't terribly elevated but you should probably have it retested after some time has passed to see if it has remained elevated or dropped back down to normal.
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It was dropped to normal as sgpt n shot was 25 n 33. But after again only sgpt got elevated to 57. I got tested for fibroscan n was mild fibrosis.n two days before I got sonography done which stated intrahepatic bilary calculi or calcified foci measuring 17mm.old healed granula ? The hematologist only said to talk to a nutritionist.n avoid alcohol n oily spicy n fatty foods.n yes low salt.
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Was it a heptatologist (liver specialist) or hematologist (blood specialist) that you saw and he/she advised you to seek out a nutritionist? I am not dr but I was gonna say that I don't think mild fibrosis would cause an elevated INR and that perhaps you should also consult with a hemotolgist (blood specialist) but if you have already done this,  I am out of ideas except for maybe a 2nd opinion is in order??
He was a hepatatologist.
Okay so then perhaps consult with a hemotolgist next... If your primary care dr isnt trying to figure out the cause of your elevated INR a hemotolgist should be able to help you.
Ok
Avatar universal
Those are results are common in people with cirrhosis unfortunately, just like low platelets...
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He said his platelets are normal and only INR is elevated. There are other causes of elevated INR other than cirrhosis.
First off I didnt say his platelet's were low, I said those 2 labs that he has elevated were common in people with cirrhosis just like people with cirrhosis also have low platelets. Also it isn't just his INR but also his Prothrombin time is also elevated.
The mistake I made was mistaken one of your comments for his. I thought it was him that said he had cirrhosis but just realized it was you.  My bad..
Still with the results of his ultrasound "corse echo texture" and his labs he should see a liver specialist.
I meant people with cirrhosis often have low platelets but I know some who have normal platelets.

I dont have cirrhosis, I have an enlarged liver 21cm and its fatty. I do have ALL the skin symptoms seen in cirrhosis like palmer erythema in both palms, 6 spider angiomas, thread veins all over my face, sudden thin skin where all my veins are showing through my skin etc but they say no cirrhosis and I hope you come out okay too.
I totally agree he should see a liver specialist.

I believe INR and PTT are essentially the same test result just reported in different ways. At least for me that is what my test result is the same report with two different results with both PTT and INR.

My current PTT is 11.2 normal range 9.1 to 12.0
INR is 1.1 normal range 0.8 to 1.2

So even though I have had cirrhosis for over 10 years my INR/PTT is normal.

My platelet count is my only out of normal result 110 with normal minimum at 150. My platelet count is up post hep c treatment it was about 80 to 90.

Seems to me I have heard that low platelets are the first symptom of cirrhosis indicating portal hypertension.

As far as symptoms I don’t have any of the skin symptoms you are having. I did have grade 3 esophageal varicies that needed banding. I also have pitting edema and a small amount of ascities.

Best of luck to you both and help with your symptoms.
My platelets was480 before 8months n now i have 290platetelets .the only problem is sgpt 57 n elevated pt n inr
Some of the reasons blood clots to fast are

Blood-thinning medication

Liver problems

Inadequate levels of proteins that cause blood to clot

Vitamin K deficiency

Other substances in your blood that hinder the work of clotting factors

You deff need to consult with a liver specialist about your ultrasound results and if I were you I would request a fibroscan... a fibroscan can tell you how stiff your liver issue and this will give your dr a good idea if you have any fibrosis or possibly even cirrhosis... Have you spoken with whoever ordered the labs about the results? I would call them or make an appt to go over my results too.

In the mean time if you drink alcohol, stop and start a clean healthy diet consisting of lots of fresh veggies, fresh fruits and lean meat. Try to limit simple carbs as much as you can. If you dont already, start getting some exercise even if it's just walking for 30 mins a day. If your overweight try and get down to a better weight.

Your liver will thank you for all these changes and if it is found that you do have liver disease this is all you can do to make the situation better.

If your gonna consult with a liver specialist I would get an appt right away because a lot of the times the wait for an appointment can be lengthy. I waited around 6 months for my appointment at Miami university.
I wouldn't worry about your platelets at this time, 290 is very good.
Elevated INR/PTT numbers mean your blood clots too slowly not too fast. PTT means  prothrombin the time it takes blood to clot. Higher numbers means it takes more time for your blood to clot. This means it takes longer to stop bleeding which is why people bruise with elevated INR/PTT may bruise more easily and are at higher risk of excessive blood loss if injured.

One thing you should do is avoid NSAID pain meds like Aleve, Advil, Motrin and Aspirin as meds in that class NSAID all can increase INR/PTT and increase the risk of uncontrolled bleeding in serious injury.
Sorry I meant to say "clots to slowly"
683231 tn?1467323017
I did find this but you should discuss your situation with your doctor

Effect of Vitamin K on Coagulopathy of Liver Disease: A Single Center Retrospective Review

Introduction: Liver disease is often marked by changes in hemostasis. Vitamin K is frequently administered to cirrhotic patients with an elevated INR to improve their coagulopathy, though strong evidence justifying this approach is lacking. Questions regarding the efficacy of vitamin K have been gathering based on an increased understanding of the rebalanced hemostasis of liver disease. This study evaluated the effect of vitamin K on the INR 24-72 hours after administration.

Methods: This retrospective chart review used the VA Informatics and Computing Infrastructure (VINCI) database to identify 886 admissions for patients with liver disease who received vitamin K between January 1, 2001 and March 31, 2014. Patients were included if they had a coded diagnosis of cirrhosis, acute hepatitis, non-alcoholic steatohepatitis, hepatocellular carcinoma, or end stage liver disease. Charts for patients with one of those diagnoses who received vitamin K at the LSCDVAMC were included.

All data was collected from the Computerized Patient Record System (CPRS). Medication route and dosing was determined from the pharmacy administration record. Patients were excluded if they received heparin, LMWH, FFP, or if they did not have an INR value before the administration of vitamin K or 24-72 hours after the dose was given.

Results: A total 886 individual admissions were identified, 333 admissions met inclusion criteria for analysis. The mean INR on admission for the included encounters was 1.88 (95% CI 1.798 - 1.955) the lowest INR was 0.86 and the highest was 5.99. In the 333 admissions analyzed the mean decrease in the INR was 0.08 (95% CI 0.028 - 0.132). 180 encounters had a repeat INR during the hospitalization. The mean decrease in INR from admission to the second post-vitamin K INR was 0.123 (95% CI 0.058 - 0.187). Of the 333 included patient encounters 37 had a change in INR (increase or decrease) >0.4, of which in 11 the INR increased and in 24 the INR decreased (mean change in INR 0.313; 95% CI -0.139 to 0.765). The average INR of those 37 encounters was 2.83 (95% CI 2.497 - 3.171). There was no significant difference in albumin in encounters when the INR increased vs. decreased in response to vitamin K. There was a trend towards higher total bilirubin (TBILI) when the INR did not decrease in response to vitamin K. Mean TBILI was 5.9 in INR responders (95% CI 5.011 - 6.789) and was 6.66 (95% CI 5.219 - 8.101) in the encounters where the INR increased despite vitamin K.

Conclusion: Vitamin K administration to improve the coagulopathy of patients with liver disease is common and often administered in response to an elevated INR. This is the largest retrospective review to date evaluating the effect of vitamin K on the INR of patients with liver disease. While a statistically significant decrease in INR of 0.08 was found, it is unclear if such a difference from vitamin K would be clinically significant. Moreover, only a very small portion of the patients included in this study (24/333) had an INR decrease of greater than 0.4. A limitation of our study is that patient centered outcomes, such as bleeding events, were not assessed. Future research should evaluate if there is a role for vitamin K in liver disease patients with a significantly elevated INR and low total bilirubin.
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Thanks dear for reply.doctor says every enzyme are normal .platelets are normal .only pt n inr are elevated.
I have cirrhosis but no ongoing injury because my hep c is cured so my liver enzymes are normal even though I have advanced liver disease. I do have a reduced platelet count.

Found this about elevated INR

What Abnormal Results Mean

If you are not taking blood thinning medicines, such as warfarin, an INR result above 1.1 means your blood is clotting more slowly than normal. This may be due to:

Bleeding disorders, a group of conditions in which there is a problem with the body's blood clotting process.

Disorder in which the proteins that control blood clotting become over active (disseminated intravascular coagulation).

Liver disease.

Low level of vitamin K.
683231 tn?1467323017
If the cause of your increased INR is advanced end stage liver disease if you have decompensated cirrhosis the only treatment for elevated INR is a liver transplant.
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683231 tn?1467323017
You said after treatment your liver enzymes improved? What treatment? Did you have Hepatitis c and were treated and cured?

Elevated liver enzymes do not relate to extent of liver damage they only mean something is irritating and injuring your liver.

Have you had any other testing for your liver like liver biopsy or a Fibroscan or blood test called fibrosure to determine the amount of liver damage you have? Have you been diagnosed with liver cirrhosis and are seeing a liver specialist like a hepatologist?

You really can’t diagnose liver damage with only an ultrasound but yours does sound like possibility the beginnings of cirrhosis. However I am only a patient who has had cirrhosis for 10 years you really need to discuss your diagnosis and prognosis with your hepatologist. My INR is in normal range but my platelet count is well below normal due to my cirrhosis and portal hypertension.

If your high INR is caused by cirrhosis this is serious and you need to see a liver specialist. If your high INR is caused by cirrhosis the only treatment would be if you go into total liver failure a liver transplant. Other wise if you have cirrhosis the only treatment is watchful waiting and a healthy diet, exercise as tolerated, NO alcohol, and use caution with all medications.

Bottom line see a liver specialist and follow their recommendations.
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1 Comments
I was n alcoholic. Any meds to control inr. Consulting a hepatologist.
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