peripheral neuropathy

[me_just34]

i had nash 2 years ago and then liver enzymes improved.
my last test result done 2 months ago is attached.

Recently, I have burning in hands and foot (called peripheral neuropathy).
I do not know if this can be related advanced  liver disease.
any idea?

[Livelife777]

I have periferal neuropathy caused from chemotherapy for my Cancer treatment.  It is a fairly benign condition with no treatment.  Other then being annoying, it causes no harm or is it life threatening.  More so a nuesence.

Periferal Neuropathy is not related to Liver Disease.  It involves nerves in the outer extremities which can cause burning or numbness.
.....Kim

[flyinlynn]

no that is not a liver symptom and your liver tests are normal

[me_just34]

I have feet burning a lot. Is this not rela
ted to liver?

[me_just34]

my ggt is normal (under 20).

[ralph2014]

HI

I have been following your posts and I know how anxious you are.

The ultrasound isn't used for staging Fibrosis, but it can be very useful, full on well established Cirrhosis will have a very high change of being seen.  They check things like, Liver edge, Liver cell echo, Liver surface echo, portal vein width.  If you have a completely clear Ultrasound and your bloods are good chances are that you don't have Cirrhosis, but you could still have some Fibrosis. I have read a paper on Ultrasound for staging Fibrosis and it had a 90% positive predictive value for seeing Cirrhosis and an 80% negative predictive value for a normal liver, its the in-between where it was hazy.  A good blood marker that is very much understated is GGT, if you have a GGT of under 20 you should be in a good place with your other data.  

The only tool that actually measures Fibrosis is the Fibroscan

[Sarah1949]

I also have PN and was told it was from my Hep C. I also have cirrhosis, which certainly doesn't help any.

[HectorSF]

While an ultrasound is not used to stage liver disease. Ultrasound as well as other imaging studies, such as an abdominal CT scan or MRI, can see the physical changes to the liver and the surround blood supply which occur when a person has cirrhosis of the liver.

For example ultrasound cannot tell if a person have no liver disease at all (stage 0) or if they have even extensive fibrosis (stage 3). This is because there is no change to the physical architecture of the liver and the surrounding blood supply. Only when a person develops cirrhosis does the certain physical characteristics of the disease appear. Typically it takes many decades of ongoing damage to the liver before a person develops cirrhosis.

If a person has cirrhosis the most common signs of the cirrhosis will be;
a nodular surface to the liver,  "coarsened" echo texture, changes to the size of the liver or different portions of the liver. Changes to the blood supply around the liver will also be seen if the cirrhosis is more advanced. Such as an enlarged spleen, hepatic artery and changes in blood flow direction. These are due to the back pressure created by a scarred liver that is unable to pass blood through the liver as a noncirrhotic liver does. Ascites (fluid buildup) in the abdomen which is the most common complication of advanced cirrhosis can also be seen using ultrasound.
If any of these abnormal features were found they would be noted in the ultrasound report.

Please note that many of these signs can also be detected by a proper physical exam. Indication of cirrhosis may also be seen on certain blood test results such as a low platelet count (typically less than 100,000) because of an enlarged spleen which sequesters the platelets. High Bilirubin and INR levels and low Albumin levels may also be seen reflecting extensive damage to the ability of the liver to function. Of course a person with this amount of cirrhosis will feel ill as well.

I hope this answers your questions.
Hector

[me_just34]

Thank you very much Hector. I had two ultrasounds (normal and with dopler) done 6 moths ago and they were normal. Can they exclude liver cirrhosis?

[HectorSF]

Hi and welcome to the cirrhosis community.

Peripheral neuropathy is not a symptom of cirrhosis of the liver. Peripheral neuropathy is caused by nerve injury. There are many conditions and diseases that can cause nerve damage. For example diabetes is one cause of peripheral neuropathy but there are many other conditions as well. It is best to talked to your doctor to get a diagnosis for what could be the cause of your neuropathy.

Your doctor should perform NAFLD Fibrosis Score, Enhanced Liver Fibrosis (ELF) panel and transient elastograph test such as a Fibroscan or a liver biopsy if they suspect you have advanced fibrosis or cirrhosis. The blood tests you have had done can not diagnosis either advanced fibrosis or cirrhosis.

Please talk to your doctor about your concern of having advanced liver disease. They can explain the risk of developing advanced liver disease and what you can do to prevent that from happening by working with your doctor to manage your NASH.

If you are interested in learning more about the symptoms and complications of cirrhosis of the liver please read the MedHelp Health Page “What is Cirrhosis of the Liver?” which will explain what is cirrhosis and the symptoms and complication that can occur when the liver is so damaged it can no longer perform all of its body functions.
http://www.medhelp.org/tags/health_page/3466/Hepatitis/What-is-Cirrhosis-of-the-LIver?hp_id=1304

Best of luck to you.
Hector