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Merck Manual...say whaaat?!!?

Here is a page from the Merck Manual:


Immediately below is an excerpted statement that I frankly found surprising.  Any comments or feedback are welcomed - thank you!!


Quoting the Merck Manual:  
"Clinical signs that suggest a chronic liver disorder or chronic alcohol use but ARE NOT SPECIFIC FOR CIRRHOSIS** include muscle wasting, palmar erythema, parotid gland enlargement, white nails, clubbing, Dupuytren's contracture, spider angiomas (< 10 may be normal), gynecomastia, axillary hair loss, testicular atrophy, and peripheral neuropathy."

** emphasis added.  
This statement seems to suggest that one could be presenting with any or all of these symptoms - and yet still not be cirrhotic.  Presumably it's saying that F3 status...a seriously damaged/fibrotic liver that's not yet cirrhotic...could present with any or all of these symptoms.  

My question (to anyone on the forum):

Do you know this (above) to be an accurate statement?  
Has anyone had such an experience verified by - or such a statement made by - their hepatologist?
Do you have a differing interpretation... and/or remarks?

Many thanks! PD
2 Responses
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Avatar universal
How are you? Cirrhosis may be asymptomatic or with few symptoms and signs of liver disease. Some of the symptoms may also be nonspecific and may not suggest that the liver is their cause. This may be what it meant. Aside from symptomatology, clinical correlation with the medical history and results of diagnostic tests are still important considerations in the diagnosis. Take care and regards.
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978469 tn?1433547946
I have red palms and have had pale fingernails for 30 years, I'm not cirrhotic (hopefully)
I think there has to be concrete findings via labs and imaging tests. Cirrhosis or any other disease can't be diagnosed based on secondary symptoms. Just my opinion.  
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