Discussions By Condition: I cannot get a diagnosis.

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Posted In: I cannot get a diagnosis. 2 Replies
  • Posted By: Anonymous
  • June 25, 2009
  • 01:14 PM

Thank you for letting me join the forum.

I am a 51 year old single male living in the UK. I am self employed, do not smoke or drink and walk for half an hour each day. My food is normally reasonably healthy, but may contain too much sugar and animal fat to be ideal.

Family health history. Mother diabetic class II, father in his late 80s had a deep vein thrombosis in his leg ten years ago now on blood thinners otherwise healthy. Grandparents although now passed had no serious health issues.

I am 5ft 11 and weight 220 pounds.

I have had abnormal LFT (liver function tests) since 1997. At the time an ultra sound and CT scan found a fatty liver infiltrations but no mass. An urgent US was done again in June 2009 as the LFT still remained elevated, (ALT 97, AST 71), ferritin marginally raised. although they had been higher, again fatty liver was seen no mass.

I suffer from elevated blood pressure, 130/90 but not in need of treating. Resting pulse rate 80.

All other blood tests are within the normal range, FBC, ESR, Hepatitis screen, C3, C4 and immunoglobulins normal, but the cholesterol was elevated at 5.2 as was triglyceride at 2.73. The LDL cholesterol 2.96.

Further tests, Brain MRI and CT, Chest x-ray, EKG, EEG all normal. All May > June 2009



I have been assed by a Gastroenterologist (June 2009) who after exam and review also suggested fatty liver.

Symptoms,

Nausea (2-3 Month duration)

No noticeable weight loss,

Loss of appetite

Acid stomach, burning in stomach some reflux prescribed Omeprazole which I have taken once and does help with the acidity. No indigestion or heartburn.

Fatigue

I feel that my stomach is distended but the doctor said it is fat?

I am unable to tolerate alcohol, any amount makes me light headed, this has been the case for over 10 years


The above symptoms have been longstanding, lasting for at least 10 years maybe longer. The only reason symptom a few months is the nausea. The fatigue was originally put down to CFS/ME?


My thoughts and concerns,

I believe that many if not all my symptoms can be contributed to my liver failing to work correctly, and that although the condition has detiriated it has been present since 1980s when I first experienced unexplained fatigue.

I have presented this to both my primary doctor, a general hospital consultant and a well respected Gastroenrologist at a well known UK hospital. None of the Doctors feel that all the symptoms are related to my liver, but do say that if I have a simple fatty liver it is unlikely to cause these symptoms. Non of the doctors I mentioned want to do further testing, just review me in six months time.

Being in the UK and a very rural part of the UK I am unable to get another doctor, I have no insurance so must rely on the NHS.

I am in no pain, but am possibly a pain in the a—as far as my doctors are concerned lol.

I would be very interested in peoples thoughts.

Thanks, Ian

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2 Replies:

  • Your clinical presentation suggests the diagnosis of nonalcoholic fatty liver disease (NAFLD), also known as nonalcoholic steatohepatitis (NASH). This condition in now the most common cause of elevated liver enzymes in the Unites States and Western Europe. Liver enzyme elevation is not especially useful in diagnosis, but ultrasound, CT, or MRI of the liver usually shows the fatty liver. The definitive diagnosis is made by liver biopsy. In the interest of brevity I shall not discuss this in detail, but will provide a link to more information about this condition. http://www.uptodate.com/patients/content/topic.do?topicKey=~FXYFR93Lol53pY Hope this helps.
    m3dh31p 69 Replies Flag this Response
  • Your clinical presentation suggests the diagnosis of nonalcoholic fatty liver disease (NAFLD), also known as nonalcoholic steatohepatitis (NASH). This condition in now the most common cause of elevated liver enzymes in the Unites States and Western Europe. Liver enzyme elevation is not especially useful in diagnosis, but ultrasound, CT, or MRI of the liver usually shows the fatty liver. The definitive diagnosis is made by liver biopsy. In the interest of brevity I shall not discuss this in detail, but will provide a link to more information about this condition. http://www.uptodate.com/patients/content/topic.do?topicKey=~FXYFR93Lol53pY Hope this helps.Many thanks, that was very helpful,Kind Regards,Ian
    Anonymous 42789 Replies Flag this Response
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