Liver complications with Chantel

Last week was one of waiting. We waited for test results... we waited for appointments to be setup... and we waited for a couple of our Dr.'s to come back this coming week to review next steps.

The abdominal ultrasound showed issues with Chantel's liver. Dr. Savage sent Chantel to see a Gastro-Intestinal (GI) Specialist (Dr. Yoshida) last week (Monday February 13th). Her case was briefly reviewed by Dr. Yoshida who requested more blood work and explained that it is likely that the mass that was discovered on her liver was not likely related to the lymphoma.

Dr. Yoshida then presented Chantel's case to a GI Conference where it was reviewed by Brian's Dad (Brian Scudamore is my boss at 1-800-GOT-JUNK? and his father is a liver transplant surgeon) among other GI specialists. Dr. Scudamore has taken over the as the GI specialist on the case. His office is now scheduling a MRI on her liver to get more info in conjunction with the bloodwork. We are expecting it to be schedule for the week of February 20th.

We are currently speculating on what the liver issue is (until we get the results from the MRI and bloodwork)? It appears that it could be Acute Fatty Liver of the Pregnancy or cholestasis . In fact, it may be a blessing that Chantel was diagnosed with Hodgkins as the tests for it have shown the liver issue and hopefully we will move quickly on this to solve it.

Here is more info on the Fatty Liver issue:

AFLP is "acute fatty liver of late pregnancy" a syndrome in which the clinical presentation is malaise, nausea, vomiting, abdominal pain in the 3rd trimester, elevated aminotransferases (AST, ALT), ultrasound findings, and the exclusion of viral or toxic hepatitis or biliary tract disease. It is considered a life-threatening condition, with an 18 percent maternal and a 23 percent fetal mortality rate. Note: Chantel is fortunate that if this is the diagnosis - we have caught it very early and reduces these odds radically.

Symptoms associated with acute fatty liver of pregnancy include anorexia, nausea, emesis, abdominal pain, jaundice, headache and central nervous system disturbances. Hepatic histopathology reveals pericentral microvesicular fat with minimal inflammation or necrosis. The laboratory abnormalities in acute fatty liver of pregnancy include moderate elevations of transaminase levels (AST and ALT less than 1,000 IU per L), prolongation of prothrombin time and partial thromboplastin time, decreased fibrinogen, renal failure, profound hypoglycemia and bilirubin levels of 1 - 10 mg per dL (17 - 17 µmol per L).

http://www.marchofdimes.com/professionals/14332_14543.asp

http://www.medterms.com/script/main/art.asp?articlekey=9404

http://www.aafp.org/afp/990215ap/829.html

More info on Cholestasis in Pregnancy:

Some women experience a very severe itching in late pregnancy. The most common cause of this is Cholestasis; a common liver disease that only happens in pregnancy. Cholestasis of pregnancy is a condition in which the normal flow of bile in the gallbladder is affected by the high amounts of pregnancy hormones. Cholestasis is more common in the last trimester of pregnancy when hormones are at their peak, but usually goes away within a few days after delivery

Pregnancy hormones affect gallbladder function, resulting in slowing or stopping of the flow of bile. The gallbladder holds bile that is produced in the liver, which is necessary in the breakdown of fats in digestion. When the bile flow is stopped or slowed down, this causes a build up of bile acids in the liver which can spill into the bloodstream.

Symptoms include:

Itching, particulary on the hands and feet (often is the only symptom noticed)
Dark urine color
Light coloring of bowel movements
Fatigue or exhaustion
Loss of appetite
Depression

http://www.babycentre.co.uk/refcap/552042.html

http://www.itchymoms.com/