Dr Al drops a bombshell

Those who have followed my blog through 2010 may remember that in November I was asking for help confirming what I thought might be a diagnosis of autoimmune hepatitis. A British Liver Trust hepatologist and my GP cousin came to my aid with a yes, the phrase ’persistent florid activity’ in my first biopsy report could be suggestive of autoimmune.

In December I saw Dr S in clinic, and voiced concern over my continuing fatigue, aches, pains and occasional feverishness. I’d made notes about autoimmune and highlighted some of my blood tests. On my blog of 7th Dec I wrote "We went through my Hepatitis blood tests and he looked at the notes I’d made about autoimmune. He still feels that Hep B is the most likely cause of all the problems, including the persistent inflammation".

He ordered a second biopsy, the one I had in February. This was discussed at the medical team meeting on 9th March. I scrounged the report from the GP last Friday and it was the reason for today’s appointment with Dr Al, the new hepatologist at Salford.

He read the reports and underlined bits, so I asked him what he was underlining. He said my history, including the speedy response to steroids plus the biopsy evidence of inflammation in the liver is suggestive of autoimmune hepatitis, and that was why I was there.

That left me speechless! I’d put autoimmune to the back of my mind and had been told by O’Blimey’s secretary that the referral was for cirrhosis.

Dr Al took another bucket load of blood tests – just to be doubly, trebly sure. I’ve had about 8 vials taken today, as I’d been to the GP in the morning to have Vit D and iron levels checked. Sore arms – argh!

It’s back to see him in a month to get the results and confirm treatment.

Co-infection with autoimmune and viral hepatitis is tricky. Standard treatment for autoimmune is immunosuppressants – just the ticket for bringing those pesky little hep B cells trapped in my liver back to life . Dr Al’s method is to give me an anti-viral to keep the hep B down, at the same time giving me immunosuppressants to treat the autoimmune. For life – b**ger.

The good news is, yes there is good news, that Dr Al doesn’t think the liver damage is too bad and that treating the autoimmune will stop its progress. It’s the Hep B, he thinks, that triggered the cancer.