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Liver fibrosis is a serious health job associate with meaning morbidity and mortality .
What is Stage 4 Fibrosis of the Liver?
It is the final common route in the phylogeny of multiple liver pathology , whose last stage is cirrhosis of the liver . Fibrosis pass as a result of an exaggerated reception of the liver to inveterate aggressions that , regardless of their origin , get tissue damage . These alterations in the hepatic architecture resolution , ultimately , in a functional deterioration .
The main disease that cause hepatic fibrosis are hepatitis C and excessive alcohol consumption , but many others complete the list of potential etiologies .
The speed of advance of fibrosis has a wide interpersonal variableness . broker such as age over 50 age , male person sex , or high alcoholic beverage consumption have been related to the development of liver fibrosis . At present , there would be therapeutical agents that could cease the exploitation of hepatic fibrosis , although the declaration of the experimental condition involves eliminating the underlie etiology . Treatments with interferon , venesection or corticoid , depending on the etiology of fibrosis , have been show to be potentially effective .
Detecting the comportment of liver fibrosis , quantify its magnitude and verify its forward motion is essential for the appropriate decision make related to clinical management allot to the prognosis , survival and treatment of patients with chronic liver disease . Determining the good clock time to start treatment , which the patients will benefit or assess the reception to it , are important for the prognosis of these patients .
Currently , liver biopsy is the diagnostic proficiency of choice to ascertain the liver fibrosis stage , considering it as the reference study for the diagnosis of liver fibrosis . Liver biopsy is normally execute percutaneously with ultrasound follow - up .
In patients with ascites or coagulopathies due to alcoholic liver disease , the risk of complication concern to post - puncture hemorrhage is more frequent . The transjugular biopsy would be the alternative path to contract the jeopardy of them .
As a reference test , it has some disadvantage such as its invasive lineament , inter and intraobserver variability , even acceptance by the patient role , high price , potential severe complications , and death . The size of it of the biopsy sample roll between 1 and 4 cm in length and between 1.2 and 2 mm of diameter . The histopathological analysis of the biopsy reports on liver fibrosis , necroinflammatory body process , the degree of hepatic steatosis and on the etiology of the liver disorder .
There are several histopathological scales to measure the degree of liver fibrosis by biopsy . The most commonly used is METAVIR , which mensurate fibrosis on a musical scale of 0 to 4 .
Fibrosis/Stage:
Stage 0 = absence seizure of fibrosis
leg 1 = Portal fibrosis without septum
phase 2 = Portal fibrosis with some septa
degree 3 = legion septa without cirrhosis of the liver
point 4 = Cirrhosis
meaning fibrosis is consider when the microscope stage of fibrosis is equal to or greater than S2 and advanced fibrosis , when a fibrosis level equal to or greater than S3 is report . The signal detection of affected role in stage S2 or higher entails important clinical implication since in most cases , the threshold for initiating treatment is considered .
Due to the characteristic and limitation antecedently account on biopsy , non - invasive testing ground and imagery techniques have been developed as potential alternative methods for the diagnosing of hepatic fibrosis .
In late years , the interest in identifying and describing hepatic fibrosis through the utilization of non - incursive marking has been increase .
The fibrosis can be determined in two non - invasive way ; one of them is based on a biological approach , by quantifying markers in serum and the second in a forcible glide slope , measuring the rigidness of the liver . Both are complementary and although there is no idealistic marker for fibrosis , molecule have been key that can be useful even when combined .
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