RE: Needing Info. about phases of PSC

[Guest guest]

ravenbird28904 wrote:

> Hey group:

>

> I believe that PSC is labeled as Phases 1-4. My coordinator told me

> today that based on my last PTC, which was in April 2007 that it showed

> that I had recurrent PSC( had transplant 12/2004) and it was in

> the " moderate phase " . My question is, what is the " moderate phase " and

> how bad would that be?

>

I don't know that " moderate phase " has a technical definition in regards

to PSC, so the best I can do is give these definitions I found for moderate:

|1. Limited in degree of activity

||2. Limited as to degree of progress

||3. Limited in scope or effects

||4. being within reasonable or average limits

||5. not extreme

Actually my doctor never would classify my PSC by the numbered stages

because he said that PSC varies so much from patient to patient that one

may sit at stage 3 for five years, while another goes all the way from

1-4 in the same five years.

|

athan

[Guest guest]

Mayo defines the stages of PSC as:

Stages of PSC

Stage 1 — Fibrosis or scar tissue limited to a few spots called portal areas, little areas of " plumbing " or ductwork in the liver tissue

Stage 2 — Fibrosis begins to appear outside the portal areas. The strands of fibrosis are not yet connected to each other.

Stage 3 — Areas of fibrosis connecting to each other

Stage 4 — Widespread, honeycomblike scarring known as cirrhosis

A MedScape article (http://www.medscape.com/viewarticle/552500_6) defines the PSC stages as:

Stage I (portal stage) -- focal inflammation limited to portal triad, with or without bile duct abnormalities, without fibrosis;

Stage II (periportal stage) -- enlargement of portal tracts, periportal fibrosis with or without periportal inflammation;

Stage III (septal stage) -- extension of septal or bridging fibrosis with bridging necrosis; and

Stage IV -- biliary cirrhosis.

A PTC would give biliary tree visualization similar to an ERCP. Without a biopsy, I don't know how you would judge fibrosis. I can only guess they're seeing biliary tract abnormalities.

You might ask the liver transplant group (http://health.groups.yahoo.com/group/Livertx-PSC/)? Definitely a question for your Dr.

Arne

57 - UC 1977 - PSC 2000

Alive and well in Minnesota

________________________________

From: [mailto: ] On Behalf Of ravenbird28904

Hey group:

I believe that PSC is labeled as Phases 1-4... My question is, what is the " moderate phase " and

how bad would that be?

[Guest guest]

athan:

I was like Barb and thought that moderate would be around 1-2 but a

few weeks ago they told that even though the liver showed no

cirrhosis, they doubted that they could do another PTC because they

had to stop during the last one in April 2007 because my bile ducts

were already so closed up, they could not get the wire (or whatever

they use) through to finish the test. I'm just thinking that it

sounds funny to have such awful bile ducts but yet labeled as being

only moderate PSC. Any thoughts??

Nikki in NC

> > Hey group:

> >

> > I believe that PSC is labeled as Phases 1-4. My coordinator told

me

> > today that based on my last PTC, which was in April 2007 that it

showed

> > that I had recurrent PSC( had transplant 12/2004) and it was in

> > the " moderate phase " . My question is, what is the " moderate

phase " and

> > how bad would that be?

> >

> I don't know that " moderate phase " has a technical definition in

regards

> to PSC, so the best I can do is give these definitions I found for

moderate:

>

> |1. Limited in degree of activity

>

> ||2. Limited as to degree of progress

>

> ||3. Limited in scope or effects

>

> ||4. being within reasonable or average limits

>

> ||5. not extreme

>

> Actually my doctor never would classify my PSC by the numbered

stages

> because he said that PSC varies so much from patient to patient

that one

> may sit at stage 3 for five years, while another goes all the way

from

> 1-4 in the same five years.

> |

> athan

>

[Guest guest]

Nikki,

In my humble opinion moderate sound more

like stage 2-3. Mild would be stage 1-2, severe would be 3-4, that would leave

moderate for stage 2-3.

Regards,

Chaim

From:

[mailto: ] On Behalf Of ravenbird28904

Sent: Tuesday, June 03, 2008 02:46

To:

Subject: Re: Needing

Info. about phases of PSC

athan:

I was like Barb and thought that moderate would be around 1-2 but a

few weeks ago they told that even though the liver showed no

cirrhosis, they doubted that they could do another PTC because they

had to stop during the last one in April 2007 because my bile ducts

were already so closed up, they could not get the wire (or whatever

they use) through to finish the test. I'm just thinking that it

sounds funny to have such awful bile ducts but yet labeled as being

only moderate PSC. Any thoughts??

Nikki in NC

> > Hey group:

> >

> > I believe that PSC is labeled as Phases 1-4. My coordinator told

me

> > today that based on my last PTC, which was in April 2007 that it

showed

> > that I had recurrent PSC( had transplant 12/2004) and it was in

> > the " moderate phase " . My question is, what is the

" moderate

phase " and

> > how bad would that be?

> >

> I don't know that " moderate phase " has a technical definition in

regards

> to PSC, so the best I can do is give these definitions I found for

moderate:

>

> |1. Limited in degree of activity

>

> ||2. Limited as to degree of progress

>

> ||3. Limited in scope or effects

>

> ||4. being within reasonable or average limits

>

> ||5. not extreme

>

> Actually my doctor never would classify my PSC by the numbered

stages

> because he said that PSC varies so much from patient to patient

that one

> may sit at stage 3 for five years, while another goes all the way

from

> 1-4 in

the same five years.

> |

> athan

>

[Guest guest]

The strands of fibrosis connecting to each other mentioned in stage 3 - is that what's referred to as "Bridging portal fibrosis"? would have been stage 3-4. He had bridging fibrosis, and cirrhosis.Arne wrote: Mayo defines the stages of PSC as: Stages of PSC Stage 1 — Fibrosis or scar

tissue limited to a few spots called portal areas, little areas of "plumbing" or ductwork in the liver tissue Stage 2 — Fibrosis begins to appear outside the portal areas. The strands of fibrosis are not yet connected to each other. Stage 3 — Areas of fibrosis connecting to each other Stage 4 — Widespread, honeycomblike scarring known as cirrhosis A MedScape article (http://www.medscape.com/viewarticle/552500_6) defines the PSC stages as: Stage I (portal

stage) -- focal inflammation limited to portal triad, with or without bile duct abnormalities, without fibrosis; Stage II (periportal stage) -- enlargement of portal tracts, periportal fibrosis with or without periportal inflammation; Stage III (septal stage) -- extension of septal or bridging fibrosis with bridging necrosis; and Stage IV -- biliary cirrhosis. A PTC would give biliary tree visualization similar to an ERCP. Without a biopsy, I don't know how you would judge fibrosis. I can only guess they're seeing biliary tract abnormalities. You might ask the liver transplant group (http://health.groups.yahoo.com/group/Livertx-PSC/)? Definitely a question for your Dr. Arne 57 - UC 1977 - PSC 2000 Alive and well in Minnesota ________________________________ From: [mailto: ] On Behalf Of ravenbird28904 Hey group: I believe that PSC is labeled as Phases 1-4... My question is, what is the "moderate phase" and how bad would that be? Ami - Migraines, FMSmom to - 10 yrs - Double Lung Tx 2/26/2006, PSC - Tx 7/16/2007, Diabetes, Hypothyroid, GERD, ADHD, Osteopenia http://caringbridge.org/visit/seanfoxmom to Emma - 14 yrs - Migrainesstepmom to - 15 yrs - ADHD, ODD~~~~~~~~~~~~ ~~~~~~~~~ ~~~~~~~~~ ~~~~~~~~~ ~~~~~