does fatty liver or nash cause hives?

It is a few months that my skin (especially some parts in arms or legs) sometimes 5-6 times in a day turn red and then starts to itch for a short while and then the redness and itching disappears.

does fatty liver or nash cause hives?

DGinSD, i think i have raynaud also. is there any connection between liver diseases and raynaud?

I agree with the miz, you should speak to your doc.  Are you seeing a hepatologist or just your primary?

I have an autoimmune disease and it isn't uncommon to have Raynaud's along with that.  So I don't think it's a liver thing, necessarily.  I know a few people who have Raynaud-like symptoms but haven't spoke to a doc about them and don't have any other conditions.  So it can occur on its own.

How long ago since you were diagnosed?  Have you changed your diet?

DGinSD, why did you ask "Have you changed your diet"? Any connection of diet for raynaud?
yes, i have changed and i am almost not eating things with sugar and fat.

We are not medical professionals, just-man. If you think it is liver or Raynauds, or really serious...please do see your doctor. Itching can be many things, including a mild allergy to soap or sizing in clothing. A derm may be your best specialist.

no smoking. 1 month ago i had chest and left arm pain and heart murmur but now it is okay. i went to cardiologist and he said things are okay except i have a little bit high heart beating.

I agree with the others. It could be from so many things. I asked about diet as I was leaning towards an allergy causing the itchies. So many things can cause it and it may never be sorted out. Moisturizer is probably your best defense. Bring it up to your doc. They do have meds for itching if it's that bad and moisturizer doesn't help. Maybe change your soap?

Wonderful! There you go, from the expert, so now you can focus on other possible causes other than your liver.

He's right in that the cholestatic forms of liver diseases, PBC and PSC (my favorite!), do cause the greatest amount of itching discomfort in it's patients. They can even award exception points towards your MELD score due to this "quality of life issue".

Chronic hepatitis can cause lesser amounts of cholestasis as the inflammation increased towards the more acute forms. This causes hepatomegaly and can impede the bile flow through various intrahepatic, constrictive pressures. But this tends not to cause the kind of itching seen in PBC or PSC patients. I've learned to try and ignore it most of the times myself as we all learn as kids - scratching doesn't really help, it just makes it worse.

I am not sure if that professor is right because I have seen many opposing ideas that liver disease cause itching.

My liver enzyme history is as follows (I do not drink alcohol):

November 07, 2012: 74 kg and height 162 cm (BMI=28.2).
FIRST TEST (November 07, 2012):
bilirubine direct: 0.5 mg/dL (range: 0.-0.3]
bilrubine total: 0.7 mg/dl (range: 0.2-1.3)
ast: 97 U/L (range: 17-59)
alt: 186 U/L (range: 21-72)
alp: 92 U/L (range: 38-126)
ggt: 81 U/L (range: 15-73)
ldh: 641 U/L (range: 313-618),
After doing exercise and sports, I had the following tests with regular periods

SECOND TEST (December 03, 2012)):
bilirubine direct: 0.43 mg/dL (range: 0.-0.3]
bilrubine total: 1.1 mg/dl (range: 0.2-1.3)
ast: 61 U/L (range: 17-59)
alt: 115 U/L (range: 21-72)
alp: 85 U/L (range: 38-126)
ggt: 45 U/L (range: 15-73)
ldh: 512 U/L (range: 313-618),


THIRD TEST (January 30, 2013)):
bilirubine direct: 0.24 mg/dL (range: 0.-0.3]
bilrubine total: 0.7 mg/dl (range: 0.2-1.3)
ast: 34 U/L (range: 17-59)
alt: 53 U/L (range: 21-72)
alp: 81 U/L (range: 38-126)
ggt: 28 U/L (range: 15-73)
ldh: 480 U/L (range: 313-618),

After third test, the pain in my right quadrant was still existing and I asked my doctor to do a CT scan for right hand side organs on February 03, 2013 and it was
totally normal for all organs, I had gas, bloating, mucous in the stool problems (symptoms of irritable bowel syndrome=IBS) and my doctor told me that
the pain is not related to liver and possible from IBS.

FOURTH TEST (April 22, 2013)):
bilirubine direct: 0.26 mg/dL (range: 0.-0.3]
bilrubine total: 0.8 mg/dl (range: 0.2-1.3)
ast: 28 U/L (range: 17-59)
alt: 44 U/L (range: 21-72)
alp: 81 U/L (range: 38-126)
ggt: 28 U/L (range: 15-73)


FIFTH TEST (January 07, 2014)):
ast: 50 U/L
alt: 101 U/L
alp: 71 U/L
triglyceriden: 45 mg/dL (range: 70-170)
cholestrol: 204 mg./dL ( range: 0-190).
hdl cholesterol: 58 mg/dL (range: 35-55)
ldl cholesterol: 137 mg/dL (range: 0- 115)
Note: before FIFTH TEST, i consumed a lot of tuna fish can to improve my b12 deficiency. Since tuna fish involves mercury which is toxix, maybe it caused liver enzymes again. I am not sure!

Then, again I did a strict exercise and diet program and after 2 months (my weight was 66 kg):


SIXTH TEST (March 14, 2014)):
bilirubine direct: 0.2 mg/dL
bilrubine total: 0.74 mg/dl
ast: 33 U/L
alt: 37 U/L
alp: 71 U/L

SEVENTH TEST (May 22, 2014)
ast: 32 U/L
alt: 27 U/L
alp: 82 U/L

jm -

Was the doctor you refer to here, for the CT, your hepatologist or just your pcp? Also, I can only see your recent past in the previous notes. Has your liver been previously diagnosed with NASH or fatty liver before, and if so how, MRI imaging or biopsy?

It's clear from your serum data that you were suffering from mildly impeded bile flow. While your total bilirubin is normal, your direct bilirubin is high. In particular, the ratio (a far more sensitive marker or indicator) of the direct to the total is quite clearly high with a slow and gradual decline: 0.71 (nov2012), 0.39, 0.34, 0.33, 0.27 (mar2014). The ratio should always be less than 0.2 so you can see that you slowly drifted down to nearly the normal range now.

This is the reason I ask about your liver diagnosis - a simple fatty liver wouldn't be a factor at all here (wrt elevated direct/total ratio) but is something that you can and did improve wrt lower liver enzymes, ast & alt, through your diet/exercise, good job btw! However, if you did have NASH, this may have caused your mildly impeded bile flow. NASH can cause hepatomegaly and this swelling of the liver would compressively reduce the bile flow. And your diet/exercise would also be able to reduce the NASH as well but I'm amazed that it happened so quickly.

If the bile flow was impeded enough, you may have been able to feel some RUQ vague pain or dull ache. That's what I typically feel - nothing sharp or pronounced - just a dull, vague ache in my RUQ. And my bile flow is constantly impeded, which affects my digestive process - maybe in your case as well at one point or maybe simply was IBS?

Wow, very detailed answer, bbibt!

For research on pruritus in liver disease, the best person I know is Nora Bergasa MD in Brooklyn. I cut and pasted this from a PBCers forum.

>>Answer
I referred this question to my colleague Dr. Nora V. Bergasa. Dr. Bergasa is one of the world's leading experts on prutitus (itching) of cholestasis. Dr. Bergasa replied: there are no studies that have specifically compared the perception of itch with the degree of liver injury, as assessed by liver biopsy. The itch of liver disease does not tend to correlate with the values of liver enzymes reported in laboratory results, and it does not correlate with bilirubin levels. >>

I don't know how old this info is, but the bottom line when I knew her was that Dr. Bergasa found no scientifically proven reason for the itch. Now - it is clear that people do have the itch, but unless there is new research that I am unaware of, the evidence is not there to definitively know the cause of the itch.

Pruritus Susan
who does not wear wool - too itchy!

dear all, first og all thank you very much for your valuable comments. based on my medical history and the test results, what do you think about my situation? is my liver getting better or worse?