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Gastroenterology (Expert Forum)
Extremely high liver enzymes - no cause yet
Answered by
Kevin Pho, MD - Internal Medicine
Kevin, M.D.
Boston - MA
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/ Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
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Extremely high liver enzymes - no cause yet
by DEBMOM, Oct 13, 2006 12:00AM
Brief background: I am a 36 y.o. female, 2 vaginal births, no significant med history. the only history is mono at 17, and a TIA related to L&D. no further problems.
I was admitted to the hospital on 10/4 with jaundice. I work as a nurse and was told by my colleagues that I looked really yellow. I had been feeling very, very fatigued and gernally lousy. No sore throats, fevers. I have not been exposed to anything and no needlesticks. I took Levaquin 2 months ago for a sinus infections for 5 days. I have taken it before several times. I did have some nausea (no vomitting) a few days befoer the jaundice appeared.
In the hospital, my ASt at the highest (it went up and down a couple of time but never below 1000) was 1438. ALT the same. Total bilirubin was 14.
I had an ultrasound which was unremarkable. Dopple of the biliary ducts, normal.
I have tested negative for Hep A, B(vaccinated) and C. Negative for mono spot, CMV, ANA,Anti-mitocho and Anti-smooth M.
I was released from the hospital last friday. My levels have started to drop. They are now ALT and AST 859. Bilirubin 10.
I am scared b/c I do not know what caused this. ANy ideas a suggestions. I do not want the doctors blowing this off b/c the jaundice is resolving.
Thank you
I was admitted to the hospital on 10/4 with jaundice. I work as a nurse and was told by my colleagues that I looked really yellow. I had been feeling very, very fatigued and gernally lousy. No sore throats, fevers. I have not been exposed to anything and no needlesticks. I took Levaquin 2 months ago for a sinus infections for 5 days. I have taken it before several times. I did have some nausea (no vomitting) a few days befoer the jaundice appeared.
In the hospital, my ASt at the highest (it went up and down a couple of time but never below 1000) was 1438. ALT the same. Total bilirubin was 14.
I had an ultrasound which was unremarkable. Dopple of the biliary ducts, normal.
I have tested negative for Hep A, B(vaccinated) and C. Negative for mono spot, CMV, ANA,Anti-mitocho and Anti-smooth M.
I was released from the hospital last friday. My levels have started to drop. They are now ALT and AST 859. Bilirubin 10.
I am scared b/c I do not know what caused this. ANy ideas a suggestions. I do not want the doctors blowing this off b/c the jaundice is resolving.
Thank you
Doctor's Answer
by Kevin Pho, MD, Oct 13, 2006 12:00AM
, Oct 13, 2006 12:00AM
Those are markedly high liver enzyme levels. I'm surprised a biopsy hasn't been performed already. If not, then this would be the appropriate next step to determine why they are so elevated in light of negative testing.
Further testing can be considered with an MRCP to evaluate the biliary ducts. I agree with the blood tests that were performed. I would also add a ferritin level looking for hemochromatosis.
These options can be discussed with your personal physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
kevinmd_
Further testing can be considered with an MRCP to evaluate the biliary ducts. I agree with the blood tests that were performed. I would also add a ferritin level looking for hemochromatosis.
These options can be discussed with your personal physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
kevinmd_
Member Comments
by DEBMOM, Oct 14, 2006 12:00AM
Thank you. I am scared that it is either PSC or PBC. I am going to ask for the MRCP and biopsy.
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