Elevated enzyme levels

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ms.santos1216
New Member


Date Joined Feb 2010
Total Posts : 3
   Posted 2/14/2010 12:14 AM (GMT -7)   
Hello, everyone! I'm new here... I'm probably freaking out over nothing, so forgive me for the long post.
 
I went to the ER a few days ago due to a stomach virus that left me extremely dehydrated. I work in this emergency room, and I knew I needed fluids! The doc came in to talk to me about elevated liver enzyme levels. He could see my lab work for the past year, and noticed my enzymes were high in April of '09. I explained that I had my gallbladder removed about 2 days before those labs were run... he said it was normal for my liver to be "freaking out" after having the gall bladder removed. So, no biggie (My AST was 98, and my ALT was 337). Then, in January '10 (last month) I was hospitalized for sciatic nerve pain contol. My liver enzymes were normal then.
 
The doctor then told me that my values for the labs they ran in the ER were-- ALT: 549, AST: 186, bilirubin: 2.1, and I can't remember my ALP... don't have the paper with me, but I know it was elevated as well. He asked if I had been drinking in the past few days, taking medicine, etc. I told him that I don't drink (maybe a couple of glasses of wine per year) and that the last time I took pain reliever was about 4 or 5 days ago... one vicodin for sciatica. When I followed up with my family doctor, he said I would had to have ingested 30 tylenol for my enzymes to be that high. He wrote an order for a CBC, and a hepatitis panel. I will be able to look at the CBC results tomorrow when I go into work. The hep panel had to be sent off, so I won't know those results until next week.
 
I am a 28 year old female. I am overweight, but I am generally healthy and have no history of liver issues-- asside from the enzyme elevation I experienced after my cholecystectomy. I don't drink or use drugs, and I have not been sexually active for the past 3 years. My husband is in Honduras waiting for a visa. I know I didn't have hepatitis when I delivered my child 3 years ago. I have been vaccinated for Hep B. I am in nursing school, studying to become an RN. I am guessing that I may have some autoimmune hepatitis or PBC. Hopefully, this is just a fluke, and NOTHING is wrong with me!
 
I know I have seen people here talking about levels in the 1000's and even in the 3000's. Am I flipping out over nothing?? I think I'm googling myself silly over this...

hep93
Elite Member


Date Joined Jul 2005
Total Posts : 12014
   Posted 2/14/2010 12:03 PM (GMT -7)   

Hello, ms.santos, and welcome.  My first thought, with you working in an ER and being in nursing school, is that you might have gotten a needle stick somewhere along the way with someone who was infected with hep C.  Also, I was diagnosed with hep C in '93 and have had liver cancer, and my AST and ALT have never been anywhere near that high and currently are actually normal, although I still have chronic active hep C.  In my case, labs are not an indication of my status and, in fact, were at first ignored when they were slightly elevated. 

Anyone can have an elevation from time to time, but it's when the LFTs are continuously elevated that it raises a red flag.

There is really nothing to know for sure until you get the results of your hepatitis and other results.  As you mentioned, it could also be an autoimmune disorder or PBC.

Try not to worry, but do let us know when you get your results.

Good luck!

Connie



hep93
Forum moderator - Hepatitis
 
"But that was yesterday, and I was a different person then."
Lewis Carroll, Alice in Wonderland


ms.santos1216
New Member


Date Joined Feb 2010
Total Posts : 3
   Posted 2/14/2010 10:46 PM (GMT -7)   
Thanks for the reply and the encouragement, hep93! WOW... you're a fighter. Congrats on beating liver cancer and being such a support to everyone on this forum.
 
I'm a clerk/dispatcher in the er, so I'm not really around the needles... I haven't gotten to administer shots or start IV's in school yet, either. I'd say it's possible-- I mean, I won't completely discount that theory-- but I'd say the chances of having been stuck are pretty slim in my case. 
 
Here are the enzyme levels from Friday: ALT- 353; AST- 84; ALP- 167; bili- 0.5. Looks like they all went down quite a bit, but are far from being in normal range. The bilirubin is close, I think. I'm floored at how much they went down within 72 hours... perhaps my liver wasn't happy with my stomach virus??
 
Can you remind me what an LFT is? Is that something I'll find out when I get the hepatitis profile results? I have a appointment with my doctor later this week to go over the results of the lab work that was sent off. I found out today that I have a friend at work who is battling autoimmune hepatitis, so it's wonderful to know that we'll have each other for support if I learn that I do have some type of liver disease.
 
I will definitely let you know how my appointment goes!

hep93
Elite Member


Date Joined Jul 2005
Total Posts : 12014
   Posted 2/15/2010 12:22 PM (GMT -7)   

LFT is shorthand for liver function tests.  Those are the tests you've already had (ALT, AST, etc.)  It's good news that your values have decreased.

All you can really do is wait for the hepatitis test results.  There are also a number of people here with AIH and a couple with PBC, in case it turns out you have one of those.

You will be in my thoughts.

Hugs,

Connie


hep93
Forum moderator - Hepatitis
 
"But that was yesterday, and I was a different person then."
Lewis Carroll, Alice in Wonderland


ailsa
Regular Member


Date Joined Nov 2009
Total Posts : 35
   Posted 2/16/2010 7:58 PM (GMT -7)   
ms. Santos, I had gallbladder surgery in june 2007, and my LFT's became elevated shortly after. A Dr. explained this is seen after general anesthesia. I had never heard this, and I'm an ER nourse. Oct. 2007-Dx. w/ AIH-Auto immune hepatitis. I was a drinker, and though this didn't cause the AIH, my liver damage was accelerated by alcohol. My advise is to see a hepatologist. Good luck.

DGinSD
Forum Moderator


Date Joined Apr 2007
Total Posts : 839
   Posted 2/17/2010 11:42 AM (GMT -7)   

ms.santos,

Don't get too alarmed just yet.  The stomach virus could have something to do with it.  You'll need to get all your results in.  Have you been on any antibiotics lately?  Do you take any herbal supplements?  A hepatologist will ask you about that.  Those were the first things they asked me when they were trying to solve my elevated LFT's.  I have AIH (autoimmune hep).  You mentioned you were overweight.  Fatty liver disease can also be the cause of the elevation.  Your bili is fine, the normal is usually 0-1.  There are several viruses that can cause increases in LFT's too...like CMV (cytomegalovirus) and EBV (Epstein-Barr).  There are blood tests for those as well.  They are quite common viruses and usually only cause flu-like symptoms but they can get out of control and cause more trouble.

Definitely get a referral to a hepatologist.  Primary care physicians know the basics but you'll want someone with a specialty.  Even GI docs have better understanding but not as much as a hepatologist...their focus is the liver.

Keep us posted!


Dany
 
Diagnosed with AIH January 2007,
CMV (cytomegalovirus) June 2008
Raynaud's February 2010
meds: Azathioprine 100mg, Ursodiol 250mg BID
 
 


ms.santos1216
New Member


Date Joined Feb 2010
Total Posts : 3
   Posted 2/18/2010 2:01 PM (GMT -7)   
OK... the results are in. The lab test showed that everything was non-reactive for Hep A, B, and C. I am SOOOO relieved-- but at the same time, I'm still questioning why my enzymes are so high.

Thanks for the info, everyone! I think I will have another test run next week to see if the enzymes are still elevated. If they are not, I'd say there's a pretty high chance that the virus caused my enzymes to go nuts.

As fat as the fatty liver, I know for sure that in April (less than a year ago) they checked my liver out when they removed my gallbladder. The surgeon said everything looked great! The doctor who did the cholecystectomy is a co-worker, so I trust his word. Is it possible for a liver to have become fatty within a 9 month time period?

DGinSD- the ER doc, and my family doc both asked about herbal supplements and daily medications-- of which I take none. I tested negative for mononucleosis & EBV... they did not test me for CMV. If my enzymes are still high next week, I will definitely see if I can find a hepatologist who accepts my insurance.

hep93
Elite Member


Date Joined Jul 2005
Total Posts : 12014
   Posted 2/18/2010 5:37 PM (GMT -7)   

Ms. Santos, that's a relief that you didn't test positive for hepatitis of any kind!!  Here's hoping it was just the virus that elevated your enzymes and that you will have normal results next time!

Please keep us updated.

Hugs,

Connie


hep93
Forum moderator - Hepatitis
 
"But that was yesterday, and I was a different person then."
Lewis Carroll, Alice in Wonderland

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