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Gastroenterology (Expert Forum)
Nail abnormalities
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD
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.
Nail abnormalities
by ALybella, Jul 13, 2006 12:00AM
I am a 27 year old healthy female.
While pregnant 2 years ago, I was not getting sufficient food intake and not taking my vitamins. At around 5 months into the pregnancy, my nails began to grow out a complete opaque white from the root, (they did not turn white, and they grew out white). I began taking my vitamins, and the nails slowly grew back normally. At the time no renal or liver abnormalities on blood work, Dr. said it was nothing to worry about. Problem resolved. About six months later after chronic severe stress, I began to have some white lines grow again, not uniformed on several nails. Some nails just had minor spots other had lines that were not even and did not follow the lunula, had renal and liver panel all normal. This happens now about twice a year, always following a traumatic experience for some reason, for example my moms near overdose. My concern is that I always read online that this could be a liver problem. My Doc just performed a physical, said no liver enlargement, he said the liver felt very good., no organ enlargement My LFT are as follows
total protein:7.3
Albumin: 3.8
Globulin: 3.5
ALT: 15
AST: 20
Ratio: 1.3
Alk Phosp: 45
Bill total: 0.5
All CBC within normal range, Platelets 285, WBC 8.0
All within limits.
PT: normal
PTT: normal
No loss of appetite
Normal stools
Normal abdominal CT Scan
Only slight pressure on right side of flank by belly botton, Dr. said it’s too low to be liver associates
Doctors don't seem to care about these nail changes. I do suffer from Seborrhea Dermatitis, but no other skin disease, also some diagnosed eczema on back. I'm real concerned about this being a liver problem, even though all panels for the last 2 years (almost 6) have shown up completely normal at an optimal level. Could this be caused by stress or something less serious?
Ex: The lines grow out, they are not identical, some follow the proximal fold but not all the length around, usually like a crescent shape. Not all fingers, almost always ring and pointer on left hand involvement. I read that Terry’s nails and Muerckes lines are associated with liver disease, can these abnormalities be liver disease aswell, despite normal LFT’s, CT Scan and physical examination.
While pregnant 2 years ago, I was not getting sufficient food intake and not taking my vitamins. At around 5 months into the pregnancy, my nails began to grow out a complete opaque white from the root, (they did not turn white, and they grew out white). I began taking my vitamins, and the nails slowly grew back normally. At the time no renal or liver abnormalities on blood work, Dr. said it was nothing to worry about. Problem resolved. About six months later after chronic severe stress, I began to have some white lines grow again, not uniformed on several nails. Some nails just had minor spots other had lines that were not even and did not follow the lunula, had renal and liver panel all normal. This happens now about twice a year, always following a traumatic experience for some reason, for example my moms near overdose. My concern is that I always read online that this could be a liver problem. My Doc just performed a physical, said no liver enlargement, he said the liver felt very good., no organ enlargement My LFT are as follows
total protein:7.3
Albumin: 3.8
Globulin: 3.5
ALT: 15
AST: 20
Ratio: 1.3
Alk Phosp: 45
Bill total: 0.5
All CBC within normal range, Platelets 285, WBC 8.0
All within limits.
PT: normal
PTT: normal
No loss of appetite
Normal stools
Normal abdominal CT Scan
Only slight pressure on right side of flank by belly botton, Dr. said it’s too low to be liver associates
Doctors don't seem to care about these nail changes. I do suffer from Seborrhea Dermatitis, but no other skin disease, also some diagnosed eczema on back. I'm real concerned about this being a liver problem, even though all panels for the last 2 years (almost 6) have shown up completely normal at an optimal level. Could this be caused by stress or something less serious?
Ex: The lines grow out, they are not identical, some follow the proximal fold but not all the length around, usually like a crescent shape. Not all fingers, almost always ring and pointer on left hand involvement. I read that Terry’s nails and Muerckes lines are associated with liver disease, can these abnormalities be liver disease aswell, despite normal LFT’s, CT Scan and physical examination.
Doctor's Answer
by Kevin Pho, MD, Jul 14, 2006 12:00AM
, Jul 14, 2006 12:00AM
Nail changes can be indicative of liver problems. However, with normal LFTs, this would be less likely. Imaging the liver with an ultrasound can provide further evaluation, but I probably won't go much further than that.
If the nail changes continue, a referral to a dermatologist can be considered for further evaluation. Sending part of the nail off for culture can be considered to evaluate for fungus.
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_
If the nail changes continue, a referral to a dermatologist can be considered for further evaluation. Sending part of the nail off for culture can be considered to evaluate for fungus.
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_
come up on a Ct scan.
Lung disease
Heart disease
Kidney disease
Liver disease
Thyroid disease.