Elevated Liver tests

[Pennychild]

I am a 30 year old female, relatively healthy (aside from some autoimmune problems).  I am taking coumadin (for an autoimmune blood clotting disorder), glucophage, and singulair.  I recently had a physical and had some "blips" in my blood work.  here are the blips with normal ranges in ().  I am concerned about these numbers, especially the liver function tests.  I have a call in to my dr, but she can't see me this week.  The nurse who did the blood work suggested that it is mono.  is this possible?  Or could the liver abnormalities be from any of the drugs I am taking?  or are the abnormalities likely to something more serious?  Any information would be greatly appreciated.

Cholesterol, total: low 112 mg/dL (125-200)
Bilirubin, total: High 2.6 mg/dL (0.2-1.2)
Bilirubin, direct: High 0.5 mg/dL (<=0.2)
LD: high 218 U/L (100-200)
WBC: High 12.7 thous/mcL (3.8-10.8)
MPV: High 12.6 fL (7.5-11.5)
Neutrophils, absolute: High 9360 cells/mcL (1500-7800)
Carbon dioxide: Low 18 mmol/L (22-33)

[joekjr5]

A related discussion, chest pain was started.

[Pennychild]

I apologize, I should have reported the other liver enzyme numbers as well.  With the exception of bilirubin and LDH reported above, they were all normal.

Bilirubin, total: High 2.6 mg/dL (0.2-1.2)
Bilirubin, direct: High 0.5 mg/dL (<= 0.2)
Alkaline phosphatase: 55 U/L (33-115)
GGT: 13 U/L (3-40)
AST: 18 U/L (10-30)
ALT: 15 U/L (6-40)
LD: High 218 U/L (100-200)
Lymphocytes, absolute: 2096 cells/mcl (850-3900)

[Kevin Pho, MD]

Mono is possible.  The lymphocyte count should be obtained, as well as a Monospot or EBV blood test for further confirmation.

The bilirubin is elevated, which can be due to a blockage in the biliary tree.  

I would obtain the other liver enzymes, as well as a liver ultrasound.

If the bilirubin is elevated, and the other enzymes normal, you can consider GIlbert's Syndrome, which is a benign cause of bilirubin elevation.

These questions should 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 patients education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
www.kevinmd.com