High Liver Enzymes in 2 Month Old Infants

My husband & I are planning to adopt two girls from Vietnam and recently received a referral for twin girls that included their blood test results.  They are 2 months old.  The results indicate that they are negative for HIV, Hepatitis (the test may have only been for Hepatitis B, but we're not sure) and Syphilis.  And their thyroid tests are within normal levels.  However, their GOT and GPT is elevated--quite a bit for one of the babies.  N's GOT is 37.9 and her GPT is 59.8.  D's GOT is 116 and her 137.  The form says that normal levels for women should be under 33 and 32 respectively.  They were about 4 pounds at birth and are now 7.5 pounds.  We do not have and will be unable to get any further family history.  Is there cause for concern?  Is it likely that they have liver damage?  If there are major medical issues, we will have to decline the referral as we are not financially or emotionally prepared to handle any major health problems.

Thank you very much for any information you can provide.

[Forum-M.D.-DT]

Thank you for your question and for visiting the Family Practice Forum.

I would agree the liver enzymes appear to be elevated.

GOT and GPT are also referred to as AST and ALT.

Transaminases (ALT/AST)
Transaminase levels are performed to determine if a patient has inflammation of the liver, which may incdicate liver damage. An enzyme called serum glutamate pyruvate transaminase is normally found in high concentrations within the liver. If the liver is injured, high levels of the enzyme alanine transaminase (ALT) are released into the blood. Abnormal test results may indicate inflammation of the liver (hepatitis) which can be caused by any of a number of conditions.

Another transaminase test, the AST level, looks for elevated levels of aspartate aminotransferase (AST) in the blood. AST is in high concentrations within liver cells, the heart, skeletal muscle cells, and other tissues. An elevated AST is used to diagnose and monitor liver disease (in combination with ALT and other enzymes). It can also be seen with hepatitis.

My advice to you is to have the babies tested for Hepatitis A, B and C and possibly have a liver (abdominal) ultrasound to help to determine if there is any underlying abnormality of the liver. These elevations may be due to previous neonatal jaundice or possibly a blood cell abnormality. If there is no evidence of hepatitis, blood cell abnormality (which can be determined by doing a blood test known as a "CBC" (complete blood count), and the ultrasound is normal, in all liklihood there is no serious underlying physiologic abnormality. These transaminases should be monitored however every few months to make sure they return to normal.

Please let me know if I can be of further assistance with this matter. I wish you well.

Dean M. Tomasello, M.D.

[twins dad]

Hi..we recently adopted 11 month old twin girls from a former soviet union country.  They were severly malnourished and when we returned, their liver enzymes were very elevated.  They were tested positive for Hep C.  We recently had a liver biopsy and there is some scarring.  Because they are malnourished, we just do not know if that affected it.  We are going to do a blood test every 3 months for until they are two (October 2002) and see about doing some sort of treatment.  There could be a correclation between the two.

They are thriving both physically and developmentally and would not turn them in for the world!!!

Good luck to you.

Jack