Liver Panel and Low Lymph #

I just got a copy of my lab work and would like some direction on the results. I follow up with my doctor in 3 days and he has always been a little too easygoing in my opinion. This is my second high liver panel. I recently had a high temp (from 100-102.5) for 7 days with a rash and very painful legs and arms. I am in normal health ( I thought), 30 year old female and do not drink alchohol. I would like your imput and ideas where to go from here. I am only putting in the very high or low values. If not listed, they were within normal range.
Bun/Creat Ratio 10.0 Low
A/G Ratio .9 Low
Total Bili 1.9 Range is .2-1.0  High
Alk Phos 263 Range is 42-121 Very High
Ast (SGOT) 102 Range is 10-42 Very High
Alt (SGPT) 153 Range is 10-60 Very High
RDW 15.2 Range is 11-15  High
Lymph # .80 Range is 1-4.8 Low
to note, Lymph % was 16.8 and range is 10-50.

thanks

[Kevin Pho, MD]

The liver tests are moderately elevated.  There are a variety of causes including alcohol, medication, fatty liver, etc.  The lymphcytes have a normal percentage - this can be repeated if there continues to be concern.

I would further evaluate the liver.  An ultrasound and blood tests for hepatitis are the next steps.  You should abstain from alcohol, and repeat the tests within a reasonable period of time.  

If the enzymes continue to rise, a liver biopsy can be considered for a more definitive evaluation.

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_b

[shrubie]

forgot to mention I am over 50 lbs overweight.

[Kalio1]

You are right to be concerned. See a heptologist ( liver specialist)if you don't feel your doc is taking this seriously enough so you can get a diagnosis, better safe then sorry. You are high is quite a few areas so it's might be worth another opinion.
I am no doc  but two things come to mind, fatty liver ( try googling it) and have you been screened for Hep C? It is a simple blood test. There are large numbers of people with Hep C who are not drug users and have no known risk factors for contracting it yet have it.
Are you taking any medications? There are lots of things this could be, but it is something to get to the bottom of and not ignore.
Good luck to you and keep in mind that YOU are in charge of your medical care, your doc is your advisor but you are the one that has to live with the consequences, be pro active.

[shrubie]

Thank you, Dr.Kevin, for the answer. I mentioned before that I do not drink alchohol. I drank when I was younger but have not had a sip in over 6 years.  I am also a blood donor and would think that if I had Hep of any form, it would show up there.

[shrubie]

Thank you very much for commenting. I noted above that I am a blood donor, I would really think (hope) that if I had Hep it would show up there and they would not continue wanting my blood, or notify me. My first high panel was about 5 years ago, I was retested and the Dr. said the first test was an error. I now, of course, will request a copy of both lab results. I do not take any meds except occasional OTC headache relief of various types (excedrin or tylenol) and OTC sinus ie, claritin D.
Thank you for reminding me that I am in control of my medical care, depending on how this goes and how the Dr. responds I will not hesitate to fire him as my physician and find a new one.

[Kalio1]

Don't be reassured because you donated blood, they woudn't necessarily have notified you. I know, it is hard to believe, but it is true. Hep test is simple and easy and worth ruling out. If they have been elevated in the past, all the more reason to follow up. Fatty liver can be controled by diet, so you can do some research and adhere to the diet plans to work towards improving the situation. Are you dealing with depression too? All those symptoms probaby contibute to the weigh gain and I know depression can contribute to weight gain too, and weight gain is connected to fatty liver. Try not to worry too much until you have some definitive answers. Health issues are a struggle to deal with, you hang in there.