AST AND ALT'S TEN TIMES THE NORMAL

HI...My daughter, who is 28, was having symptoms of nausea, vomiting and loss of appetite for around a week perhaps more.  PeptoBismal helped a little.  Her symptoms subsided finally.  She saw doctor (during the symptom stage) and had blood wk. Her AST and ALT's were ten times the normal range.  Her hep screen came back negative as did her pregnancy test.  She is waiting on the results of the H-Pylori test.  What could make these tests be ten times the normal? She has 2 children eight and two and has an IUD.  Could the IUD be the cause of this ten times the normal range levels? She says the IUD doesnt bother her at all. Thank you for your quick response and keep up the good work. Sincerely, K's mom.  God bless you and fam! Luv in Christ Jesus our Lord and Savior, guitarsong4Jesus


This discussion is related to High SGOT (AST) SGPT (ALT).

[Myown]

Sorry to hear your daughter is not feeling well.

I will post an article about "Toxic Shock,",,,,,It seems there hasn't been many cases of IUD's causing TS, but it seems some may have gone unrecognized and it does mention pelvic inflammatory disease and IUD's. I don't want to scare you with this article and when we google things, not being doctors, we can and do scare ourselves at times, but just incase you think this is worth checking into, I wanted to post it for you. I hope your daughter feels better soon.


Take care,
MO

http://www.medscape.com/viewarticle/405840_4

Excerpt:

"To date, there have been two documented cases in the literature of toxic shock syndrome in patients related to IUD use.[13] Two cases exist where IUD use was concurrent with tampon use.[14] Although IUD use has not been cited as a risk factor for toxic shock syndrome, epidemiologic studies show that up to one third of cases come from an unknown focus of infection.[15] IUD use might be a more common and heretofore unrecognized cause of toxic shock syndrome. IUD use has been shown to be associated with an increased incidence of pelvic inflammatory disease most commonly seen in the first 4 months after insertion.[16] These infections are commonly polymicrobial and are consistent with the typical vaginal flora of healthy women. Some studies have reported S aureus in vaginal cultures of 5% to 20% of women,[17,18] with the highest prevalence in women using diaphragms and IUDs as contraception.[19] One study found that a small percentage (4%) of IUDs was colonized with S aureus.[20] This finding clearly illustrates that S aureus infection is possible in women with IUDs.

"IUDs cause an inflammatory response and microtrauma in the uterus that can allow bacteria or toxins to enter the systemic circulation. Microulcerations of the cervix might also serve as a portal of entry. It has been shown that tampon use leads to ulcerations of the cervix and vagina,[21] and that toxic shock syndrome can be associated with this disruption in mucosal integrity.[22] It could be argued that the strings from the IUD also form microulcerations on the cervix and vagina, which might allow bacteria and toxin to enter the circulation, leading to toxic shock syndrome and subsequent bacteremia, as seen in this patient.

An IUD as the focus of infection in this patient can be debated. S aureus bacteremia has been found to have no focus in up to one third of cases, and the initial infection by S aureus leading to toxic shock syndrome can be subclinical. This patient, on closer examination at the hospital to which she was transferred, was found to have a mild case of chronic scalp folliculitis with impetigo. Although a dermatologist dismissed this infection as clinically important, it could have served as the portal of entry for the bacteria and toxins. Her viral syndrome might have contributed as well. Influenza has been shown to act as a precursor to toxic shock syndrome in clinical studies.[23,24] One might also debate whether the diagnosis of toxic shock syndrome was accurate in this patient. It could be argued that the patient's signs and symptoms, including acute respiratory distress syndrome, disseminated intravascular coagulation, and shock, were caused by S aureus septicemia from an unknown source. Although the sequelae of adult respiratory distress syndrome, disseminated intravascular coagulation, shock, and endocarditis could be easily attributed to bacteremia, her initial symptoms, including her prodrome, are more consistent with toxic shock syndrome.

The differential diagnosis of toxic shock syndrome is broad (Table 3),[25,26] but a few features should alert the provider. Although headache, myalgias, emesis, and fever can be symptoms of an acute viral syndrome or gastroenteritis, the severity of the patient's symptoms, along with a great amount of immature leukocytosis, suggests a more serious infection......"