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Gastroenterology  (Expert Forum)
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Another Elevated ALT Post
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
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.

Another Elevated ALT Post

by dutchnl607, Nov 22, 2006 12:00AM
History-
I am a 34 year old male 6’2” 220 lbs. I am a light smoker. I have had 3 surgeries in the past 6 months. Before each surgery I had blood work done. The first surgery I had in mid June was for a hernia. I had blood work done but never saw the results. My primary doctor did mail me a letter stating that my triglycerides were a little high and I should cut down on fatty foods and exercise more. After the surgery I was on antibiotics and vicadain for one week.

From July 22-31 I was taking Fluconazole for a fungal infection. I was taking 1-100mg tablet a day for 10 straight days. My pharmacist told me to be careful taking Fluconazole because it could damage my liver.

Next Surgery was on August 16 to remove a Cholesteroltoma (growth the size of a marble) in my inner ear.  I had blood work done on August 11 and my ALT was 88 High. Everything else was in the normal range including AST at 40. After the surgery I was on antibiotics and steroids for 1 ˝ weeks. I also started taking Wellbutrin XL for about 2 weeks after the surgery.

My last surgery was Nov. 13 to reconstruct my inner ear. I had blood work done and my ALT was at 68 High. Everything else was normal.  That’s when my primary doctor called me about the abnormal results. He wants me to have blood work done again in about 1 month.
  

Questions-
1. Could the meds that I had been taking (Antibiotics, Fluconazole, Wellbutrin XL, Steroids and Vicadain) cause my ALT to be elevated?

2. Could general anesthesia and the surgeries that I have had cause my ALT to be elevated?

3. If the meds caused my ALT to rise, how long does it take my liver to heal from the meds (days, weeks, months)?

4. Is it a good sigh that my ALT has dropped from 88 to 68 over the past few months?

5. Is a slight elevation of 88 or 68 something that I should be concerned about?

Thanks,

by Kevin Pho, MD, Nov 24, 2006 12:00AM
To answer your questions:
1) It is possible for the medications to cause an elevation of liver function.

2) Less likely, but still possible for the anesthesia to transiently lead to an elevation in liver enzymes.

3) It would depend on which medication caused the enzymes to elevate.  An ultrasound can be considered to further evaluate this.

4) Yes, a decrease is ALT is encouraging.

5) Further testing can be considered - including the ultrasound and blood tests for hepatitis.  If negative, serial monitoring of the enzymes can be considered.

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_
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