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Gastroenterology (Expert Forum)
Drop in liver enzymes
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.
Drop in liver enzymes
by Triunbad, Sep 22, 2005 12:00AM
I had previously left a post regarding the potential of having PSC, the diagnosis being made based on me being a 38 year old male with colitis and elevated liver enzymes. I am trying to see if I can donate a kidney to my wife, and before I go in for an ERCP next week, I thought I would get some advice from you.
Back in June I got back results from my liver enzyme tests showing that my liver enzymes had gone up significantly. Because my colitis was also acting up, I started taking prednisone again, and my colitis stabilized. Then on Aug 29, I went into the hospital to have an ERCP, at which time the doctor was hoping to determine whether I had PSC. However, there was a twist in my bile duct, and he was unable to complete the ERCP. Instead, he had to put a cut into the bile duct in order to straighten it out so he could do the procedure again at the end of this month.
When I went back into the hospital two weeks ago, I found my liver enzymes had reduced significantly from June's tests, ALP from 643 to 139, AST 131 to 21, GGT 547 to 108, and ALT 156 to 37. Could this normalization be just due to a blockage in the bile duct which was corrected when the twist was removed. Or is this likely due to the prednisone (I didn't know whether prednisone worked with PSC).
Thank you for your time.
Back in June I got back results from my liver enzyme tests showing that my liver enzymes had gone up significantly. Because my colitis was also acting up, I started taking prednisone again, and my colitis stabilized. Then on Aug 29, I went into the hospital to have an ERCP, at which time the doctor was hoping to determine whether I had PSC. However, there was a twist in my bile duct, and he was unable to complete the ERCP. Instead, he had to put a cut into the bile duct in order to straighten it out so he could do the procedure again at the end of this month.
When I went back into the hospital two weeks ago, I found my liver enzymes had reduced significantly from June's tests, ALP from 643 to 139, AST 131 to 21, GGT 547 to 108, and ALT 156 to 37. Could this normalization be just due to a blockage in the bile duct which was corrected when the twist was removed. Or is this likely due to the prednisone (I didn't know whether prednisone worked with PSC).
Thank you for your time.
Doctor's Answer
by Kevin Pho, MD, Sep 23, 2005 12:00AM
, Sep 23, 2005 12:00AM
There are no studies suggesting a benefit with steroids in treating PSC.
It is possible that the ERCP may have cleared a blockage that previously obstructed a bile duct.
Another possibility is a diagnosis of autoimmune hepatitis - where steroids are indeed the choice of treatment. Measurements in various autoantibodies can be considered if this diagnosis is suspected.
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.
http://www.straightfromthedoc.com
It is possible that the ERCP may have cleared a blockage that previously obstructed a bile duct.
Another possibility is a diagnosis of autoimmune hepatitis - where steroids are indeed the choice of treatment. Measurements in various autoantibodies can be considered if this diagnosis is suspected.
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.
http://www.straightfromthedoc.com
