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Elevated Bilirubin and Lipase, Pain Under Left Ribs
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Elevated Bilirubin and Lipase, Pain Under Left Ribs

Hi there,

Me:
Age: 24
Sex: Female
Height: 5'2
Weight: 111lbs
Race: Caucasian
Past surgeries: Tonsils removed when 10 years old
Otherwise healthy and active before all this started.
Family history of:
Lupus
Breast Cancer
Eczema
High Blood Pressure

March 2010 - I started to feel nauseous at work; I left early and before I could get home I was so sick to my stomach I could hardly bear it. I spent the night extremely nauseous, making runs to the bathroom (diarrhea) frequently. This lasted for hours.

June 2010 - I started to feel pain in my stomach, especially after eating fatty food or drinking. General feeling of being unwell. I went to the doctor and blood tests revealed incredibly low and unexplained iron level of 2, though I wasn't anemic.

When My Life Changed:
One night I made fettucini alfredo and started to feel sick shortly after. A bit nauseous, sweaty. I went to sleep and woke up a couple hours later in the worst pain of my life. I sat on the toilet but never passed anything. I felt like I was having contractions, and when they'd come they were so painful I'm surprised I didn't pass out. I kept getting in and out of the bathtub for about 4-5 hours before I went to the ER. They did not check my pancreatic enzymes (probably because of my age), but both my amylase and lipase were very slightly elevated days later so my gastroenterologist assumes it was a bout of pancreatits.

July 2010 - Upper Scope and Colonoscopy results NORMAL.

July 2010 - December 2010 Ultrasounds, CT Scans, MRCP - everything came back normal. However I was so sick I was unable to eat and soon was underweight. It got bad enough that I was forgetting to eat altogether, my diet consisted of jello and small amounts of water. I was in and out of the emergency room, always told that I looked fine.

December 2010 - December 2010 - I lost my job, had to quit university and move back in with my mom. For the most part I'm better than I was. I've been very strict about my diet, no alcohol - taking every precaution as I've thought my pancreas was causing my problems. However, despite being able to eat solid food again, I'm still suffering from debilitating symptoms.

They did another upper scope endoscopy and said it looks like I have very mild gastritis. I've been on a PPI since June of 2010.

I've been in the hospital several more times during 2010, and after reviewing my blood tests I've noticed a pattern:
1. My indirect bilirubin is always elevated.
2. My lipase is always elevated.

A few other abnormal results have appeared on my tests - liver enzymes, urine PH, but for the most part the only abnormal results consistent on every test are the elevated indirect bilirubin (direct is normal) and lipase.

Current Situation:
I'm going back to the doctor tomorrow. I plan to ask for food allergy tests, celiac disease, crohn's disease, lupus, leukemia, hemolysis, Glucose-6-phosphate dehydrogenase deficiency.

Consistent Symptoms:
Pressure and pain under left rib cage
Shortness of breath (though I'm always told I'm getting enough oxygen)
I can't sleep on my left side. I feel I can't breath well. I sleep sitting up or on my right side.
Relentless thirst and dehydration - I wake up feeling like I've slept in the Sahara
Stomach bloating (I can't wear jeans or anything at all restricting)
Gas/Belching (Perhaps from gasping for air because of shortness of breath)
Fatigue and weakness
Anxiety (Probably from not knowing what is going on)
Muscle cramps
When I get hungry or thirsty I just feel so incredibly sick and abnormally irritable.
Back hurts when standing or walking for more than an hour

Recent Symptoms (the past 1 month):
Eczema type rash on my right knuckles (Never had eczema before)
Itchy, dry flaky irritable scalp
Episode of high blood pressure when I attempted to exercise. Went to the hospital and my heart was fine, probably just dehydrated.
Scab on mole on back of thigh, could be from scratching since I noticed it when I noticed my eczema.
Achy feeling in my chest

A list of blood tests, by date, showing abnormal results:
7-7-10
ALK PHOS - 28 (38-126) L  
Calcium - 8.4 (8.7-10.2) L
Amylase - 139 (36-128) H
Lipase - 63 (22-51) H
A/G Ratio - 1.5 Normal
Total Bili - 1.3 Normalish
AST (15-43U/L) & ALT (5-54U/L) - Both 20 Normal

7-16-10
Lymph - 42 (15-41%) H  
Basos - Normal
Mono - Normal
Amylase & Lipase - Normal
MPV - Normal
RBC - 4.73 Normal

7-18-10
Lymph% - 47 H (15-41%)
Atypical Lymph - Present (Negative) Abnormal
Total Bili - 0.9 Normal
RBC - 4.93 Normal
ALT - 15 Normal (5-54U/L)  (decreased by 5 since 7-7-10)
AST - 20 Normal (15-43U/L)
Lipase - Normal

9-16-10
RBC - 4.97 Normal
Lymph% - 20 Normal
Baso% - 1 Normal
Amylase - 109 ?
Lipase - 67 (22-51) H
Urine PH - 7

10-3-10
ALB - 5.4 (3.2-4.7) H
AG Ratio - 2.0 (1.0-1.6) H  
Total Bili - 3.2 (0.3-2.2) H
MPV - 11 (7.4-10.4) H  
Basos - 2 (0-1%) H
Ketones - 15 (Negative) Abnormal
ALT - 14 Normal (5-54U/L) (decreased by 1 since 7-18-10)
AST - 22 Normal (15-43U/L) (increased by 2 since 7-18-10)
ALK PHOS ALP - 45 Normal
Lymph - 29 Normal (15-41%)
RBC - 5.09 (Steadily increasing)
Lipase - 34 Normal
Urine PH - 5.5

10-10-10
A/G Ratio - 1.8 (1.0-1.6) H  
ALK PHOS ALP - 37 (38-126) L
Urine or blood ph? PH - 7.5 (5-7) H
OCC. BLD - Large (Negative) Abnormal (On my period?)
Lipase - 66 (22-51) H  
Urine PH - 7.5 (5-7) H
Total Bili - 1.1
ALT - 10 Normal (5-54U/L) (Decreased by 4 since 10-3-10)
AST - 15 Normal (15-43U/L)(Decreased by 7 since 10-3-10)
RBC - 4.81 Normal (Decreased 0.28 since 10-3-10)
MPV - 10.2 Normal  (7.4-10.4) (Decreased by 0.8 H since 10-3-10)
Lymph - 40 Normal  (15-41%) (Increased by 11 since 10-3-10)
Basos - 0 Normal
Mono - 8 Normal

10-23-10
BUN - 6 (8-22) L  
Total Bili - 2.0 (0.3-1.3) H  
Direct Bili - 0.2 Normal (0-0.2)
MPV - 11.2 (6.8-10) H
Lipase - 49 Normal (22-51)
ALP - 35 Normal (35-115)
RBC - 4.65 Normal (3.7-5.5)
Lymph% - 34.5 Normal  (15-41%) (Decreased by 5.5 since 10-10-10)
Hematocrit - 41.1 Normal  (34-44)
Basos - Normal
ALT - 10 Normal (5-54U/L)
AST - 16 (15-43U/L)

1-12-11
Hematocrit - 44.5 (34-44) H
Total Bili - 1.8 (0-1.2) H  
Iron Serum - 90 Normal
RBC - 5.07 Normal (3.7-5.5)
Basos - Normal
BUN - 12 Normal (8-22) (Increased by 6 since 10-23-10)
Lymph - 41 Normal (15-41%)
A/G Ratio - 2 Normal?  (1.0-1.6) H on previous tests, however this test measures normal range as (1.1-2.5)
ALT - 10 Normal (No change since 10-10-10, Decreased by 4 since 10-3-10)
AST - 12 Normal (Decreased by 3 since 10-10-10, Decreased by 10 since 10-3-10)
Thyroxine - 7.1 Normal (Thyroid test)
Mononucleosis Test - Negative

1-15-11
Total Bili - 1.8 (0.2-1.0) H  
AST - 12 (15-37) L
ALT - 25 (30-65) L
Protime - 12.3 (10-12) H
Mono% - 10.3 (0-10%) H
Urine PH - 8 (5-6) H
UR Amor Debris - 4+ (None) H
A/G Ratio - 1.5 Normal (1.0-1.6) H on previous tests, however other tests measure normal range as (1.1-2.5)  
RBC - 4.92
Lymph% - 31.9 Normal
RBC - 4.92 Normal
Baso - Normal
BUN - 13 Normal (8-22) ( Increased by 1 since 1-12-10, Increased by 7 since 10-23-10)

8-2-11
Creatinine, Serum 1.02 (.57-1.00) H
Iron - Normal
H.Pylori - 1.00 (0-.79) H
Lipase - 86 (0-59) H
RBC - 4.91 Normal
Lymphs% - 29 Normal
Basos% - 1 Normal
BUN - 10 Normal
A/G Ratio - 2.1  Normal? (1.0-1.6) H on previous tests, however other tests measure normal range as (1.1-2.5)  
ALT - 14  (15-37)
AST - 19  (30-65)
Urine PH - 7
Reticulocyte Count - 0.9 Normal (0.5-3.0)

9-2-11
Osmo, Calc - 272 (273-304) L
Total Bili - 1.5 (0.3-1.3) H
Lipase - 354 (65-230) H
Urine PH - 6
BUN - 12 Normal
A/G Ratio - 1.5
ALT - 31
AST - 16
ALK PHOS ALP - 52
RBC - 4.65
Lymph - Normal
Mono - Normal

Does anyone have any insight to offer? Tests I should take, similar experiences, specialists I should see - absolutely anything at all? I'm so desperate to get on with my life.
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3 Comments Post a Comment
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Try diabetes and breaking out eczema test for them and get renew lotion for the eczema
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Ca-125( cancer screen.. May come out false positive) but still they can do full body scan if positive.. Get full abdominal ultrasound
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How are you doing ? Did you get your results back ? Please let us know.
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