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Gastroenterology (Expert Forum)
Elevated Liver Enzymes Test
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.
Elevated Liver Enzymes Test
by RJF, Mar 01, 2004 12:00AM
Prior to February 2003, all of my wife's LFT's returned normal results.
In February 2003, my wife was 4 months pregnant and underwent extensive blood work for an insurance policy. The LFT's were as follows: ALP(132) in 30-135 range, AST (21) in 0-33 range, ALT (25) in 0-45 range and GGT (43) in 0-45 range. Cholesterol was 225 with LDL at 140. During the pregancy, my wife's weight went as high as 199 lbs. She is 5'2" and her BMI indicates a normal body weight b/w 119-130. In additon, my wife is currently taking Celexa and sometimes takes Allegra.
My wife delivered our beautiful son in July 2003 and all was well.
In February Nov. 2003, the ALP went to 264, AST 46, and ALT 90.
In follow up blood tests taken in January 2004, the LFT's came down to ALP 139, AST 27, and ALT 43. The GI specialist believed the LFT's were regulating themselves and in February 2004, the numbers went back up. ALP 147, AST 183, ALT 235. A liver ultr sound was negative as was an ultra sound of the gall bladder. Hep. results foir A, B, C were all negative. In conjunction with these LFT's, my wife occasionally (once every 2-3 months)has abdominal pains followed by diarhea (diarrhea) and vomiting. Years ago (7)she was diagnosed with collitus.
After the previous ultra sounds tests were negative, a pelvic ultra sound was performed, These results are not back yet.
My wife has never drank alcohol or smoked. Presently, my Wife is 167 lbs. and still taking the Celexa. Could you please offer some expertise?
Sincerely RJF
In February 2003, my wife was 4 months pregnant and underwent extensive blood work for an insurance policy. The LFT's were as follows: ALP(132) in 30-135 range, AST (21) in 0-33 range, ALT (25) in 0-45 range and GGT (43) in 0-45 range. Cholesterol was 225 with LDL at 140. During the pregancy, my wife's weight went as high as 199 lbs. She is 5'2" and her BMI indicates a normal body weight b/w 119-130. In additon, my wife is currently taking Celexa and sometimes takes Allegra.
My wife delivered our beautiful son in July 2003 and all was well.
In February Nov. 2003, the ALP went to 264, AST 46, and ALT 90.
In follow up blood tests taken in January 2004, the LFT's came down to ALP 139, AST 27, and ALT 43. The GI specialist believed the LFT's were regulating themselves and in February 2004, the numbers went back up. ALP 147, AST 183, ALT 235. A liver ultr sound was negative as was an ultra sound of the gall bladder. Hep. results foir A, B, C were all negative. In conjunction with these LFT's, my wife occasionally (once every 2-3 months)has abdominal pains followed by diarhea (diarrhea) and vomiting. Years ago (7)she was diagnosed with collitus.
After the previous ultra sounds tests were negative, a pelvic ultra sound was performed, These results are not back yet.
My wife has never drank alcohol or smoked. Presently, my Wife is 167 lbs. and still taking the Celexa. Could you please offer some expertise?
Sincerely RJF
Doctor's Answer
by Kevin Pho, MD, Mar 03, 2004 12:00AM
, Mar 03, 2004 12:00AM
Most of the common things, including fatty liver and hepaptis, have already been evaluated for. Ensure that there are no medications are being taken that can affect the liver.
Other possibilies include hemochromatosis and autoimmune hepatitis. These can be evaluated for via iron studies and an ANA level to start off with. If the liver enzymes continue to be elevated (i.e. in the triple digits), then a liver biopsy is a reasonable test to ensure there is no undetected disease.
Finally, there are some non-liver causes that can elevated the enzymes. This can include muscle disorders, thyroid diseases, and celiac disease. These entities can be considered if the liver evaluation is not revealing.
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.
Thanks,
Kevin, M.D.
Other possibilies include hemochromatosis and autoimmune hepatitis. These can be evaluated for via iron studies and an ANA level to start off with. If the liver enzymes continue to be elevated (i.e. in the triple digits), then a liver biopsy is a reasonable test to ensure there is no undetected disease.
Finally, there are some non-liver causes that can elevated the enzymes. This can include muscle disorders, thyroid diseases, and celiac disease. These entities can be considered if the liver evaluation is not revealing.
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.
Thanks,
Kevin, M.D.
