Elevated immature red blood cell count, and elevated Liver Function Tests????

[NeedAnAnswer]

In December I became sick with what started out as a cold, but it quickly changed.I went to the Dr. because it has triggered my asthma. He gave me some meds and sent me on my way.A couple of days later I noticed little swollen knots in my eye, vaginal area, and where my thigh meets my abdomen.Alarmed I went in again, and he said it was a stye in my eye.No answer for the others.Then the next night, when I would take a deep breaths in I noticed a pain in the upper right and left quadrants.This became progressivly worse and then I could not eat much due to the pain, and then I noticed that I had very dark urine.Went back to the Dr. and he said it was just part of the flu that I was getting. That weekend I became very sick, and I went to the emergency room with a 103 temp. and "flu symptoms" with very dark urine that I mentioned again to the Dr.My blood was taken and an X ray because of my asthma.The ER Dr. finally came to tell me something funny happened with my blood test.He said that my immature red blood cell count was extremely high, and that I probably had Leukemia or Lymphoma!Well I was very scared and upset thinking this is why I am so sick.He sent me home with antibiotics and said to come in 2 weeks for another blood test.4 days later I went in because I developed jaundice.Along with that was a high fever, stomach pain, nausea, aches, DARK URINE, asthma, and a sinus infection. Back in the ER and of course you could see that I was glowing yellow.The first thing the nurse says is that I have hepatitis. I am wondering how I could have gotten it.Finally see the Dr. and told him about the elevated immature red cell test and the Leukemia and lymphoma scare.So he runs more tests.I had Ultrasound and it was within normal range.And I will list all the problems:
URINEALYSIS, IRIS
URINE:  AMBER COLOR
URINE BILIRUBIN: POSITIVE
URINE BLOOD: 1+
HEPATIC FUNCTION PANEL
BILIRUBIN< TOTAL  H 4.5  (0.0-1.2) g/dL
BILIRUBIN, DIRECT  H 2.6  (0.0-0.3)mg/dL
ALKALINE PHOS H  132 (32-92)  mg/dL
AST   (SGOT)  H  232  (10-40) IU/L
ALT   (SGPT)  H  227  (0-38)  IU/L
% ATYP LYMPHS H  12   (0-8)    %
Acute Hepatitis Panel
Hepatitis B Core IGM: Non Reactive
Hepatitis A IGM AB: Non Reactive
Hep B Surface AG: Non Reactive
Hepatitis C AB: Non Reactive
After getting these results I saw my Dr. again and he did not think that I had hepatitis, he said it was probably mono, cocisackie virus (I don't know the spelling), or some other virus that caused me to develop hepatitis, which I know means inflammation of the liver.But the fact that I was not given a clear answer based on my test results really bothers me.These tests were done 12/20/2003, and on Jan. 8, 2004 I went and took another blood test and it all came back fine, and it does every month following. And my immature red blood cell count was normal. My question is what do you think it could possibly be? Will I ever be able to drink alcohol again?Could I get it again?And how long does it take for jaudice to leave eyes 27/ fema

[Kevin Pho, MD]

It is certainly possible for a transient virus to cause an elevation in liver function tests.  Specifically, mononucleosis can cause an elevation in atypical lymphocytes, as well as a transient elevation in liver function tests.

With a normal ultrasound, it is less likely that a severe liver or gallbladder infection is present.  Furthermore, the successive normal liver tests makes it more likely that the cause was due to a transient virus.  

As for the alcohol, I would discuss this with your personal physician - but it there should not have adverse effects with a normal ultrasound and enzymes.  As for jaundice to leave the eyes - it would be different for every person (i.e. there is no set time period).  This should be discussed with your personal physician.

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.
Medical Weblog:
kevinmd_b

[scarey0911]

A related discussion, Red blood cells out of range was started.