Elevated liver enzymes and Aldolase

[ellaboobella]

Hi,

I can't get in to see a specialist for a couple of months and am in pain.  I was hoping I could at least get some information here while I'm waiting.

I've been having issues with severe upper abdominal pain, stomach pain, and intense reflux/indigestion for about 4-5 months now.  Prior to that my indigestion was only mild and depended on what I ate and if I ate too close to bedtime.  My PC physician put me on a PPI (Protonix) for an entire year (beginning dosage), but it stopped working after about 5-6 months.  I tried to come off of it and had a difficult time, but I did manage to wean myself off over time and onto generic Zantac-- 75mg once per day.  It's not working, however.  Also, the pain in my upper abdomen was so severe that my PC Dr (I now have a new one) ordered a HIDA scan (at my urging/insistance) of my gallbladder.  Gallbladder was fine.  This was several months ago.

I've been experiencing terrible crushing fatigue for longer than I've been taking anything for my stomach issues, but it's gotten severe over the past year, and many times worse over the past few months.  My muscles feel as if they simply don't work anymore and any small task (doing dishes, drying my hair, taking a shower, brushing my teeth) are becoming impossible.  My muscles hurt for no reason at times and often keep me up at night.  My joints hurt severely as well.

I saw a rheumatologist about this, and my swelling joints in my hands, and he ordered blood tests and a 24 hour urine test.  21 vials of blood---and the results came back with a LOT out of range, including liver enzymes and things associated with muscle deterioration/breakdown (Aldolase), as it was explained to me.

I guess I was hoping it's just something medication was causing, maybe the Zantac.  I've only been on it about 6-8 weeks, 75mg once per day.  But I'm not so sure since this pain has been coming on long before the Zantac.

Some of the abnormal lab results are below:

Alkaline Phosphatase:  214 (H)    normal range is: 40-120
ALT(SGPT):                  283 (H)    normal range is: 7-52
AST(SGOT):                198 (H)     normal range is: 13-39

ALDOLASE:                 18.3 (H)   normal range is:  < 8.1


DRVVT SCREEN:               46     normal range is:  <45

CREATININE                      116    reference intervals have not been established for random collections (?)
urine, random

MCV                             98.5 (H)   normal range is: 80-98  
MCHC                          31.6 (L)    normal range is: 32-36

Vitamin D,25-hydroxy   24.8 (L)   Insufficiency 10-30

PROTEIN ELECTROPHORESIS and IMMUNOFIXATION, SERUM

ALBUMIN                      54.5 (L)  normal range is:  55.8-66.1
ALPHA 1                         5.0 (H)  normal range is:  2.9-4.9
ALPHA 2                       12.3 (H)  normal range is:  7.1-11.8

24 HR URINE/Bence Jones Protein, Quantitative Urine

ALPHA-1, URINE          DETECTED A
ALPHA-2, URINE          DETECTED A
BETA, URINE                DETECTED A
GAMMA, URINE           DETECTED A

URINE FREE KAPPA/LAMBDA RATIO   14.00 (H)  normal range is:  2.04-10.37

Not sure if anyone has had any similar experiences or results and can shed some light, but my appointments are weeks away and I'm not feeling well at all.  PCP just tells me to wait for my appointment with the specialist.

Thanks in advance for your help.

[cnoevl21]

you could always go to an ER to get tests run immediately. obviously it will cost more, but if you're in this much pain, it is probably worth it

[ellaboobella]

Thank you for your response.

Fibromyalgia was mentioned, and my rheumatologist only looked at my hands for literally a second... only the briefest of a glance but didn't even touch my hands, which are becoming weak and stiff, almost worthless, even at age 53.  But no specific tests have been ordered other than the blood work and urine tests.

My primary Dr. and rheumatologist seem only focused on the liver issues.  However, all have also mentioned "musculoskeletal" issues but didn't specify with regards to that.  No one is being specific with anything outside of the labs.  I also have a 1.1 cm pulmonary nodule, and when I saw the pulmonary Dr about that (getting a second opinion because she kept drawing a 1 mm dot and referring to it as 1cm) she saw my labs and focused primarily on the liver enzymes and aldolase and commented that the aldolase was "highly elevated and needs to be investigated right away."  She actually got her nurse to call my rheumatologist's office, as well as a GI specialist to try and get me in to both to have this looked into further.

So I'm kind of hanging here.

I have 2 friends with fibromyalgia who speak about the daily pain and discomfort, but they tell me they haven't had any symptoms like I'm having.  I've literally gotten to where I can't walk up the couple of steps to get in and out of my house, can't walk my dog, can't exercise, I have to push myself up off of whatever I'm sitting on now just to stand up... so weak.

The stomach pain is getting unbearable, though.  Nothing seems to digest, or it takes all day.  I ate yesterday and 9 hours later I was still having reflux and stomach pain... and that was during the day, not even at night.  I just don't know what to do, but I know I'm not going to be able to handle this until july 20th when I see the GI doc.  I have a very high pain tolerance, but this.. this is something I'm having a lot of trouble handling.

Thank you again for your response.  I appreciate it very much.

[cnoevl21]

Did they test for any autoimmune disorders? Fibromyalgia, Rhumetoid arthritis, celiac. You shows symptoms of these. I am not saying you have them, but these should for sure be ruled out as the cause.