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Gastroenterology (Expert Forum)
Elevated unconjugated bilirubin
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 unconjugated bilirubin
by WorriedSick1981, Nov 10, 2005 12:00AM
Hey Doc,
I posted a message a few backs but we have uncovered a few more things since then. I have Crohn's disease and have been on 6mp for 4 years. Recent bloodtest showed increased elevation in unconjugated bilirubin and a mildly elevated ALT (under 100). We had a metabolite test that showed I was barely over the toxic threshold with a 6mmp at 6100( cut off is 5700). My doc ordered me to lower 6mp dose from 100mg to 75 mg. Keep in mind my Alk Phos, Albumin, AST, and Direct Bilirubin are all normal. ESR was also normal with a value at 8. Did we most likely find the cause of the problem? If it turns out to not be the medication what other conditions can likely cause this? All of my Hep tests were negative and since my Alk Phos and Direct Bilirubin aren't elevated my doc basically ruled out any problems with my liver ducts. I also have a previous diagnosis of Gilbert's. Can the 6mp cause Gilbert's to worsen? How long from lowering my dose should I expect to see a drop in levels if the medication is indeed the problem?
Thanks
I posted a message a few backs but we have uncovered a few more things since then. I have Crohn's disease and have been on 6mp for 4 years. Recent bloodtest showed increased elevation in unconjugated bilirubin and a mildly elevated ALT (under 100). We had a metabolite test that showed I was barely over the toxic threshold with a 6mmp at 6100( cut off is 5700). My doc ordered me to lower 6mp dose from 100mg to 75 mg. Keep in mind my Alk Phos, Albumin, AST, and Direct Bilirubin are all normal. ESR was also normal with a value at 8. Did we most likely find the cause of the problem? If it turns out to not be the medication what other conditions can likely cause this? All of my Hep tests were negative and since my Alk Phos and Direct Bilirubin aren't elevated my doc basically ruled out any problems with my liver ducts. I also have a previous diagnosis of Gilbert's. Can the 6mp cause Gilbert's to worsen? How long from lowering my dose should I expect to see a drop in levels if the medication is indeed the problem?
Thanks
Doctor's Answer
by Kevin Pho, MD, Nov 11, 2005 12:00AM
, Nov 11, 2005 12:00AM
It is possible that the medication can raise the liver function levels.
In addition to the hepatitis tests, you can also consider a liver ultrasound to evaluate the liver anatomy.
If the tests return normal, Gilbert's would certainly be a likely cause.
I am not aware of 6-MP being linked to Gilbert's specifically. If the elevation was caused by the medication, you can repeat the liver function tests in 4-6 weeks to ensure they are not rising.
These options can 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.
http://www.straightfromthedoc.com
In addition to the hepatitis tests, you can also consider a liver ultrasound to evaluate the liver anatomy.
If the tests return normal, Gilbert's would certainly be a likely cause.
I am not aware of 6-MP being linked to Gilbert's specifically. If the elevation was caused by the medication, you can repeat the liver function tests in 4-6 weeks to ensure they are not rising.
These options can 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.
http://www.straightfromthedoc.com
Thanks