What can cause liver enlargement?

[helen]

Dear Dr,
10 days ago I was at my swimming class after work and felt a pain on my upper right abdomen. The day before, I noticed that my belly was swollen and I was felling pain in that area. As I couldn't identitify where the pain came from, I went to a hospital near my job and ask a doctor. He asked for a US. The result of the US is "hepatomegalia". As I'm under treatment for depression and have to take lots of medicines, I called my doctor for instructios. She doesn't think that there is a relationship with all this things and said that the liver doesn't pain. As the pain was still bothering me, I went to see a gastrodoctor. She said the pain is in fact in the liver and asked for lab tests for hepatitis (A,B,C) and liver function. She said that my liver is "very grown" and "painfull". The lab tests are all negative and the only finding is a high hemosedimentation rate. I'm following the instructions for rest these days. I want ask you this: if I don't have any kind of hepatitis, what could be the cause of this pain and enlargement? Is there a possible link between muscle weakness and this liver enlargement? Drugs to treat depression (reboxetine+paroxetine+valproic acid) can cause liver enlargement? What should be the next appropriate step after the lab tests?
Thank you very much for your attention (sorry for any English mistake)
Helen

[Gloria]

Helen,
I am curious how you got on Reboxetine?  It has not been approved for use in the U.S., yet.  Do you live in the U.S. and are part of a clinical trial with Reboxetine?  Where, if that is the case?  I know several folks with intractable depression that are eagerly awaiting Reboxetine's approval.  Has it helped you?  As for your meds not causing liver dysfunction, I totally disagree.  One of the most common reasons for Valproic Acid being discontinued in therapy is elevated liver enzymes.  Valproic Acid IS hepatotoxic (toxic to the liver) and psychiatrists routinely monitor liver enzymes of their patients that are on Valproic Acid for at least one year after initiation of the drug.  Best of luck to you.

[helen]

Dear Gloria,
Thank you for your reply. You asked me about Reboxetine: i'm teaking it for 2 years, since its approuval here in Brazil. I have a very resistant depression and this med really helped and help me. Thank you again,
Helen

[Gloria]

Helen,
Most doctors will say that determining what causes liver enlargement or elevated liver enzymes, is a process of elimination.  As I said on my previous post, Valproic Acid is a known hepatotoxin (a drug that is dangerous/toxic to the liver).  Not everyone on the medicine will have trouble with it, but some do.  Since you were negative for hepatitis and your enzymes were normal, and the only abnormal lab test was your sedimentation rate, one has to wonder if your meds are causing this problem.  If you are anemic, or were on your period when your blood was drawn, you can have an elevated sedimentation rate.  This test is prone to being unreliable due to it being affected by the length of time the specimen sits around before being processed--usually that gives false low readings, though.  Is the ultrasound the only diagnostic procedure you have had?  Usually, a doctor will do a CT Scan of the abdomen if the ultrasound is positive.  As for your pain in your abdomen, most people experience pain when their liver (or spleen) is enlarged.  Is your abdomen "swollen" because you have fluid (ascites) in it?  Hopefully, your doctors will be able to help guide you through this process of trying to figure out what is wrong with you.  Best wishes to you and your family.  Good luck.  Gloria

[muirl stout]

I went to my doctor about after I eat anything I would get real ill in my stomach and she sent me to get a ultrasound done.She told me I had a diffuse fatty infiltration of the liver.Now she wants me to get a Hida scan with a eck order can you please tell what that is?

[Tellah Taylor]

Dear Helen,

My name is Tellah Taylor my email address is ***@****.  I also have an enlarge liver but no pain.  I had extensive test done the last being a hepatic angiogram and I was doagnose with hemangiomas of the liver.  I have no symtoms.

Please let me know what your doctor said.  I am in the process of having my tumor shrunk or embolize.


Good Luck

Tellah

[leo]

The is a rare genetic disorder called Polly Cystic Liver that
causes the liver to enlarge by displacing it with hepatic cysts
that range in size from small to very large.  The total weight
of both cyst an liver can be significant.  I have this disorder and the weight of my liver/cysts is currently about 67 pounds
(that is not a misprint!).  I had unbearable progressive pain and
had a liver resection to turn the position of the liver; however the size is still big and I am on fluid pills for the last 3 years to keep the total size under control.  After the surgery, I have experienced no pain except in my back because I have to carry this enormous weight around.  It looks like I have been 9 months pregnant for the last three years.  This disorder is passed on through generations and someone in your family must have had it in the past (review your family history).  The only cure is transplant, but it is not a life-threat disorder in itself.  It is very rarely caught because of how similar it could be to other things and how rare it is.  More women than men are candidates for this disorder (I am male).  The internet has other data you might find usefull (keyword: polycystic liver)

[Fred Kline [e-mail]]

I have a swollen stomach withmild stomach pain after taking a nap in a recliner or when I get up in the morning. The symptom occurrs when I have been in a prone position for a period of 1 or 2 hours. I also have very shortness of breath with any slight exertion or activity. In some cases I can twist my shoulders to the left and this also takes my breath             After I am up amd moving around for a while the swelling resides somewhat and the mild pain goes away.
     I had triple Bypass surgery 23 months ago.
    I am presently taking 25 MG and an aspirin each morning. and an occasional Lassics with potassium if my wieght increases or ankles are puffy

[Fred Kline [e-mail]]

I have a swollen stomach withmild stomach pain after taking a nap in a recliner or when I get up in the morning. The symptom occurrs when I have been in a prone position for a period of 1 or 2 hours. I also have very shortness of breath with any slight exertion or activity. In some cases I can twist my shoulders to the left and this also takes my breath             After I am up amd moving around for a while the swelling resides somewhat and the mild pain goes away.
     I had triple Bypass surgery 23 months ago.
    I am presently taking 25 MG and an aspirin each morning. and an occasional Lassics with potassium if my wieght increases or ankles are puffy

[Fred Kline [e-mail]]

I have a swollen stomach withmild stomach pain after taking a nap in a recliner or when I get up in the morning. The symptom occurrs when I have been in a prone position for a period of 1 or 2 hours. I also have very shortness of breath with any slight exertion or activity. In some cases I can twist my shoulders to the left and this also takes my breath             After I am up amd moving around for a while the swelling resides somewhat and the mild pain goes away.
     I had triple Bypass surgery 23 months ago.
    I am presently taking 25 MG and an aspirin each morning. and an occasional Lassics with potassium if my wieght increases or ankles are puffy

[Crystal]

Hello,
It it wonderful to see this site.  I am 34 years old and have had elvated liver enzymes for approx 4 years.  The source is unkown.  I did however when this was first found cut everything out of my diet except green vegetables  and it worked in 3 months my levels were normal, then having a HMO I lost my doctor and had to see another.  Well I am back where I started with the exception I am worse.  My levels are high and now I am having pain in my back.  I think maybe my kidneys!  My question is has anyone experienced this?  Are there any treatments available for the treatment of evalted liver enzymes?

[Iris]

To Crystal, check out pbc (primary billiary cirrhosis) for the elevated enzyme symptoms

[Shelly K.]

Crystal, I would like you to write to me about your elevated enzymes. Upon routine blood I was found to have elevated ALT of 85 And AST of 170 2-3 weeks ago. Repeat blood work showed increase of ALT to 125 and AST to 225, triglcerides of 324 and cholestrol of 235.( the last two are very elevated for me)Ultrasound showed a generous sized liver and eveything else was normal. Hep C came back neg, Hep B was questionable because of vaccine series for it. Lupus was ruled out. I have constant abdominal bloating feeling and generalized diffuse pain in right upper quadrant. My maternal grandfather died of liver cancer(70), my mother has liver cysts and her brother died of cirrhosis of liver at age 44. I am 41. I can't get into to a GI doc for 2 months and physcian doesn't feel my situation is urgent. Needless to say I am concerned. Please write-
shell_k***@****

[Crystal]

Dear Shelly,  
It sounds like a fatty liver to me.  I just seen my Dr. yesterday for more recent blood results.  ALT of 209 and AST 182.  I will be seeing the specilast for a Biopsy.  As with you I am negative on all hep test too.  I do know with the high cholestrol and enlarged liver that goes hand and hand with a fatty liver.  I also have a bloted stomach.  How frustrating.  Keep in touch with your progress. Crystal

[ferd]

I did not receive an answer Re: previous letter. Probably a mix up on my part.
     I have problem as follows. When I lay down for any period of time, 1 t0 2 hours, and also when I ge up in the morning , My stomach is swollen. This swelling is in front and imediately below my rib cage.
There is some pain, not extreme but I know it is there. After I am up and about for a hour or two the pain leaves alomg with most of the swelling. Also I am very short winded, any exertion hardly at all     or some times when I turn my shoulders extremely to left it gives me the it acuses shotness of breath.                              
     I had triple bypass two years ago and the operation went very well. I was mot able to participate in rehab because I have neuropathy from my knees to my toes and have to wear braces because of this condition

                     Awaitting your comments

                                      Fred

[Linda]

Cecilia ~
    If I were you, I would see a liver specialist. You need a contrast liver CT scan, and if that indicates a problem, a liver biopsy. I have very similiar symptons, and after these tests, found that I have NASH...non-alcholic sterotic hepatitus (hepatitis). It progresses to cirrhosis, which is where I am now. The liver certainly CAN have pain! You obviously have inflammation in yours, and there has to be a reason. Having dealt with this the last 2 years, I would highly recommend this. I hope and pray you find some help and relief.

[Kent]

Eight years ago I came down with bad flu like symptoms that settled into chronic fatigue.  This was accompanied with sensitivity to many drugs and a sudden intolerance to alcohol. Other symptoms were experienced that are normally associated with chronic fatigue and some occasional twitching occurred.  The fatigue symptoms improved after about 18 months.  Some blood work was performed and the only significant result the doctor discussed with me was elevated active titers for Epstain Barr.

More recently I have been experiencing a bloated abdomin (abdomen), increased fatigue, and occasionally what feels like a pounding heart.  I had my ALT-SGPT tested once a month for 4 months with normal Lab readings under 40 mine were in the 50s and 60s. Viral Hepititus tests were conducted with no sign indicated.  

Next I went to an internist and much bloodwork was done.  This included WBC, RBC, HGB, HCT, MCV, MCH, RDW, MCHC, Platelet, MPV, Neutro, Lymph, Mono, EOS, BASO, Neutrophil ABS, Lymph absolute, Mono Absolute, eosinophil ABS, Basophil ABS, RBC Morph, Protime, INR.  Of these Lymph% was marginal low at 19.8 with 20 to 46 normal.  Mono was 13.9 with 4 to 11 normal.  EOS was 5.1  with zero to 4 the normal range.  All the others fell into normal range.  

The chemistry tests were:
AST-SGOT.  ALT-SGPT, Alkaline Phosphatase, Bilirubin, total; Bilirubin, direct; Bilirubin, indirect;  Protein, Total serum; Albumin, serum; Globulin, Iron Serum, Iron Binding capacity, Saturation, Thyroid stimulating Hormo, and Ferritin.  Of these the ALT-SGPT level was moderately high at 55 and the globulin level was 2.3, while normal range should be 2.8 to 4.4.  The Ferritin level normally runs 24 to 340 while my level was at 653.

An abdominal sonogram was conducted and it showed increased echogenicity with decreased though transmission, consistent with diffuse fatty infiltration and/or cirrhosis.  No evidence of bile duct dilation was seen.  Intrahepatic lesions could not be ruled out due to the dense nature of the liver.  The common bile duct was not dilated.  

I am 50 pounds overweight and am a 45 year old pear shaped male.  I am scheduled for a liver biopsy on March 16.  My questions are what is the likely cause of the enlarged liver and test abnormalities?  Could this be something that started 8 years ago?  I have cut out all alcohol and aspartame.  I have not been a heavy drinker but have drank 2 quarts of diet pepsi for the last 15 years.  Thanks for any advice you can offer.

[tator]

I  am 20 and very  soon to be 21 and I went to the Docter and he is sending me for test because my liver is enlarged and I have very bad pain right under my rib cage on my right side The doc told me that in his 30 years of work he has seen only two women with this type of problem he stopped my birth control pills and said that this is a very very rare side effect from the pills if anyone can tell me more on this please e-mail at
***@**** I'm very scared i go for my test today
3-8-01 maybe nothing is wrong with me thats what i keep telling myself. I hope its nothing thank you for your help, Stacy

[vicki]

Hi my name is Vicki and on Thanksgiving of 2000 I was having some pain in my stomach and I was real dizzy and I almost fainted. About three years ago I tried to give blood to my sister when she was in the hospital and a few weeks later I got a note in the mail saying that they could not use my blood because my liver and my thyroids were elevated. So that day I went to the doctor and told them about it. They put my liver of and said that it was fine there wasnt any thing wrong with it and my thyroids they put me on sinthriodand about five or six monthes being on that they webt back to normal. And at that time they did tell my that they thought that maybe my birth-control was the cause of my liver going up. So for four and a half years I havent had any thing. I just had my second baby and I thought that I would get back on birth-control and then I started having this dizziness and fainty, nauses, vomiting and shaking all of the time . So when I went to the doctor in November they tested my liver again and this time it was coming up as 109 and I know that it is suppose to be coming up as 31. At that time my doctor scared me because she had said that she thought that I had liver disease. Now at that time it was right before Christmas. I have two kids and I am 25 and I didnt know what I was going to do.So they continued running test. I have had an ultra sound done and it came back negative that every thing was fine. At that time my regular doctor didnt know any thing else to do so she sent me to a specialist. I went to the specialist and they told me that they thought that I had gallstones in my gall bladder so they had a CT Scan done and just yesterday I got a EGD where they go down your throat to see if you have ulcers in your stomach well I didn't and they found out that I have a fatty liver they are running some sort of blood test and if it comes back positive  they are going to run a liver biopsy. Now the did run test to see if I have hepatities A B C and they all came back negative. If any one is having the same problem and have any advice to give me or what to do next please write me back .  And if there is any one that can tell me more about a fatty liver because they did put me on a low fat diet.           Thank you

[kimmba]

hi all, i was at the dr. 5 trs ago they told me my liver enzymes where high, I thought nothing of it he gave me a ultra sound it was fine . now last week i was at the dr. so i said to do another blood test to see if the enzymes came down so he did and they are still high they came back a 113 he said they should be 0to 42 so now i go to a specialist to talk i have 2 kids i need some help figuring this out. thak you !

[kimmba]

if any one can help me  you can e mail me at ***@****

[Joey]

Hi,
I am 33 years old and have had elevated Liver Enzymes for about 10 years.  The doctor did testing for hepatitis ABC years for years and they were always neg.  About 1 1/2 years ago I had a ultrasound (i was pregnant) and the doctor said I had a large liver.  After my son was born I was told we would follow up on the liver.   a couple of weeks ago I had elevated Liver enzymes again as well as some other high readings that go along with the test.  We did another ultrasound and the liver was still large.  I so a Doctor this week who is running a whole bunch of blood work for a number of different things.  The doctor scared me with a bunch of situations that could be the problem, most of which sounded bad.  I am so comfused.  He said that it is most likely a fatty liver.  Is there treatment for this and is there anything I should be doing.  He also mentioned something called NASH.  I have a 11 month old son and want to be here for him for a very long time.  Feedbcak and some direction would be great..  Thanks

[firstlight]

I have a 14 year old daughter who has been jaundiced for a little over a month. She was hospitalized for 3 days at the beginning with liver enzyme levels at 1900 and 1400. They have ruled out hepatitus (hepatitis) ABC she doesn't have mono. she's tired and yellow and so far nothing has showed up. This all started with a cold. Has anyone ever experienced anything like this and could cough syrup cause these reactions cause that was our main treatment for the cold was treating the cough but mostly at night. If anyone has any suggestions please contact me at ***@****. She is loosing weight because she has no appetite and this teenager use to eat every hour on the hour. Now I am lucky to get her to eat a small portion. Help!!!Denise ***@****

[OUTLAW]

Helen,                                         What you probally have is HEPATOMEGALY.That word alone stands for elarged liver.I have HEPATOSPLENOMEGALY which is enlarged liver & spleen.It couses very bad pain & swelling in the abdomen.My disease was coused from taking opiod medication for over 10 years.

[shepdog]

Please help me.  I had my gallbladder removed in September 2000, just two months after the birth of my first child.  Since then I ahve periodically had mild to severe pain on my right side just below my ribs.  I was still having this pain until December, which was the last time I had blood tests to check my liver, which came backnormal.  My doctor told me to drink Citrucel or Metamucil to help with the pain.  I have just started having the pain again and the Citrucel is not working.  About two weeks ago I though I had the sytomach flu - severe vomiting and diahrrea for days.  Now I realize that this was preceded by one glass of wine.  It seems that everytime I drink alcohol now I become sick and vomit or have diahrrea.  Can there be any connection of these symptoms to my gallbladder removal?  Is it possible there was damage done to my liver.  I feel I have exhausted any possibility of resolving this with my surgeon, who I fear thinks I am a hypocondriac.  Please advise.
Thank you,
Kathryn Sheppard

[maryann]

what can cause your liver to be swollen?