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Dark urine
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Dark urine

My son was diagnosed with hepatitis last week.  He is 17, and has absolutely no risk factors for A B (immunized) or C, and those tests came out negative.  His liver enzymes, however, went up overnight -- AST was 45, went to 566, ALT was 766.  Abdominal pain, vomiting lots of bile, and a fever for a little while.  His urine was dark, and was + for bilirubin twice.  Gallbladder ultrasound was negative.

They aren't sure what has caused this.  We are waiting CMV and Epstein Barr results.  Meantime, he is still having right side pain that hasn't gotten better, but isn't worse.  Nausea, but manageable, and is drinking a lot of fluids.  He's not eating hardly at all, but that's expected, our pcp tells us.  He has an appt with a GI guy tomorrow, which our pcp said we can cancel, but I think I'm taking him anyway, just for another opinion.

Thing is, his urine is still dark.  Thursday it was better, darker again Friday and "thick," as he said.  Same thing Saturday, yesterday was better as far as the thickness (not positive what he means, maybe concentrated), but it's still quite dark.

Hubby and I are both nurses, so we kind of know a little about this, but we don't know about this type of situation -- for a 17yo to develop this is a little crazy, because this is a kid who just never, ever gets sick, and hardly comes out of his room except to go to work, so it's really weird, cause he had no risk factors.

How long should his urine stay dark in a situation like this?  I know that the pain can last quite a while, but I don't know if I should be concerned about his urine or not?

If anyone has experience with a case like this, I would love to have some input.
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Avatar_m_tn
Is he taking a lot of supplements?  

                                                                                                        Ron
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Although you didn't say I assume he was diagnosed with hepatitis B. I only know one person who has had it and it is quite painful. Their AST shot up to 800. It took them about a month to recover. It can be dangerous though. I would still see the GI doc.
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Since he tested negative for all forms of hepatitis, hard to offer any suggestions (we're only patients here, usually no doctors around). You say he was vaccinated against hep A and B, but are you sure his antibody level was high enough to prevent an infection of either one of these? The hep A and B vaccinations require booster shots and follow up visits to ensure they "took" and built up enough antibodies to offer reliable protection. If he was just given some shots once as a baby, that might not cut it. I would have him tested again, sometimes it takes a little time for the antibodies to build up and become detectable.

On the surface it sounds like he's come down with a classic case of hep A. Has he eaten anywhere that might pose a higher than normal risk? Maybe at a restaurant that has immigrant labor and serves undercooked food, or dishes with raw/uncooked portions in it? Or raw oysters/seafood that sorta thing?? Has he recently gotten a tattoo? Maybe even a secret one where you cant see it? Hep B and C are commonly transmitted this way, contaminated needles and/or pigments are used which can spread these forms of hepatitis from one person to the next.

Also, has he "hooked up" with anyone new lately? Hep B is commonly transmitted via sexual contact. I don't know about you, but when I was 17 years old I didn't always tell my parents about everything I was up to. Don't assume you know everything about what he's been doing just because he hasn't conveniently volunteered the info. Make sure he understands the gravity of the situation and feels safe in admitting it if it did happen.

Hoping the best for your son, take care.
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