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high ast and alt on blood test
I recently had a lot of blood work done because I have lupus and a chronic kidney disease.  My results showed the AST(SGOT) was 45H and the ALT(SGPT) was 58H.  Could you please give me some sort of reason for this?  Thank you very much.
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151263 tn?1243377877
I'll give it a stab, although keep in mind I'm not a doctor. Lupus is a term for generalized autoimmune disease, which you probably already know something about. As you've probably already learned, autoimmune disease is where the body's immune system basically becomes confused and starts attacking itself. Autoimmune disorders can involve attacks against various multiple organs/parts including the heart, lungs, joints, kidneys etc. They can also involve the liver, and when that happens it's called Autoimmune Hepatitis, or AIH. AIH can be very subtle in some people, whereas in others it can be very aggressive (and life threatening). AIH varies in intensity from person to person and varies over time for each person. Sometimes it can come and go, sometimes it can flare up dangerously, sometimes it can go away and never come back. If AIH is present, from what I've read its diagnosis is not always easy. But one thing they look for are certain antibodies which are indicative the immune system is attacking the liver. There's several of them including SMA, ANA and a few others that I don't remember offhand (you can google it and learn all about it). Anyway, if these markers are present, and other signs are also present, you may be diagnosed with a form of AIH. And yes another possible indicator of ongoing liver damage is when your AST and ALT are elevated above normal. AST and ALT are liver enzymes that are released from liver cells when they are damaged. So if they're elevated, it's indicative that something is damaging your liver (that "something" might be AIH/lupus in your case).

But try and not get all worked up over this just because your AST and ALT are elevated. They're really not that high at all. My liver enzymes have been higher than yours for, oohhh, about 25 years (from Hep C) and I have minimal liver damage. Many others here are very similar, the liver's a pretty tough cookie. Plus it can regenerate and heal itself if you resolve the AIH or whatever it is that's eating at it.

Lastly, AIH can and usually is treated successfully. As far as I know most people live out full lives with it. Treatment involves prednisone and/or imuran, which I suspect you already know about having lupus. Hope some of this helps, best of luck to you.
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