Extremely high AST/ALT levels

I have a situation with our son Joshua, and we're looking for everybody to start praying for him, and for us. Here's the story...

My wife noticed about 2 weeks ago that Joshua's eyes were yellow, and then I noticed that his urine was dark yellow, and almost orange in color one day. So I immediately thought that he was dehydrated, so we cut all juices and sodas, and gave him strictly water for about a week. His urine went back to normal, but his eyes didn't. We made an appointment with the doc to get bloodwork done last Tuesday.
So the doctor called us Wednesday morning, and told us that he had hepatitis, but she wasn't sure if it was A, B, or C. We were freaking out because he's had all the vaccinations for everything, and we didn't understand how he could catch that. So she told us to bring him back on Friday for more bloodwork to see if his numbers had decreased at all. The normal AST/ALT numbers for his age are 41 and 40-50. His were 1845, and 2120.
We had the bloodwork done again on Friday morning, and in the afternoon, the Children's Hospital of Philadelphia called us and told us that his numbers were through the roof, and we had to bring him to the ER first thing Saturday morning to get evaluated. The wierd thing is that he's not showing any physical signs of any of the forms of hepatitis. The on base doctor told us that if he had that, then he should be real lethargic, and yadda yadda. But he's very active, and there's no change in the way he's acting.
They did an ultrasound of his liver, and took more bloodwork. Both showed that he has an enlarged liver for his age. They discharged him, saying that he likely had hepatitis, and to follow up with the doctor on the base Monday morning. We were relieved that they sent him home, thinking that his situation wasn't as bad as we initially thought.
Again, took him for bloodwork yesterday morning. This time, the CHOP called us in the afternoon and told us that we had an appointment Thursday at 3 with two Gastroenerologists. They will determine if this sickness he has is a viral hepatitis and let it run its course, or if they will do a liver biopsy on him. I'm nervous as you know what.
Does anybody have any more info/encouragement out there for our family?  Thursday seems like a lifetime away!  Thanks in advance

[sdevert]

Praying for Joshua . . . Thursday probably does seem like a lifetime away, but if you can step back and look at how long it sometimes gets to get an appointment, Thursday is pretty darn quick.  Plus you don't get ONE GI doctor, you get TWO!  That in itself is amazing.

Joshua's numbers are extremely high compared to my 9-year-old son's numbers.  We are rechecking his ALT/AST in October which seems like forever away.  My aunt is trying to get me to try Juva Cleanse®  which provides support for the liver through a carefully formulated blend of therapeutic-grade essential oils that supports normal liver function.*  I'm not sure I am buying into the whole "oils" thing.  She also recommended a few foods to help with liver support.  Has anybody suggested anything like that to you?  Like I said, I am not sure I am buying into any of this, but if you could always ask the GI if he/she has an opinion on it.

Praying for a speedy recovery for Joshua.  Hopefully you keep me posted.  Take care.

Dawn

[mikesimon]

I am not a doctor or involved in the medical profession in any capacity. I have been a patient with liver disease. Please bear that in mind when you read this post.

I agree that Joshua's numbers are extremely high and I too would be concerned.

The word "hepatitis" actually means liver inflammation. So when the doctor tells you that he had hepatitis that tells us nothing aside from the fact that his liver is inflamed and we know that from his AST/ALT results. "Viral Hepatitis" refers to a viral infection that attacks the liver - Hep A, B, C, D & E. I have no idea of which tests showed that Joshua has viral hepatitis but they don't know if it is Hep A, B or C. Generally the first tests performed are antibody tests but it does take some time - weeks perhaps - for antibodies to develop and show up in blood tests. So, with hepatitis c for instance a viral load test - a PCR RNA - would show a recent infection sooner than an antibody test for Hep C would.

I'm just guessing here but with enzymes as high as Joshua's I would think it is probably a very recent infection - if it is indeed a viral infection. Hep A can cause very high elevations in AST/ALT but Hep C usually doesn't and neither does Hep B typically cause elevations that high. The good thing about Hep A is that it does not develop into a chronic illness whereas Hep B and Hep C can become chronic. Hepatitis A resolves and the liver is fine after a while. I don't know anything about Joshua - age, physical characteristics (obese or lean) his lifestyle or living conditions so it is hard for me to have a context within which to think about this.

I don't know whether there is a hepatologist available in your area but if there was I would want to see a hepatologist soon. If there are none available then a gastroenterologist is the next best choice and there are some very competent gastros. I would just prefer a liver specialist if my child had liver enzymes that high.

I think it is encouraging that your Son shows no signs of sickness but I would still want a diagnosis soon and answers to all of the question you must have. I might push a bit harder than you but I have had enough experience with liver disease that I have become rather bold when it comes to my medical care.

Good Luck,
Mike

[gr79]

Thanks for both of your comments.  We brought him to the doctor on Monday, and we got the appointment to see the GI for tomorrow afternoon.  He's showing no physical signs of being sick.  The yellowish tint in his eyes is slowly fading, and his urine is going back to normal.  Joshua just turned 4 this past week, and weighs a whopping 31 lbs.  So he's small, and skinny to say the least.  
Some close friends of mine in the medical field told us to cut his diet immediately until we met with the GI's tomorrow.  So we've been giving his fresh fruit/veggies, organic when possible.  He's also drinking nothing but water.  At the age of 4, he's pretty stubborn, but we play games at the table to get him to eat.  We're also leaving all the seasonings and oils out of the food for now.
I'll post again tomorrow afternoon on the results.  Thanks for the encouragement from you both!