High ALT, AST with inflammed liver and spleen

I'm a 45 yr old female, non-smoker, very rarely drink. Two years ago I lost 100 pounds after gastric bypass surgery. Also in 2007 my gallbladder and appendix were removed. In 2007 I started having some chest pains and had 3 stents placed in the LAD in 2008. I do not take Tylenol or Ibuprophen ever. I am supposed to take Vytorin for cholesterol but don't take it. My cholesterol is good after weight loss. I take Effexor 150 mg, Plavix 75 mg, and Diamox 500mg daily.

About 6-8 weeks ago, I began having RUQ pain just minutes after a meal. The pain is now pretty constant with occassional sharp pain radiating to my back, along with fatigue. My recent lab work was fine except for AST 733 and ALT 350. My Dr thought I had gallstone pancreatitis. I had a CT scan of the abdomin (abdomen) revealing inflammed liver and spleen. No note of stones. Since then I've been tested for hepatitis and all were negative. I am now having some itching and am so puzzled by all this. I have an appt with a GI Dr, but can't be seen until June 3rd. I'm hoping some of you may have ideas or suggestions for me. I'm just not feeling well and just want to know what I'm dealing with. I'm not sick (feeling sick) enough to be hospitalized, but can't work or do much before I'm exhausted and the pain gets worse then. Any ideas?

[Sir_Osis]

Sorry to learn of your trouble - and I know how frustrating it can be.  I would also see if I could be placed on a cancellation list to see the hepatologist sooner.

My initial advice would be to check for known - and even low risk side effects of the drugs you take.  Even things like antidepressants can (in some people) cause liver related side effects - i/e increased enzyme readings due to cell damage.  Both the liver and spleen are in concert with many problems and they can both swell.

Next would be to have a series of ANA (Anti-nuclear antibodies) run, and have ferritin/TIBC checked as well as ceruloplasmin - Those detect/rule out things like PBC PSC Wilson's and Hemachromatosis - All of which are able to cause a type of (non viral) Hepatitis.

Hang in there - and you may want to investigate taking milk thistle extract 3x a day - as prohylaxis for whatever is causing your liver problems - its slow to work - but I swear that it helps - just takes time  for it to work, and it purportedly lessens the severity of cell injury.

Let us know - and if you notice yourself getting sicker, yellow eyeball whites, and bad itching - go to the er...otherwise, try to see that doc sooner - and at least see if they could run the ANA labs now.

Jack

[angelab4]

Thank you very much for your help. I spoke with the nurse today and will be having additional lab work on Monday. She said it would be "further liver tests and antibodies".

All of the medications I currently take list the possibility of effects on the liver. I have taken two of these for 5+ years and the other for 1 1/2 years. The last time my liver functions were tested was May 08. ALT was normal and AST was 75. I was not told of these results. I have since moved to another state and have a new Dr.

I have the milk thistle but am so afraid to take any additional meds or supplements that I haven't started taking it. I think I will start now, after reading the recommendation of you and others that have been helped by it.

Again, that you for your response. It feels like I'm alone in the world with this illness and so many questions. This forum helps me realize that there are many others that face these same issues.

Angela