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727499 tn?1239627655

High enzymes-low BUN

Hi, I have been suffering from a long term - undiagnosed - illness
Fever (for 6 months)
Weight Loss
night sweats
joint, back pain
levido reticularis (vascular discoloration on legs)
tachycardia
facial flushing

Anyway

Does the combiination of elevated ALT and AST and low sodium, low BUN, low CO2 mean anything to anyone?

Side note, I did suffer from congestive heart failure 8 days post partum in '04 and an aortic regurge was found, though mild-at least it was.

Thanks alot
Rose
11 Responses
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727499 tn?1239627655
So, mammogram was clear, but I'm too thin for for them to fully include axillary lymph nodes in image, so they would not perform ultrasound, need a separate order - medical red tape

new CMP returned with normal liver enzymes, but high glucose, low chloride Bun and Sodium, so we'll see.  Dr. T is having someone at rush review my gallium scan and then assuming these nodes haven't magically disappeared, he'll decide on a biopsy proceedure.

I am so frustrated! Where is the answer?  Thanks again for your ideas and concern.

Just keep swimming, swimming, swimming.......
Helpful - 0
Avatar universal
You're welcome Rose. I hope to hear that everything works out real soon.

Please post when you find out anymore information. I hope the biopsies are all negative.
Wish you the best.
MO
Helpful - 0
727499 tn?1239627655
I can not tell you how awesome it was that you gave my situation so much thought.  
From the bottom of my heart, thank you.

My liver enzymes have only been elevated once before and that was back in 2004, otherwise they have been stable.

My infectious disease doc at Rush is really my main doc now, and he is going to have someone look at the gallium scan there, and he wants a retest of the cmp to make sure it is legit and not a lab error or error due to clotting.

After my very silly appointment with the hemo onc. from Loyola,  I went home, cried a litttle, and then made a game plan to get someone else to check out this lymph node issue.

I had an abnormal mamorgram at Mayo last year, though they deemed it "OK" after an ultra sound, anyway, my breasts have been quite lumpy, so I called the gyno and went in for a check, she identified the enlarged underarm lymph nodes right away, as well as a dense area on the left breast (also noted that nodes under left arm were more pronounced)  So, I have a diagnostic mam and ultra sound on Monday, I will also retake the cmp blood test on Monday.  

Now I have two confirmed findings of enlarged lymph nodes under my arms in addition to the cervical ones, so Dr. T at Rush said, "It looks like we're going to have to get those nodes biopsied," so once he get's the mam results, the actualy cd of the gallium scan to review, and the blood cmp back, we'll schedule the surgery for the following week.  It is weird when you feel like you have scored, in a situation like this.

If they did find breast cancer, the outlook would be pretty grim, if it had spread to my lymph nodes and in some way my liver.  So, I'm really hoping that is not the case.  

Thank you again

Rose
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Avatar universal
Yes, I agree finding a good doctor would be the thing to do. And its true, its not known if Rose has liver disease - she does know its not hepatitus, but as to whether anything else is wrong with the liver would be my concern besides getting the lymph nodes checked out. The answer the doc gave her as far as the lymph node bx is the thing that disturbs me. But anyhow, I didn't read Rose's thread clearly. She has been sick for 1 year, but has had 'fevers for 6 months'. I said she was sick for 6 months which was not correct. But anyhow, hopefully Rose will find a good doc like you said and this way she can hopefully have her health back soon.

MO
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Avatar universal
I don't disagree with you. I think that, if I were she, my first goal would be to find a really good doctor. I am questioning whether the basis of her problem(s) is liver disease and that is why I would try to find a PCP who could start narrowing it down so it would be clearer which specialist should take the lead. I won't go further because, really, I have no idea what's going on.
Mike
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Avatar universal
I assume Myown & KjFlicka are talking about a liver biopsy- is that correct?
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I was refering to the cervical lymph node that Rose mentioned. I don't know if KjFlica meant a liver biopsy though.

Being Rose is negative for hep, I wasn't thinking of the liver, but now that I am thinking about it, I don't know what I would do in her case. Maybe I would ask the doctor for a liver bx too being the high enzymes means cell death. I would want to know for sure that this hasn't been going on longer than the 6 months. Rose has been sick for 6 months, but what if the high enzyme problem has been going on for a longer period of time. We know through our experience with hepatitus that people can have high enzymes for years and show absolutley no symptoms of liver disease. I wasn't going to doctors over the years, so I have no idea how long my enzymes were slightly raised, so I think if I was Rose, I would FIRST DEFINITELY get the lymph node bx AND yes maybe I would want a liver biopsy maybe too, unless the doctor could give me a good reason as why not. Don't you think Rose should get the lymph node bx and maybe even a liver biopsy?

MO

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Avatar universal
I understood her doctor's comment on the value of a biopsy to have been in reference to a lymph node biopsy and not a liver biopsy. I could be all wrong but that is how I read it.

I assume Myown & KjFlicka are talking about a liver biopsy- is that correct?

Mike
Helpful - 0
729009 tn?1237326883
Hi Rose! Hope you're feeling okay today. I whole heartedly agree with MO. Get yourself another doctor. You know your body better than anyone. Also, from my understanding, a biopsy is the ultimate test. The scans always seemed to me it was meant to guide the docs to the areas that may need a biopsy.

I have been through the bleeding stuff myself. I would scratch a little scab and it would bleed much longer than normal. And brushing my teeth would make my teeth bleed and if I blew my nose I would get a nose bleed. I believe this has to do with your INR (International Normalcy Ratio) which is basically a measurement they take to see how well/fast your blood is clotting. Just so you know, mine is totally back to normal and I don't have any bleeding/clotting issues at all. So, it IS something you can start to manage (via Rx? not sure), if not fix. The little red marks can be common in liver patients (known as spider angionomas (sp?) and mine were mostly on my chest. (Again, totally gone now.)

good luck and let me know what's up!
Nicole

(how many people actually live on Martha's Vineyard? It can't be too many! That's so funny your mom lives there!)
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Avatar universal
he is not willing to biopsy b/c he is not "sure" it will give an answer.   Does that sound right? Should I get yet another opinion?
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Hi Rose, No that doesn't sound right at all. I would run from that doctor and get another opinion and I would get a biopsy.

Really sorry to hear that you are going through all of this.
Please keep us posted,
MO
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727499 tn?1239627655
Hi MO, yes, I have been tested a number of times.  It seems to me that those hep tests would have come up positive before becoming this sick from it.  

I have been ill for over a year with a weight loss of over 40 lbs. (108 now)  Fever as I mentioned as been daily for over six months.  It stayed under 100* most of the time, but since december it is always over 100 and has registered 104, for the last two evenings in a row. That has to be a mistake.

I went to my hemotologist and although the cervical lymph node I have had all along for almost a year- that used to be under 1 cm. is now 1 cm. and he found another one on the other side as well as under arm nodes, he is not willing to biopsy b/c he is not "sure" it will give an answer.   Does that sound right? Should I get yet another opinion?

Oh there was also uptake in my gallium scan, though the report said it was normal. I saw the pictures and I made him bring up the actual pictures and showed him the uptake under both arms. he said, "yeah, there is a little bit there, but I don't know."

I have these little tiny red spots that seem to get a tiny scab and then if that is removed for some reason, it bleeds, a lot. These are on my ear lobes along with peeling of the skin, my neck, legs hand, for instance when I wiped my mouth with the washrag after brushing my teeth, my lips started bleeding. I mean bleeding.

Anyway, I am under the care of the Director of Infectious Disease at Rush I will definitely look at the information you sent, thank you.  I do appreciate your time!

Rose

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Avatar universal
You should be tested for Hepatitus - (Hepatitus panel - A,B and C)... That's if they haven't tested you already.

Here is some info on liver enzymes. Also for anything pertaining to liver its best to see a Hepatologist (liver Specialist)....they are found at Teaching Hospitals. My post will bump you up to the top and maybe others will have advice or info.

I don't know if there could be any connection with the heart problem you had - but others may know.

I hope things work out for you real soon.
MO

http://www.liverdisease.com/liverenzymes_hepatitis.html
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