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Should I be having a liver biopsy?
Hi there,
Back in August I became very ill with high fevers, extreme nausea and vomiting.  Blood work showed low platelets, and wbc.  High liver enzymes AST, ALT around 6x the upper limit of normal.  Bili was elevated but I don't remember how much, and a Alk Phos I believe was around 600.  Also a slightly elevated creatinine at around 1.3.  Blood cultures, Hepatitis acute panel (A,B,C) ANA, Serum protein electrophoresis, Anti smooth muscle Ab, Antimitochondrial Ab, and RUQ ultrasound all negative.  I eventually got better, but it took weeks before I could eat, and walk normal distances with out feeling extremely weak.  All labs have normalized except for AST, ALT, and Creatinine.  I saw GI in October, he thought I had developed post partum hellp syndrome, and enzymes would eventually normalize.  I saw him again today due to the enzymes not normalizing.  oday he said he still thinks I was very ill due to post partum hellp, and now I possibly have NASH.  But he doesn't feel I need a liver biopsy.  I am questioning this because with hellp syndrome high BP is almost always reported, I never had that.  Also, this started 5 weeks post partum which is pretty far out for hellp to occur.  As for NASH, I'm not diabetic, don't have high cholesterol (total was 130 when last checked).  I don't eat high fat foods on a regular basis: red meat maybe 1 a month, otherwise poultry and fish for proteins.  I don't eat fried food, because I have celiac disease, and most fried food is breaded.  When I eat dairy (sour cream, margarine, yogurt, cheese, ice cream) I eat the low fat version.  I do however like sweets, and prob eat too much chocolate.  I am a little overweight, but am quite active and have lost 40 lbs since this started.  So my GI said to try cutting out sweets and recheck hepatic panel in 4 mo.  He feels that a liver biopsy is not necessary, and waiting and watching for now is fine.  I was just wondering if you agree with my GI's decision, and or if you have seen anything similar, or just any thoughts really.  Sorry so lengthy.  
Thank you,
Sarah
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141598_tn?1355675363
My 2 cents. A liver biopsy is best to see the health state of a liver. However, due to the possibility of post biopsy bleeding your platelet count has to be within their ranges.

Not discounting your GI but a Hepatologist specializes in liver issues and who I would consider for a 2nd opinion.
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Thank you very much for your advice! :)
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Should I be having a liver biopsy?
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