Variable LFT Results & Chronic Urticaria

[Jen_L]

I've been monitoring my liver function test results on a regular basis since 2006 when a life insurance test discovered them elevated. Now and after going through every test the gasteroenerologist (sp) could think of (including a liver biopsy, Hep test, etc.) he gave me a clean bill of health for now and to keep monitoring it and checking back in every few years. This year I'll be 28 and I still have no medically diagnosed idea of why my liver enzymes are elevated. I don't have my exact numbers with me today but my last results had my bilirubin high, ALT high and my GGT high (up in the 200's again for the GGT). Granted they were almost normal a few months before and I decided to try no coffee to see if that was the cause, well then they sky rocketed so I'm not going off coffee again. I'm okay with that. :)

So, with that bit of background I come to the background for my question. This weekend I was doing a bit of research online on another issue I've had since 6th grade when it first occurred and went to the ER. I had huge hives all over my body (lovely picture right?). Well since 6th grade I've had them consistently and they are heat induced (determined by deduction over the years), but they do not look like the heat induced hives (small bug bite looking ones), they are large welts which look like the standard chronic urticaria. In my reading I see that 20-30% of patients have an autoimmune reason for chronic urticaria (which I haven't formally been diagnosed, but do have an appointment in a week). I've been tested for all sorts of autoimmune issues and I'm hoping that they won't turn up to be false negatives.

Also over the years I have had what I thought were panic attacks where my chest tightens up and it's hard to breathe. The gastroenterologist (sp again) thought maybe I had a bile duct issue in my gall bladder, but after tests that also was ruled out. I'm thinking it may be asthma, but I'll ask my doctor that too when I go in.

And finally for my question:

Has anyone heard of Chronic Urticaria causing elevated liver enzymes or is this just another symptom to add to the list that I hadn't realized was one before? :)

[TTHOMAS840]

My son was diagnosed after 3 years of various doctor visits and lots of bloodwork. Chronic Physical Urticaria. Hives on the abdomen and knots on the inside of hands and feet. Today, we discovered for a second time through bloodwork, because of new medicine trial that breaks down the red blood cells, that his bilirubin was 5 and it should be below 1.  Last week it was fine on his bloodwork, but before that once it was high. I am wondering if this is something more than the urticaria. These knots itch but they are also very painful and feverish. Large in size. We were told that only 7 ppl have been diagnosed with what he has and it's a hit and miss on the treatment.

[Spud267]

I too just recently started breaking out in hives, started on right forearm (outside) and partial right leg.  Was told to take Antihistamine and use Advantan Ointment, urticaria cleared up and when I went back to see the doctor he was happy.  Would you believe that very afternoon after I had seen him, I had another attack, this time on both legs moving up around my knees and inner legs etc.  This was a worse outbreak than the previous one, I felt like I wanted to scratch the skin off my legs - he has put me on Prednisolone (which he didn't want to do because of my von willebrands) but didn't feel he had a choice.  He has ordered FBC, UEC, LFT and IgE total.  Will let you know what comes of the blood tests but I have no idea - have never had issues with allergy or urticaria prior to these episodes - hopefully they can tell me why on Friday

Spud267

[mikesimon]

You mentions difficulty breathing.
I have read that urticaria can be associated with anaphylactic shock. Since I don't know exactly how that feels I thought I should bring it to your attention. I do know that it can be very dangerous so if your doctor(s) are not aware of it I would make sure to describe it in detail.
Elevated liver enzymes have also been associated with urticaria. As you stated,  urticaria is believed in some cases to be an autoimmune disorder. If that is true then I would want to eliminate autoimmune hepatitis, primary biliary cirrhosis and primary sclerosing cholangitis. I have no idea whether there is evidence that these diseases may be associated with urticaria but your elevated enzymes suggest liver injury is occurring and your elevated bilirubin is additional evidence of liver injury. I would certainly ask your doctor about that possibility.
I would ask your doctor whether it might be appropriate for you to see an immunologist and a hepatologist.
Good luck,
Mike

[Jen_L]

Yeah, I'm not overly worried about the panic attack feelings, just trying to tie everything together or rule it out. They are infrequent most times. :)

I booked an appointment with my doctor just to talk, so hopefully we can come up with some next steps and ideas. Meanwhile I will definitely keep on with the coffee.

[Jen_L]

To answer your questions...

Are you on any medications?
Only thing up until about a month ago I would take was Aleve for my headaches. I've stopped that since and have not taken anything, other than Liv52, Milk Thistle and my normal vitamins (daily, b-complex, c, fish oil). I was taking SamE for a while for moods but that was supposed to help liver function... it's possible that it effected things negatively.

What kind of work do you do?
Office work.

Do you smoke?
Smoked for ~7 years before I had kids. Not since. And that was about 7 years ago now.

What kind of work up did they do for your gallbladder/bile duct?
He went in endoscopically (sp) and looked for any blockage or stones. Couldn't find anything and said everything looked fine. He did think something may have been spasming but didn't have any proof so he didn't do anything other than look while in there.

Did they do a HIDA scan?
No they did not. I'll ask when I go back to the specialist.

[Suzie123473]

I have the worst pain on my left side behind my lower ribs. Everytime I breathe it hurts, I can hardly move without pain..???
I have had no falls or injury to this area

[Sir_Osis]

One step at a time Jen...

Cant say much about the panic stuff, asthma, and whatnot...

As for the hepatic stuff, well, I would *think* a biopsy would give a clue - but if not, hopefully it was an unremarkable outcome - no fat, no fibrosis, etc.  

I'm beginning to think there can be many causes for elevated readings, maybe prescription or otc meds you may take regularly, exposure to solvents, pesticides, and other toxins - look back in your history and environment for clues. As for the hives being linked to your hepatic matter - i rightly dont know - but there may be common autoimmune condidtions that impact both, and there are certainly liver and digestive related autoimmune disorders.. If your  G-I suspects then he'she could order things like antinuclear antibody studies, etc... Meanwhile DRINK your coffee!  many feel it has some sort of protective action for your liver - dont know if anyone has ever done a bang-up study on this with any scientific outcome - but hey - anyone that lets me keep drinkin my iced amricanos is fine by me ;-)  (but I have cut back on the splenda and use nothing or sometimes equal)

[CCRN34]

Just to clarify...it was the effect of caffeine on the liver...caffeine may have a protective effect on the liver.

[CCRN34]

I suppose that when you say that they have done an autoimmune workup that they have run ANA (antinuclear antibodies), SMA (smooth muscle antibodies) and anti-LKM (antibodies to liver and kidney microsomes)...which would tend to rule out autoimmune hepatitis...especially with you having had a liver biopsy.

Are you on any medications? What kind of work do you do? Do you smoke? What kind of work up did they do for your gallbladder/bile duct? Did they do a HIDA scan?

Interesting about the effects of coffee on your LFTs. I did some research a while back about the effects of coffee on the liver and liver disease...and was surprised to find that coffee may actually have a protective effect on the liver. Interesting...