elevated LFT's

my 11 year old son was diagnosed with Hashimoto thyroiditis 3 months ago his TSH was 700 and his T3 and T4 were almost undetected, antibodies were present and he was started on Levothyroxine 75 mcg, at that time his creatnine and AST were elevated. The endocrinologist said that after a month of thyroid hormones everything should go back to normal. it didnt, his AST and ALT have gone up each week since then, they are now ALTover 500 and AST 385. His TSH is at 5 and his Kidney function is almost normal but the liver enzymes are freaking me out. He had an abdominal ultrasound and everything looked normal. They have tested him for everything under the sun, all autoimmune diseases, myopathies, metabolic disorders etc. So far nothing else abnormal.He developed an appendicitis last week and had to have an appendectomy and while they were in surgery they did a liver biopsy, it shows scar tissue and some abnormal cell changes that the Liver Specialist said it looks like drug toxicity from the Levo since that is the only medication he is on. He never takes any OTC pain relievers or any other meds or supplements. They have since changed him to the brand name Synthroid and will recheck his LFT's in 2 weeks but his Endocrinologist thinks that it is not caused from the thyroid hormones. What else could it be? How long can this go on without severely damaging his liver?

[Thomas D Schiano, MD]

i do not think that synthroid can be blamed for this.  Children can sometimes have unusual presentations of autoimmune hepatitis which i would be concerned about as it can sometimes look like a drug reaction and there is a fairly strong association with thyroid disease.