high ast/alt 10 year old boy

Two years ago my 8 year old son had inceased ast and alt levels. we were seen by a pediatric gi. over a peroid of nine months, we watched the level go as hight as 556 ast and 273 alt.then the levels returned close to normal. the physician dismissed this to a viral eposide.My now 10 year old had routine blood . again his ast 203 and alt 133 mpv=6.6 calcium 10.2 and bun creatine 21.1.can this again be viral hepatitis? he tested negative for all hepatitis. he is also not overweight and plays sports.please, what do you think this could be.
thank you,
ann-marie

[Thomas D Schiano, MD]

i think that he needs a more extensive work-up at this point, which might include a liver biopsy.  It could be wilson disease, autoimmune hepatitis or several other disorders. I think he should see a pediatric hepatologist