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Enlarged Lymph Nodes in Abdomen & Groin, Abnormal Liver Functions, Swollen Spleen - Causes?

Hello Everyone,

I've been run through the medical gamut the past couple of months, so bear with me here. About 2 months ago I started feel rather unwell. I was having terrible body aches, I was feverish, exhausted. This went on for a few weeks so I went to my family doctor. My doctor sent me for some blood work, which showed I was significantly anaemic and that one of my liver functions were abnormal. About a week later she sent me for more blood work which showed although the one liver function was better, two were worse. This test also came back negative for mono and hepatitis.

My doctor then sent me for an abdominal ultrasound. The ultrasound showed my spleen was slightly swollen and some of the lymph nodes in my abdomen and groin were also slightly enlarged. Concerned about Lymphoma, my doctor then sent me for an abdominal CT Scan and a chest X-Ray. The CT Scan showed much the same, but the report said there was no sign of malignancies. Chest X-Ray came back normal.

Although I've been feeling better, I still get very achy during the afternoon/evening - especially through my lower back/hips/upper thighs. I still feel tired, but not exhausted. I discovered in the shower that I could actually feel one of the enlarged nodes in my groin. The nodes in my neck seem to be normal.

My doctor is now sending me to an Internal Medicine Specialist. I'm just wondering if anyone has ANY idea what all of this could be from or if I should be taking a different course of action? I just want everything to go back to normal. I'm currently waiting on the results of a stool test and yet another blood test to check my liver functions.

Thanks So Much.
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Welcome to the MedHelp forum!
I am not sure what you mean by elevated liver levels. Many a times AST (SGOT) and ALT OR SGPT (both are collectively called transaminases) rise without any cause. Because AST is found in many other organs besides the liver, including the kidneys, the muscles, and the heart, having a high level of AST does not always (but often does) indicate that there is a liver problem. For example, even vigorous exercise may elevate AST levels in the body. However to reach at that conclusion the medical causes of these raised transaminases have to be ruled out. Causes of liver transaminase elevations include viral hepatitis, alcohol use, medication use, steatosis or steatohepatitis, and cirrhosis. Steatosis and cirrhosis are ruled out by the ultrasound. Other common health conditions, such as diabetes, heart disease, pancreatitis, hemolytic anemia and thyroid disease, can also cause liver transaminase elevations. Most liver diseases are characterized by greater ALT elevations than AST elevations except cirrohsis and alcohol abuse. ALT also rises in bile duct obstruction due to stone.
Raised alkaline phosphatase (The normal range is 44 to 147 IU/L (international units per liter).is often found in a growing child and at puberty. There are several bone disorders too that can raise this enzyme like rickets, osteomalacia, Paget’s disease of the bone, tumors, metastasis and recent fracture. An elevation in AP is often seen in cholestatic liver disease, pregnancy, bone disease, and occasionally with inflammatory bowel disease. In an otherwise healthy individual a rasied AP could be due to false positive test and the test should be repeated. If it is still high then other mentioned causes should be ruled out.
High concentrations of GGT are found in the liver, bile ducts, and the kidney. Hence kidney and urinary problems could be causing the high GGT level. Greater-than-normal levels of GGT may indicate: congestive heart failure , cholestasis (congestion of the bile ducts) , cirrhosis, hepatitis , liver ischemia (blood flow deficiency), liver necrosis, liver tumor, high alcohol intake, use of hepatotoxic drugs (drugs toxic to liver). The good results will start appearing within 24 hours of stopping alcohol but will be very minimal. It takes about a month for the levels of GGT to come down to near normal value provided you abstain from alcohol during this period.
Depending on which enzyme levels are raised, see if the causes for the same have been ruled out. Since you have spleen involvement, enlarged nodes and anemia, hemolytic anemia should be ruled out. I feel you should consult a hematologist and a hepatologist. Take care!
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