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very high ast alt ck counts
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very high ast alt ck counts

Very High ALT AST and CK counts.
I have these problems with my blood work.
1.  ALT=1147
2.  AST=639
3.  Alkaline Phosphatase = 206
4.  A/G Ratio= 1.0
5.  Sedimentation rate-westergren=34
6.  CK=4000
7.  EMG test done and found nothing in arms or legs but all indications of something wrong in back.
8.  Went to Rheumatoid doctor but they found nothing.

Been tested for Lyme, Hepatitis, Mono all negatives (tested within last 2 weeks.  There are other counts high but not very high.  If you need them also, just let me know.

I do not nor have I ever smoked nor Drink alcohol.

For the last 3 weeks, I've run a fever, sweats, sometimes chills at night.  Fever from 99-103.  Never in day time.  

My ALT and AST has been from 150-250 for the last 15 years.  I had a liver biopsy about 8 yrs ago and they found nothing wrong.

I have a cough that is like when you take medicine that gives you the side effect.  I'm taking no new medicine.  I take toprol and diovan.

I had a heart attack with quad by pass in 1998.  Very little heart damage.  After the attack, I had a staph infection that almost killed me.  I was in hospital 1 month and took vancromicin at home 2 times a day for 3 months.

This is the major part of my medical history.

My questions are this:

1.  Can you have a recurrence of staph with no wounds? Can it be like malaria for example?

2.  Can you give me a list of things that you think may be wrong that I can add to my list?  I want to make sure doctors are checking for everything.

Any advice you can offer would be appreciated.  We are currently seeing 4 different doctors.  Gastro, Neuro, Internal and Rheumo.

Thanks



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To answer your questions:
1) It is possible to have a recurrence of staph infection if the source is not coming externally (i.e. an abscess from within).  This is not a common presentation for malaria.

2) Further evaluation of the liver is needed with enzymes that high.  Repeating the biopsy, as well as an MRCP can be considered to look at the biliary tree.  The elevated CK levels may be indicative of muscle disease.  Obtaining an aldolase level as well as biopsy can be considered.  Rhabdomyolysis (breakdown of the muscle) needs to be ruled out as well.  

These options should be discussed with your personal physician.  A hepatology consult should be obtained to look at the muscle enzymes.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_
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