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Gastroenterology (Expert Forum)
possible hep? please help...
Answered by
Kevin Pho, MD - Internal Medicine
Kevin, M.D.
Boston - MA
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
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possible hep? please help...
by finsterman, Feb 26, 2007 12:00AM
Please help me determine what I might be dealing with. I will describe chronologically what has transpired.
October 3 – potential (?) risky sexual exposure, condom-protected (penetrative) sex, after exposed penis/vagina genital contact (non-penetrative)
November 28 – one night of nausea & vomiting/ stomach flu?????
Next 45 days – always chilled, generally/non-specifically felt unwell; armpit pain…
January 3 – negative HIV test (Orasure)
January 5 – started itching all over
January 30 - URQ pain; saw PCP - suspected Gall bladder issue. Blood/Urine results showed all within range/normal EXCEPT following: ALT elevated 49, GGTP elevated 124, Lipase elevated 148. (AST within range 20; amylase within range 74) Abdominal sonogram negative.
February 8 – URQ pain lessened to a degree; follow-up blood work showed all normal/within range. (ALT 43, Lipase 19, amylase 39) GGTP not tested for reason unknown. (AST was 22) PCP didn’t even test for hep. Why?
Today - still itchy all over, URQ pain/discomfort less intense than 1/30, but real, constant.
Is this indicative of Hep b/c?
Ie. Would blood work levels present differently if so?
Can I absolutely rule out hep b/c acute infection based on above?
What do you advise?
October 3 – potential (?) risky sexual exposure, condom-protected (penetrative) sex, after exposed penis/vagina genital contact (non-penetrative)
November 28 – one night of nausea & vomiting/ stomach flu?????
Next 45 days – always chilled, generally/non-specifically felt unwell; armpit pain…
January 3 – negative HIV test (Orasure)
January 5 – started itching all over
January 30 - URQ pain; saw PCP - suspected Gall bladder issue. Blood/Urine results showed all within range/normal EXCEPT following: ALT elevated 49, GGTP elevated 124, Lipase elevated 148. (AST within range 20; amylase within range 74) Abdominal sonogram negative.
February 8 – URQ pain lessened to a degree; follow-up blood work showed all normal/within range. (ALT 43, Lipase 19, amylase 39) GGTP not tested for reason unknown. (AST was 22) PCP didn’t even test for hep. Why?
Today - still itchy all over, URQ pain/discomfort less intense than 1/30, but real, constant.
Is this indicative of Hep b/c?
Ie. Would blood work levels present differently if so?
Can I absolutely rule out hep b/c acute infection based on above?
What do you advise?
Doctor's Answer
by Kevin Pho, MD, Feb 27, 2007 12:00AM
, Feb 27, 2007 12:00AM
Appropriate initial testing has been done. I would test for hepatitis given the liver elevations. The negative ultrasound is comforting.
With the itching, you can consider primary biliary cirrhosis - which can present with elevated liver enzymes and itching. Testing the antimitochondrial antibodies and an ANA level can suggest the diagnosis.
If the liver tests continue to be negative, you can consider other GI diseases. Various causes of dyspepsia can be considered - this can include GERD, inflammation of the upper digestive tract and an ulcer. An upper endoscopy or upper GI series can be obtained.
These options can be discussed with your personal physician.
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_
With the itching, you can consider primary biliary cirrhosis - which can present with elevated liver enzymes and itching. Testing the antimitochondrial antibodies and an ANA level can suggest the diagnosis.
If the liver tests continue to be negative, you can consider other GI diseases. Various causes of dyspepsia can be considered - this can include GERD, inflammation of the upper digestive tract and an ulcer. An upper endoscopy or upper GI series can be obtained.
These options can be discussed with your personal physician.
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_
Member Comments
by yoshi, Mar 09, 2007 12:00AM
Itchiness is also a symptom of kidney disease.
