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Re: Elevated liver enzymes

Posted By HFHSM.D.-rf on October 24, 1998 at 12:42:04:

In Reply to: Elevated liver enzymes posted by Kristy on October 19, 1998 at 15:48:02:

My fiance has had several blood tests in the last 3 months due to an initial result of elevated liver enzymes.  He is 31 years old and in good health and does not have a history of liver problems or hepatitis.  He was tested for hepatitis after the first test result and is negative.  However, his liver enzymes are increasing.  He is a social drinker, rarely drinking more than a few at an occasional party.  He refrained from any drinking for 6 weeks prior to the 2nd test yet his enzymes were even more elevated.  
He has an appointment with a specialist (gastroenterologist) in a few weeks, however, I am wondering if this may be the result of a blood transfusion that he received in 1983.  My uncle has an identical situation and has been seeing doctors for more than a year with no diagnosis (his blood transfusion was in Vietnam).
My question is:  Has anyone heard of liver damage from blood trasfusions without testing positive for hepatitis?  What should we be looking for and what questions should we be asking?  What are the other conditions that could be causing this to happen to a young and healthy man?
Dear Kristy,
There are many causes for chronic elevations of liver tests.  As was done in the case of your fiancee, it is necessary to exclude hepatitis B and C infection.  Alcohol can be excluded if your fiancee stops alcohol use COMPLETELY FOR SEVERAL MONTHS.  If he is taking any medications, he should notify his doctor to learn if the drugs can be stopped.  Industrial exposures must be considered.  Once environmental causes have been excluded it is necessary to look for autoimmune liver disease and metabolic liver disease (especially Wilson's disease, a condition of copper overload).  These diagnoses can be evaluated with a series of blood and liver tests.  If all the noninvasive testing does not provide a diagnosis and the liver tests remain elevated, then a liver biopsy is needed.
This information is presented for educational purposes only.  Always ask specific questions to your personal physician.
IF you wish a second opinion, we would be happy to see you in the Division of Gastroenterology.  You can make an appoinment by calling the Physician Referral Line at (800)653-6568 and requesting an appoinment with Dr. Fogel.
*keywords: elevated liver tests
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