Autoimmune Hepatitis

[nodaks]

I am writing hoping someone can shed some light on my recent lab results. 3 months ago I was diagnosed with Crohns disease and had a full liver panel test done which came back great. About 1 month ago I noticed dark urine and went back for a followup with my GI dr. Liver panels were again done and my enzymes were through the roof. alt of 1120 and ast of 783, total bilirubin of 1.6 with direct of .99, alk phos were 163. She immediately thought gallbladder so I had a ultrasound scan which showed my liver and pancreas looked normal, no bile duct dialation but maybe some sludge or very small stones. We have repeated blood tests 5 times thinking it would resolve if I had passed a stone but they continue to stay the same or rise. Most recently more blood tests were run including antibody tests. The following are the ones that came back abnormal. Iron serum, 209 (saturation and binding were normal) Ferritin was 1492, Ebstein Barr antibody IgG 2030, (Igm was normal), Ast was 894 Alt was 1328 , Total Bilirubin was 1.5 with direct being .85. Protein and Albumin as well as all other antibodies were normal. She is sending me to a liver specialist thinking this sounds like autoimmune hep. I am just wondering if this can come out of no where. Could I have completely normal liver tests 3 months ago and have developed this in such a short period of time, or does that mean I could have had it for a very long time and the spike in lab values mean that I have severly damaged my liver. What does Ebstien Barr antibody that high mean, could this cause autoimmune hep??  I am 43 years old with 4 kids to take care of, will this kill me or require me to have a liver transplant?? Any help from anyone going through this would be so much appreciated

[geterdone]

So, how are you dealing with your turret problems?

geterdone

[nodaks]

Sorry for lack of info. Yes I was tested for Hep a, b and c and all were negative. I did have antibody testing. None came back positive except for the Actin Smooth Muscle Antibody which was 59. Also besides my ferritin being so high my iron serum was also slightly elevated at 209 .Thanks for any info.
nodaks

[CoWriter]

Ebstein Barr .....a positive IgG with a negative Igm means previous EBV infection (If both were positive that would mean current infection).  High levels of IgG may be present and may persist at that concentration for the rest of your life.

The ferritin level is high (1492).  Normal for a female is 12-150.  This test shows higher than normal levels of iron in the body.  It can be caused by hemochromatosis, a genetic iron overload disease.  Hemochromatosis can be confirmed by doing a special blood test to detect the HFE mutation.

Autoimmune hepatitis can develop after viral infections like hepatitis A or B.....or after infection with the Epstein-Barr virus....which you've had.  The symptoms of autoimmune hepatitis can range from minor to severe and may come on suddenly or develop over time.

Blood levels of certain antibodies, like anti-nuclear antibody (ANA) and anti-smooth muscle antibody (SMA), are elevated in patients with autoimmune hepatitis.  You didn't mention whether those tests were done or whether you were tested for Hepatitis A, B and C.  

About half the people with autoimmune hepatitis have other autoimmune disorders.... and Crohn's disease is considered an autoimmune disease.  

In people with Crohn's disease, inflammation of the liver or bile ducts can also occur.... and that can cause abnormal liver tests.

I'm curious...are you taking Prednisone for the Crohn's?  or any other meds that could be causing a drug induced hepatitis?


"will this kill me or require me to have a liver transplant??"

You don't know whether you have autoimmune hepatitis....try not to awfulize.

Best of luck to you,


Source:
http://www.mayoclinic.com/health/autoimmune-hepatitis/DS00676