result of LFT

[mbis]

My elder sister is suffering from spine TB. She is bed-ridden from Feb, 2015. She has been taking AKT 4 + Benadon since 08/05/2015. LFT was done on

09/05/2015           SGOT ( AST)- 31, SGPT (ALT)- 32.

17/05/2015           SGOT (AST) -37, SGPT (ALT)-  36

29/05/2015           SGOT (AST) - 183.SGPT (ALT)- 210.

Dr. suggested  to take UDILIV 300 & HEPAMERZ 150mg after meal (twice daily). Another LFT was done on 4th June.

04/06/2015           SGOT (AST) - 415, SGPT (ALT) -348, Alkaline Phosphatase-serum -189 U/l, SGGT -193 U/l.

After the 4th June LFT report, Dr. suggested to stop ATK 4 and Hepamerz 150mg. Benadon 40mg (half tablet daily) continues. Trisoliv Syrup and Ganaton Total is prescribed on this date.

21/06/2015           SGOT (AST) -41, SGPT (ALT) -57, Alkaline Phosphatase-serum -120 U/l, SGGT -71 U/l.

After this, the doctor prescribed R Cinex (450) to be taken once daily before breakfast and Zanocin OD 400.

07/07/2015           SGOT (AST) -101, SGPT (ALT) -99, Alkaline Phosphatase-serum -119 U/l, SGGT -79 U/l,        
                           Haemoglobin -10.4gm/dl, S.Creatinine -0.6mg/dl.

The same medication continued after this report.

18/07/2015            SGOT (AST) -146, SGPT (ALT) -140, Alkaline Phosphatase-serum -145 U/l, SGGT -86 U/l.

After this report, in addition to the above medicines, Amlodac 5 was prescribed. Doctor also suggested to start using Streptomycin injection (0.75g) for 2 months after conducting MRI, USG (upper abdomen), HbsAg, Anti- HCV, Anti Smooth muscle antibody and blood test for ESR, CRP and LFT. The results of these tests are awaited.

What can I infer about her condition in this regard? Pl. suggest whether the medication is following a proper trajectory. Your opinions and useful suggestions on this matter will be highly appreciated.

Thank You.

[mbis]

thanks for your suggestion.  All the tests have done as I mentioned earlier found  (-ve). Doctors  have started STREPTOMYCITIN Inj from 01/08/2015 for 2 months.

[fntn]

Her liver enzymes recovered and dropped to normal when her medication was stopped/modified. The levels were also normal before her treatments were started, back in the beginning of May. So clearly her medications have a big effect on her liver and is causing some mild injury.

The new blood work that her doctors recently did indicates that they are looking for possible concurrent diseases: viral hepatitis-B & -C (HAV, HAC) and autoimmune hepatitis (AIH). Given the fact that her therapy is already causing some hepatic injury, her doctors are just being careful in assessing all the possible conditions that may also be causing some damage.

If her medical treatments are only being applied for a short duration, her doctors will be willing to allow some minor liver injury. as collateral damage. But only if they know the full extent of the injuries and feel that they have complete control. The liver has amazing recuperative abilities. And treatments for TB last for 6 months or more, depending on the patient and the medications being used.

So her doctors will have to settle on the right combination of medications with her liver's health in mind. But you can have him do weekly or bi-weekly liver function tests to monitor things. There is no such thing as too much, if it gives you a piece of mind wrt not worrying about out-of-control liver damage. My doctors do a compete blood work set weekly.

Take care and hope your sister starts improving.