I am 21 mos out of a renal transplant. Recently I have lab results with increasing liver enyzmes. ALT=265, AST = 131, GGT=220. Neg for hep b/c. I haven't had any new medications since transplant with the following exceptions, all of which were discontinued 3 weeks prior to the first lab indicating elevated enzymes: one week penicillin concurrent with one week acyclovir, one week mouthwash (swallow) with hydrocortisone powder, nystatin, tetracycline, and diphenhydramine. two weeks tylenol, sporadically, never more than 3 g in one day.
At the time of the test, I was still taking viscous lidocaine for throat ulcers. Used two 100 ml bottles in four weeks, just started third bottle.
I seem to either be having a gastroparesis flare or something else. Nausea until I eat in the morning, abdominal pain after eating, gurgling, weight loss, no appetite, difficulty in staying even hydrated. I supplement with ensure.
Throat ulcers are two: larger than a quarter, one on each side of the uvula. Finally 99% healed, no new ulcers in the last four weeks.
Is this just a watch and wait situation? What else should I be tested for?
The next set of labs is for a hepatic panel, g6pd, and a repeat cmv (one previous test was negative). Throat was negative for herpes. Cultures for ebv and coxsackin on the throat never came back.