High Liver Levels and Swollen Lymph Nodes: Concerns?

[sd1093]

I have been experiencing a few worrisome symptoms over the past 6 months, and would like to put my worries to rest. I had a routine physical done by my PCP in the beginning of April. I originally wanted to talk to my doctor because my lymph nodes felt swollen. He didn't think so, so he ordered a thyroid ultrasound for precautionary measures and it came back fine. However, when my blood test results came back, the doctor found my liver enzymes to be elevated. I had another blood test done three weeks later, and my liver enzymes came back high once again, so my PCP ordered an ultrasound of my liver and surrounding abdomen. The ultrasound came back fine, and my doctor wanted me to check back with him in a month. A month passed and I had my third blood test early last week. My liver enzymes came back a bit high, but they were lowering back to normal. I told him about the lymph node behind me ear that is swollen and how I get a radiating, head-ache like pain from it once in a while, but he told me it's nothing to worry about. My doctor wants me to check back in two or three months for another blood test, but in the meantime, I am concerned what it might be since we never found out what has caused these high liver enzymes. I'm 21 years old, I only have about 5 drinks a week, and I'm not on any medications. I originally thought it may have been a case of mono, but I never got the sore throat and fever that is commonly attributed to mono. Also, my girlfriend is showing no symptoms at all.

Some of the symptoms I have been experiencing in addition to the elevated liver enzymes:

-Fatigue
-Swollen lymph nodes (Lymph node behind ear sometimes produces headache like pain)
-Reoccurrence of pain in the joints (fingers, elbow, wrist, armpit, knees)
-Reoccurrence of dull achey pain in upper right breast (inch above nipple, near armpit), as well as dull achey pain below armpit
-My abdomen feels a lot more tender than it used to be. Whenever my girlfriend rests her head on my abdomen, it feels uncomfortable. Not painful, just an uncomfortable feeling.

Not so often symptoms, but have experienced a few times are:
-Brief, stabbing pain coming from right abdomen behind lower rib cage
-Brief, strange 1-second stabbing pain in pelvic area (interior pain, hard to describe)

Any thoughts on what it could be? Is lymphoma something I should be concerned about? May it actually just be mono? Could it be anything else?

Thank you!

[pralabd]

Hi, I’m having slight but similarly symptoms. Swollen inguinal lymph and high liver enzymes. Been about 3 weeks. Any updates on your condition?

[BrittanyB93]

I had the same thing happen to me. I was diagnosed with Lyme Disease. It has progressed to chronic lyme disease and is now effecting my heart, liver and gallbladder and possibly my kidneys at this point. I knew I was bit by a tick but most people never do so I would definitely get tested. The longer you go untreated the worse it will become.

[sd1093]

Thanks for your help! I really appreciate it. I will definitely keep it in mind on my neck visit to the doctor.

[Ken_PA]

Well, Lyme is something to keep in mind if no other diagnosis pans out - it might not be the most likely cause of all possibilities at this point. Most people do not see ticks or even get the bullseye rash.

[sd1093]

Ken, sorry for the late response.

I went to school in the Hudson Valley, and I live on Long Island, so yes I live in the heart of Lyme country, but I have not noticed any ticks on my body over the past several months.

[Ken_PA]

Maybe you have some virus which has got into the liver - saying so because you've got the elevated enzymes plus some occasional liver area pain.


The enlarged node behind the ear? Usually that would mean some problem in the surrounding area that is drained by that node - but you've reported none.

OTOH, one infection that's known for causing painful nodes remote (such as in the neck) from the site of infection is Cat Scratch Fever. When a node swells, the stretching of its enclosing 'capsule' can cause the pain. But lymphoma nodes usually aren't painful because the cancer grows right through the node and so doesn't stretch it.

But you've got possible inguinal and other involvement also, which would lead to a DDx such as here:
https://en.wikipedia.org/wiki/Generalized_lymphadenopathy

Wikipedia is not authoritative but is usually a good place to start. Or this:
http://www.aafp.org/afp/1998/1015/p1313.html


Do you live in Lyme country?

[sd1093]

Ken, thanks for the quick response.

There is no family history of autoimmunity.

[Ken_PA]

Hi, the short answer is that it doesn't sound like lymphoma. It's more likely infection or other "immune activation".

Any family history of autoimmunity?