Resolved question:
A week ago, I was in the ER for a few hours due to a kidney infection (first one in 12 years) that wasn't responding to antibiotics and that was causing my fever to continue to spike to around 105 degrees. When I was at the ER, they ran labs and put me on IV fluids, antibiotics, anti-inflammatory meds, pain meds, and Zofran, and sent me home a few hours later when my vitals became normal. However, I looked online at my blood test results and my liver enzymes and blood gas test results were all highly abnormal, and I'm wondering how concerned I should be. I assumed that they wouldn't have sent me home if there were concerns about the results, but then again they never discussed the results and so many of them are irregular that I wasn't sure how to respond (I sent my primary care doc at the university health center a note, but he hasn't responded). I'm hoping that it was all just caused by inflammation from the fever but I don't know. I've noticed little sharp sporadic pains on the right side of my abdomen but it goes away in a couple seconds and doesn't come back for hours so it's nothing I'd take notice of were it not for the test results.
My medical background: 28 year old female, 5'1'' and 135 lbs
* Current medications: Wellbutrin, Klonopin (as needed), Zofran, Calcium, Calcitriol, Yaz
* Current diagnoses and recurrent issues: Pseudohypoparathyroidism (with low calcium and high phosphorus), Hashimoto's (a thyroid nodule was found but it was determined not to be serious in the last couple of ultrasounds), hypokalemia, gastroparesis, heavy/irregular periods with a history of ovarian cysts, autoimmune gastritis (with iron and b12 deficiencies -- iron infusion last July, b12 injection one month ago), major depression
* Lifestyle stuff: Non-smoker, no drug use, social drinker (about 5 drinks a week, 2-3 at a time), exercise 5x/week (mainly cardio)
* Family history: heart disease (both sides), cancer (mother's side -- her father had pancreatic cancer that spread to his liver), diabetes (mother's side)
Submitted:
4 Days
Category:
Gastroenterologist, Medical
Hello,
Thanks for your query at DoctorSpring.com
I understand your concern
Your white cell count is high which is due to the infection you had. White cell count increases when you get infection.
Some of the parameters in your blood gas report is out of range. But it has to be correlated with the clinical findings. Since you are feeling better, those things can be ignored.
Your liver function test apppears deranged. The AST and ALT are significantly high. Further evaluation is needed. The probable causes are viral infection, autoimmune and metabolic diseases, fatty liver disease and drug induced liver injury.
Consult a hepatologist for further evaluation.
I hope that answers your query.
Let me know if I can assist you further.
Regards,
Dr.R.K.
Thanks. I'm better on the fever front but I pretty much always have significant GI issues, but it's always been assumed to be the combination of gastroparesis and antidepressants. My liver enzymes have been slightly elevated before, but nothing nearly this high (before it was just about 5 points too high), but they're usually normal (they were normal 6 weeks ago, slightly elevated 6 months ago). Would I have to worry about fatty liver disease if I'm a normal weight, don't drink much, and eat healthily (when I eat... low appetite)? (While 135lbs, I'm routinely told I look more like 120, but I'm really athletic and have a lot of muscle weight). I had a few overdoses in the last couple of years (a bottle of Tylenol with a bottle of Valium in 2013, a bottle of Valium with a few drinks in 2014, a bottle of Klonopin with a few drinks at the beginning of the year), though none in the last few months and since then I've had normal liver enzymes readings in a couple separate blood tests, most recently when I was in the ER for electrolyte issues in mid-April and I've been really responsible since then with respect to managing mood, meds, food and booze, exercise, etc. but I wasn't sure how much these completely anomolous (for me) results could have anything to do with my earlier acts with respect to my severe depressive episodes.
Thanks,
Miranda
Hi,
Sometimes the raise in liver enzymes could be due to insignificant causes and also difficult to know what is causing it.
I do not think this could be a result of your earlier acts.
As advised earlier you can get tested for the common causes like viral infections, autoimmune and metabolic diseases.
You can repeat the liver function test after 4 weeks.
Regards,
Dr.R.K.
Thanks. Hypothetically if it is a metabolic or autoimmune issue (I already have two autoimmune conditions...), would it produce consistently abnormal liver enzyme tests, or could they fluctuate from normal and abnormal?
Metabolic can fluctuate whereas autoimmune is always consistent with abnormal liver enzymes.
Regards.
In looking at metabolic liver issues, I'm wondering whether Wilson's Disease is something that would have come up in normal batteries of test (CBC, metabolic panel, and whatever panel of tests it is that looks at protein, AST, ALT, bilirubin, etc.) such that it shouldn't be a concern, or is it something to ask my primary doc about given these results? (I know it's rare and I don't want to be hypochondriacal, but I have a lot of the symptoms listed -- tremor, depression, low blood sugar, fatigue, lack of appetite, muscle stiffness, bruising easily, etc. -- which of course I know can also be associated with other more minor things (with a history of anemia, the bruising and fatigue makes sense, with the calcium issues the muscle tension and cramps make sense, etc.). But since I do have so many of the symptoms, it seemed worth asking.
Wilson's can be easily diagnosed by ultrasound whole abdomen, which will show the enlargement of liver ( due to copper deposits ) as well as the AST, ALT will be persistently high.
You can do Ultrasound/ CT Abdomen for the same.
Regards.