AST and ALT liver enzyme tests

[JAG10]

Sorry Kelly, pulling information from nurses via text through dh is no small fete!!!!!

 

So far, I've got the AST was elevated but NOT ALT. Don't have a number yet. Do I not rub off on him in any way???? ASK MORE QUESTIONS!!! :wub:

 

 

Last text to dh to ask PA in for doc today... Since ALT is more specific to liver than AST and her AST is elevated, but ALT normal, is it possible brain inflammation can be suspected as a cause for an elevation in AST when ALT is WNL???

 

Since it is not Dr. B, not sure they will know what to make of that question....but that is what we are getting at here, correct?

Edited June 2, 2011 by JAG10

[PhillyPA]

Ok Kelly - here are my son's results...

 

Onset of sickness and no antibiotics:(2007)

 

AST-35

ALT - 15

 

2008 - still no antibiotics

 

AST - 33

ALT - 20

 

2008 - treated for suspected Lyme disease with IV antibiotics for 6 weeks

 

AST - 47

ALT - 37

 

2010-on augmentin prior to first ivig

 

AST - 42

ALT - 41

[P_Mom]

Jill....yep, that is exactly what I am wondering.

 

Does anyone out there have any AST and ALT results for themselves or anyones else (non PANDAS) in the family? Just curious what they are as mine are so low...so are hubbys and so are my other sons....yes, he is PANDAS but very mild. (in fact no noticeable flair for him this school year for the first time ever!)

 

Pam...interesting....so, in the beginning, he had higher end AST...5 more points and he would be flagged. My question is...why??? (top range is 40)...ALT low...no antibiotics. Same for next one...still no antibiotics....(but PANDAS is going on...like in the first reading) When antibiotics are given, the ALT, liver specific rises, along with AST (which is now flagged high) but then that could be picking up brain inflammation AND liver stress......right? Same with last one.....raised ALT and out of range AST...perhaps fo the same reasons? Am I making any sense? I am just thinking that raised AST may mean more than liver stress...maybe brain "stress" in our kids.

 

Anyone got some control numbers? I'll dig up mine, hubby's and others sons and post in a few.....but, I know they are low.

 

Okay...actually found the rest of ours.

 

Mine (these were actually taken while I was getting IV Rocephin every day for my misdiagnosed Lyme...grrrrr).....they took labs every week.

 

4/01/09 AST 13 (low) ALT 14

3/25/09 AST 16 ALT 14

3/18/09 AST 13 (low) ALT 9

 

 

Older sons most recent hep. profile........AST 22 ALT 14 (on exactly same meds and supps. as younger brother...and for the same time frame)

 

 

Hubbys most recent....... AST 19 ALT 25

 

(My younger PANDAS sons numbers are in first post)

 

See what I mean? These are supposed to be low.....why are our kids on upper end or elevated???? How can two 42 year olds have better numbers than a 4 year old???

Edited June 2, 2011 by P.Mom

[JAG10]

Ok, scratch all that from before...we do not fit in the hypothesis.

 

Here's our numbers:

 

12/09

AST-26

ALT-17

 

11/10

AST-27

ALT-22

 

5/11

AST-346

ALT-729

 

Yes, I did repeat those numbers to doc to make sure I heard them accurately. We are pulling her off everything until we figure this out. Long story as short as possible, prior to last IVIG, dd had an unexplained uptick in symptoms which made doc question an IND lyme band and Bartonella. Bactrim was added to the Zithromax. When we returned home from IVIG trip, dd7 was also having an uptick in symptoms....now I get it! Increase dd7 from prophylactic dose zith to daily, symptoms gone in 6 days. DD11, more complicated, just had IVIG, headaches and nausea...what do you do? Give ibupren. Suspected strep based on lil sis's reaction, increase her zith. By week 3, she's complaining of fleeting nausea and headaches; no rashes, no significant behavioral changes. Is something dieing??? Or are all these meds putting strain on her liver resulting in nausea? Her coloring has been fine.

 

The good news; doc re-ran Igenex labs and everything came back completely clean, no INDs, just 41+igg which we are not concerned about at all. So there is no need for Bactrim, hopefully the med responsible for giving her liver a major attitude. Hopefully, we can soon re-introduce augmentin for protection since zith might be too much. We are re-running a chem panel and hep panel in two and 4 weeks.

 

It's funny, although I support those of you who are pursuing lyme for your kids, my instincts and my dd's hx have never been strong about lyme. That being said, as a mom who erroneously kept my dd on the psych med rat wheel for almost 3 years being backed into all types of diagnosis, I think it is important to keep an open mind; I've been wrong before. I was surprised at last visit to be adding Bactrim, but thought, ah, it can't hurt. Well, I guess for my kid the abx combo is too much and it probably wasn't anything dieing, but organ distress. But this is why we run the labs.

 

Sorry, Kelly. I know this wasn't the purpose of this thread.

[P_Mom]

No need to apologize! Just brainstorming.

 

 

 

Gulp! Make sure they rule out hepatitis.

[PhillyPA]

Jill what level of concern was your doctor about those numbers? Has he seen it before? Did he tell you not to worry about it? What levels do those numbers have to be to require hospitalization? Do they do anything to help bring those numbers down or is it more of a wait and see what happens?

[PhillyPA]

Here is a link to an interesting article relating to liver enzymes.

 

 

http://hepatitis.about.com/od/diagnosis/a/LiverEnzymes.htm

[thereishope]

Bactrim can be a nasty antibiotic in some and can cause side effects. One mom told me Bactrim is a very strong antibiotic and is used to sterilize the stomach or gut prior to surgery.

 

Ok, scratch all that from before...we do not fit in the hypothesis.

 

Here's our numbers:

 

12/09

AST-26

ALT-17

 

11/10

AST-27

ALT-22

 

5/11

AST-346

ALT-729

 

Yes, I did repeat those numbers to doc to make sure I heard them accurately. We are pulling her off everything until we figure this out. Long story as short as possible, prior to last IVIG, dd had an unexplained uptick in symptoms which made doc question an IND lyme band and Bartonella. Bactrim was added to the Zithromax. When we returned home from IVIG trip, dd7 was also having an uptick in symptoms....now I get it! Increase dd7 from prophylactic dose zith to daily, symptoms gone in 6 days. DD11, more complicated, just had IVIG, headaches and nausea...what do you do? Give ibupren. Suspected strep based on lil sis's reaction, increase her zith. By week 3, she's complaining of fleeting nausea and headaches; no rashes, no significant behavioral changes. Is something dieing??? Or are all these meds putting strain on her liver resulting in nausea? Her coloring has been fine.

 

The good news; doc re-ran Igenex labs and everything came back completely clean, no INDs, just 41+igg which we are not concerned about at all. So there is no need for Bactrim, hopefully the med responsible for giving her liver a major attitude. Hopefully, we can soon re-introduce augmentin for protection since zith might be too much. We are re-running a chem panel and hep panel in two and 4 weeks.

 

It's funny, although I support those of you who are pursuing lyme for your kids, my instincts and my dd's hx have never been strong about lyme. That being said, as a mom who erroneously kept my dd on the psych med rat wheel for almost 3 years being backed into all types of diagnosis, I think it is important to keep an open mind; I've been wrong before. I was surprised at last visit to be adding Bactrim, but thought, ah, it can't hurt. Well, I guess for my kid the abx combo is too much and it probably wasn't anything dieing, but organ distress. But this is why we run the labs.

 

Sorry, Kelly. I know this wasn't the purpose of this thread.

[JAG10]

Jill what level of concern was your doctor about those numbers? Has he seen it before? Did he tell you not to worry about it? What levels do those numbers have to be to require hospitalization? Do they do anything to help bring those numbers down or is it more of a wait and see what happens?

 

I'm not sure. Currently, she isn't having any overt signs of liver distress; her urine looks fine, her coloring/eyes are not discolored, no abdominal pain. Her doc is at a conference today, so my husband met with the PA who was very good, thorough and accessible. I was on speaker phone. I asked her if they were higher than she had ever seen before and she said no. She said they were not alarmingly high, but definitely a cause for concern that needs to be addressed promptly. IDK, maybe she didn't want me to panic.

 

Should I be panicking???

[P_Mom]

I wouldn't panic (lol..would I??)....I am sure whatever it is will resolve with time. It does look like, from the link Pam posted,that it could be some form of hepatitis, drug induced or whatever. I think hep produces the quickest, largest increase.

[JAG10]

Here is a link to an interesting article relating to liver enzymes.

 

 

http://hepatitis.abo...iverEnzymes.htm

 

 

Pulled from the article:

 

• An AST:ALT ratio equal to one (the level of ALT is higher or equal to AST), but the levels are very high, suggests acute viral hepatitis or drug-related hepatitis.
• An AST:ALT ratio higher than 2:1 (two times the level of AST to ALT) is very suggestive of alcoholic liver disease.
• An AST:ALT ratio higher than one (where the level of AST is higher than the ALT) could also indicate cirrhosis in a person that doesn't have alcoholic hepatitis

.....hmm, they don't comment on ALT being twice AST. I guess viral hepatitis (would have to be Hep A, right?) can rise up near 1000. She had the Hep B vaccine, not that that would mean anything.

Edited June 2, 2011 by JAG10

[JAG10]

Bactrim can be a nasty antibiotic in some and can cause side effects. One mom told me Bactrim is a very strong antibiotic and is used to sterilize the stomach or gut prior to surgery.

 

 

What kind of side effects? It seemed like it didn't do a thing.....except for the possible liver of an alcoholic.

[JAG10]

I wouldn't panic (lol..would I??)

 

:lol::lol:

[thereishope]

I've heard troubled breathing in a few kids, rashes. It may have taken a toll on her for now in terms of her liver, but if you're stopping it, it may correct itself.It may take a few weeks after stopping it.

 

Bactrim can be a nasty antibiotic in some and can cause side effects. One mom told me Bactrim is a very strong antibiotic and is used to sterilize the stomach or gut prior to surgery.

 

 

What kind of side effects? It seemed like it didn't do a thing.....except for the possible liver of an alcoholic.

[P_Mom]

I wouldn't panic (lol..would I??)

 

:lol::lol:

 

 

yeah...I thought that was funny, too. Here I am all jazzed up about his AST being 40!

 

Anyway...the liver of an alcoholic would have higher AST...so, we know she is not drinking.

 

She'll be okay.

 

 

Wait...I just looked at her numbers again.

 

Doesn't this statement fit?

 

•An AST:ALT ratio equal to one (the level of ALT is higher or equal to AST), but the levels are very high, suggests acute viral hepatitis or drug-related hepatitis.

 

She'll still be okay.

Edited June 2, 2011 by P.Mom