WHat are the antibiotics doing?

[JAG10]

I could really use your input friends. Some of you may have read the AST/ALT thread from Wed/Thursday. my dd11 was in CT having ivig. Her chem panel came back that her AST is 349 and ALT is 729, reallllllly bad. The month prior to this, doc had added Bactrim to Zith bcs dd11 had an unexplained uptick in symptoms (end of April) that made him suspect lyme/bartonella (recent labs totally clean, no more Bactrim); plus she was taking ibuprofen for headaches, but usually about 200mg/day. First week of May, my dd7 has an uptick as well which makes me now suspect strep. Increase her from every 3rd day zith to everyday and the symptoms are gone in 6 days but keep her at daily zith until we see doc last week. Fine.

 

So, this Thursday is when these crazy liver numbers come to light, all meds, ALL are stopped for dd11 and she seems no worse for it. A couple mild headaches yesterday, but she just had ivig the day before. Now I'm thinking, jeez, if dd11's liver is stressed out, perhaps dd7 should go back to every 3rd day zith like before. SOoooooo, I don't give her the Zith for TWO days and the symptoms are back. She's got the lip-licking ring around her mouth right now.

 

What is going on with my kids??? My girls don't get symptoms for strep except behavioral ones. The only way I'll know for sure is to run ASO/aDNAse B. Was the full dose zith holding off the infection, but not clearing it completely??? DD7 was fine on prophylactic dose before the beginning of May, now I can't take her back down??? DD7 could probably handle the daily zith since she isn't taking anything else.....but WHY is it now needed?

 

I can call the office on Monday, but what am I asking for???

[kimballot]

JAG - I'm not sure if I have this correct -

 

DD11 - gets IVIG, started on bactrim (in addition to zith) in May, and was taking ibuprofen. Early June her liver enzymes were up, AND she had IVIG in early June. She is now off bactrim and off zith, and labs show no bartonella.

 

DD7- Incrase of symptoms in early May with suspected strep. Zith was increased to every day and symptoms went away. You cut dd7 zith back to every 3rd day and symptoms returned.

 

 

If this is correct.....

 

I am wondering if dd7 has strep or some other infection that was not cleared with the 4 weeks of daily zith, but was kept at bay with the 4 weeks of daily zith.

 

 

dd11 may be protected from whatever dd7 has right now because she just finished IVIG and inflammation is down and good antibodies are high. However, she may not be quite so protected in a few weeks - and if her sister is harboring something you may be headed for a crash.

 

 

Could you get liver enzymes (her liver may be just fine right now), strep tests, and mycoplasma on dd7 - and put her back on daily zith until you figure out what is going on. Also - has she been tested for lyme and co-infections?

 

 

I do not know what precautions need to be taken for dd11 re: antibiotics, but I am wondering if some of the natural antibiotics that folks talk about might beneficial if she cannot be on pharmaceutical antibiotics. I don't know if things like olive leaf extract tax the liver. Also, you may want to post on the lyme board and ask about liver detox. The folks there seem to be very good at that and there are many natural options to help with that.

[momofgirls]

I know that I am a little paranoid about the lyme stuff but I just wanted to reply to this thread with a little different perspective regarding the elevated liver enzymes. I have read that sometimes lyme and other chronic infections can actually cause liver congestion/damage causing the liver enzymes to rise and even cause jaundice. I know you said that the labs were clean and no evidence of tick borne disease were present but if your daughter was receiving high dose ivig prior to testing, isn't it possible that the immune response was supressed resulting in potentially a false negative? I could be totally wrong but it's worth considering re-testing after a good period of time post ivig like maybe 3 months? Anyway, I just did a quick search to see if I could find anything to support my theory. See link below. Again, I could be totally off on this but if your child still has symptoms and elevated liver enzymes, I think it could be due to the underlying infection and maybe not the antibiotics.

 

http://www.ehow.com/about_5139926_can-disease-cause-liver-problems.html

[tpotter]

1) Go see a gastroenterologist (I'll email you one here in PA who we use.)

 

2) Our DS has the exact same symtpoms, only AST and ALT weren't as high (but high enough that Dr. L. was concerned and told us to see the gastro.)

 

3) Same happened when we stopped all abx, because we were really worried about the rising numbers.

 

4) DS15 got very, very sick almost immediately. ASO elevated, spleen enlarged, WBC low. We figured the same thing...that abx were just keeping it at bay.

 

5) Gastro said to use anything except Azith (that's what we had been using.) Yes, there are other abx that are rough on the liver, and with as high as your child's I would definitely see a gastro immediately.

 

6) Trip to ER.

 

7) Finally got IV abx...he's supposed to be on for 2 weeks (round the clock...I'm exhausted, because it includes IV at 2 a.m.) But, so far, things seem to be imnproving with symptoms.

 

8) Rechecked liver enzymes on Thursday. My fingers are crossed, because the IV abx we are using (not azith) is pretty hard on the liver, too.

[JAG10]

Thank you, Ladies, so much!.

 

Kim, you summed it up much better than I did. I'm thinking of calling Monday, asking for lab work for dd7 for strep and perhaps mono, and then asking if we can switch her to Augmentin instead of Zith.

 

MomofGirls; My dd11 now has 3 negative Western Blots; one before any ivig, and 2 from Igenex- one 6 months after ivig and one this month. The only band consistent on the 3 tests in 41 and this last one didn't even have the IND band the previous one did even after months, heck over a year on different HD abx. The dr said he and the director of the lab have confirmed the ivig does not impact the igenex results, he hands the igenex "kits" out in the office. DD11 also has two previous AST/ALT results in the past 18 months completely in the normal range. In order of likelihood the suspects are abx, ibprofen, hepatitis A, or possible EBV. We were doing detox (AbsorbToxins) last month with the zith and Bactrim plus tons of fluids and probiotics. No rashes, no behavioral changes, nothing....if it weren't for the lab results, I'd have no idea.

 

Trudy-It's my younger dd7 who had an uptick in symptoms 2 days after stopping abx. My dd11, with the awful liver enzymes, hasn't taken anything...not one pill since Thursday and she's actually doing better. This time she only took 3 days of prednisone instead of the typical 6 prescribed and she's had NO headaches or nausea which she did have with the last ivig with the pred and ibuprofen for days following. I'm waiting to repeat the labs in another week or so. If they haven't dropped, I'll officially freak out. Did you know you can elevate your AST/ALT by drinking alcohol before the draw.....or taking meds that irritate the liver hours before the draw, which she did. All of her other liver markers on her chem panel were fine, she has no symptoms of liver distress at all.....she actually seems better, like better behaviorally and cognitively too.... I'm going to wait for repeat labs before making any other moves about my older girl.

 

Sigh.....this life isn't for wimps!

[sf_mom]

If you investigate Lyme again I would NOT test for antibodies but perhaps consider doing the Dot Blot or provocation testing that looks for DNA in urine. We have similar Lyme results and are band 41 positive only via Igenex and would have never found the Lyme via antibody testing in our children. One child does test positive of Babesia/Bartonella while the Lyme results are negative via antibody test.

 

Tpotter is correct in saying that some antibiotics are tougher on the liver than others and so a potential antibiotic switch might be necessary. BUT, here are a couple of symptoms of Babesia that directly impact liver and may increase with treatment. I am suspected of having Babesia (Lyme is positive, Babesia is negative) and currently being treated for Babesia based on clinical diagnoses. My liver enzymes are climbing and we are watching closely. I am trying to manage 'if I can' with bile binders to help liver detox. I drink a cup of Bentonite Clay daily at bedtime. I am on Doryx/Clindomycin with pulsed Tindamax & Alinia.

 

1. Spleen and/or liver enlargement
   
2. Laboratory abnormalities that may include low white blood cell count, low platelet counts, mild elevation of liver enzymes, and elevated "sed rate"
   

 

http://www.latitudes.org/forums/index.php?showtopic=10804&pid=114452&start=&st=#entry114452

Edited June 5, 2011 by SF Mom