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Ask Dr. Arun Phophalia Your Own Question
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 32597
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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i have been sick for 2 weeks, fatique,high liver reading ...

Customer Question

i have been sick for 2 weeks, fatique,high liver reading 278 ,night sweats,swollen glands,headache..they have done an ultra sound on my liver,kidney and gallblatter..all is clean with the exception of 3 gall stones 15mm in size
Submitted: 8 years ago.
Category: Health
Expert:  Dr. Arun Phophalia replied 8 years ago.

Greetings.

Do you have any pain abdomen, nausea, vomiting, fullness, bloating of the abdomen?

Which of your liver enzyme is raised; ALT, AST?

Dr. Arun

Customer: replied 8 years ago.
i have none of those..i am not sure which liver enzyme it is.i have no energy,and no other ailments.the doctor i am seeing does not think it's as a result of the gallstones as there are too large to be causing any blockage.white cell count slighty evelated
Expert:  Dr. Arun Phophalia replied 8 years ago.

Hello,

I agree to your doctor as any of your symptoms like fever needs to be associated with atleast pain abdomen, nausea and loss of appetite, it was due to gallstones or cholangitis (infection and inflammation of the common bile ducts).

Just a single enzyme raise of liver, with slight elevation of white blood counts (leukocytosis) and your symptoms points towards some viral illness. A single enzyme raise of this magnitude is not very significant also. All viral illness are usually self limiting and should be well in the course of getting better in couple of days time.

A blood culture would ideally be done to rule out the any bacterial infection, which would further substantiate the viral illness diagnosis.

Feel free for your follow up questions.

Dr. Arun

Dr. Arun Phophalia and 2 other Health Specialists are ready to help you
Customer: replied 8 years ago.
i do have a loss of appetite and this is now going on for over weeks and i don't feel any better....
Customer: replied 8 years ago.
if the liver showed no tumor and the bllod test showed no markers for cancer do you think cancer can be ruled out?
Expert:  Dr. Arun Phophalia replied 8 years ago.

Hello,

I would suggest you a CT scan of the abdomen with intravenous and oral contrast, 5-nucleotidase, liver scan, CEA, if it has not been done previously.

Your second post do mention about the tumor markers. Yes, if tumor markers are normal and liver is normal by ultrasound, liver cancer is unlikely. Still CT and liver scan are more sensitive to conform it. 

Dr. Arun

Dr. Arun Phophalia and 2 other Health Specialists are ready to help you
Customer: replied 8 years ago.
they did an ultra sound on the liver,kidney etc. but if this is a virus do you find it unusual that it been over 2 weeks and i am not feeling any better
Expert:  Dr. Arun Phophalia replied 8 years ago.

Hello,

Yes it is bit unusual, but still some virus can cause this prolong illness. Cancer do not present with fever commonly though.

Dr. Arun

Customer: replied 8 years ago.
i have never had a fever
Expert:  Dr. Arun Phophalia replied 8 years ago.

Hello,

I am sorry. I apologize. I thought, when you wrote sick, fever or feverish may be associated or meant by it. Ultrasound is good diagnostic imaging for ruling out the liver cancer, but CT scan is still better. You may go for it, although it would in all likelihood be normal. Have they performed all of the virus serology like hepatitis A, B, C, etc?

Dr. Arun

Customer: replied 8 years ago.
HETP a & b negative and waiting for the results for C to come back tomorrow. it sounds like my doctor is doing pretty much what you do..any guesses of what this could be, virus?
Expert:  Dr. Arun Phophalia replied 8 years ago.

Hello,

Yes, this is the usual standard protocol. Your doctor is taking good care of you and are taking all the steps in the management of the problem. Still feel, it is a virus.

Dr. Arun

Dr. Arun Phophalia and 2 other Health Specialists are ready to help you
Customer: replied 8 years ago.
thank you
Expert:  Dr. Arun Phophalia replied 8 years ago.

You are most welcome.

I wish you a very speedy recovery.

Dr. Arun