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Dr. Brims
Dr. Brims, U.S. Licensed Physician
Category: Health
Satisfied Customers: 9206
Experience:  U.S. Licensed Physician, general surgery and internal medicine experience
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Bilirubin 1.9 High mg/dL (0.0-1.1) Urobilinogen 4.0

Resolved Question:

Bilirubin 1.9 High mg/dL (0.0-1.1)
Urobilinogen 4.0 High EU/dL (0.0-1.0)
Bilirubin NEGATIVE (NEGATIVE)

I have had MS for the past 13 years and taken Copaxone for over 10 years. New Neurologist has put me on Tysabri and I have had one infusion. Could any of these meds cause these high results?
Submitted: 2 years ago.
Category: Health
Expert:  Dr. Brims replied 2 years ago.

Dr Brims :

Hello, welcome to Justanswer, I will try to assist you with your medical question, and any medical information you seek

Dr Brims :

Why did you get this test?


 

Dr Brims :

Did you have other liver enzymes tested like ALT and AST?


 

Customer:

I took a urine test for pre-employment and they noticed a high bilirubin count and wanted me to have it checked out by my physician. She did a battery of blood and uring tests but has not gotten back to me yet. I have access to the lab results.


 

Dr Brims :

SO you don't have the results of the other tests?


 

Customer:

Yes.....


 

Customer:























































Hepatitis A+B+C Virus ProfileChemistry/Hematology16 Oct 2012 @ 0923
























































Test NameResultUnitsReference Range
Hepatitis B Virus Surface AgNEGATIVE NEGATIVE
Hepatitis B Virus Surface AbNEGATIVE
Hepatitis B Virus Core AbNEGATIVE NEGATIVE
Hepatitis A Virus Ab IgMNEGATIVE NEGATIVE
Hepatitis C Virus AbNEGATIVE NEGATIVE
Ordering Provider: 18058 GROFF, JENNIFER M
Ordering Location: 42nd Medical Group



[IMAGE][SRC][/SRC][ALT][/ALT][WIDTH]100[/WIDTH][HEIGHT]100[/HEIGHT][STYLE][/STYLE][/IMAGE]Prostate Specific AgChemistry/Hematology16 Oct 2012 @ 0923
































Test NameResultUnitsReference Range
Prostate Specific Ag0.93 ng/mL (0-4)
Ordering Provider: 18058 GROFF, JENNIFER M
Ordering Location: 42nd Medical Group



[IMAGE][SRC][/SRC][ALT][/ALT][WIDTH]100[/WIDTH][HEIGHT]100[/HEIGHT][STYLE][/STYLE][/IMAGE]Comprehensive Metabolic PanelChemistry/Hematology16 Oct 2012 @ 0923


























































































































Test NameResultUnitsReference Range
Albumin4.0 gm/dL (3.4-5.0)
Bilirubin1.9 Highmg/dL (0.0-1.1)
Calcium9.3 mg/dL (8.5-10.1)
Carbon Dioxide30 mmol/L (21-33)
Chloride104 mmol/L (98-107)
Creatinine1.1 mg/dL (0.8-1.3)
GFR Non-Black>60 mL/Min
GFR Black>60 mL/Min
Glucose102 Highmg/dL (70-99)
Alkaline Phosphatase126 Units/L (36-136)
Potassium5.0 mmol/L (3.5-5.1)
Sodium142 mmol/L (136-145)
Alanine Aminotransferase31 Units/L (12-78)
Aspartate Aminotransferase20 Units/L (15-37)
Urea Nitrogen9 mg/dL (6-19)
Protein6.8 gm/dL (6.4-8.2)
Ordering Provider: 18058 GROFF, JENNIFER M
Ordering Location: 42nd Medical Group



[IMAGE][SRC][/SRC][ALT][/ALT][WIDTH]100[/WIDTH][HEIGHT]100[/HEIGHT][STYLE][/STYLE][/IMAGE]Lipid PanelChemistry/Hematology16 Oct 2012 @ 0923






























































Test NameResultUnitsReference Range
Cholesterol205 Highmg/dL (0-200)
HDL Cholesterol31.0 mg/dL (>40)
Triglyceride148 mg/dL
LDL Cholesterol144 mg/dL
VLDL Cholesterol30 mg/dL
Cholesterol/HDL Cholesterol6.6 (<5)
Ordering Provider: 18058 GROFF, JENNIFER M
Ordering Location: 42nd Medical Group



[IMAGE][SRC][/SRC][ALT][/ALT][WIDTH]100[/WIDTH][HEIGHT]100[/HEIGHT][STYLE][/STYLE][/IMAGE]CBC W/o DiffChemistry/Hematology16 Oct 2012 @ 0923
















































































Test NameResultUnitsReference Range
WBC7.4 x 10*3 (4.8-10.8)
RBC4.92 x 10*6 (4.7-6.1)
Hemoglobin15.2 gm/dL (14.0-18.0)
Hematocrit42.8 % (42-52)
MCV87.0 fL (80-94)
MCH30.9 pg (27-31)
MCHC35.5 gm/dL (32-36)
Platelets134 x 10*3 (130-400)
RDW CV12.0 % (11.5-14.5)
Ordering Provider: 18058 GROFF, JENNIFER M
Ordering Location: 42nd Medical Group



[IMAGE][SRC][/SRC][ALT][/ALT][WIDTH]100[/WIDTH][HEIGHT]100[/HEIGHT][STYLE][/STYLE][/IMAGE]UrinalysisChemistry/Hematology16 Oct 2012 @ 0923


































































































Test NameResultUnitsReference Range
ColorYELLOW (YELLOW)
AppearanceCLEAR (CLEAR)
GlucoseNEGATIVE mg/dL (NEGATIVE)
BilirubinNEGATIVE (NEGATIVE)
KetonesNEGATIVE mg/dL (NEGATIVE)
Specific Gravity>=1.030 (1.003-1.030)
BloodNEGATIVE (NEGATIVE)
pH6.0 (5-9)
ProteinNEGATIVE mg/dL (NEGATIVE)
Urobilinogen4.0 HighEU/dL (0.0-1.0)
NitriteNEGATIVE (NEGATIVE)
Leukocyte EsteraseNEGATIVE (NEGATIVE)
Ordering Provider: 18058 GROFF, JENNIFER M
Ordering Location: 42nd Medical Group



Dr Brims :

Your other liver enzymes are normal


 

Dr Brims :

Do you have any eye or skin discoloration?


 

Customer:

No


 

Customer:

No jaundice


 

Customer:

Very little alcohol consumption; maybe a wine cooler a moth


 

Dr Brims :

Okay, the medication tysabri may cause liver damage and elevated bilirubun


 

Customer:

Ahhh. Wasn't sure on that one as they are still compiling any negatives on it. Let me look for a past blood test. just a sec.


 

Dr Brims :

You should stop all alcohol for now, since your liver enzymes are normal your liver ,ay be in the recovery phase, bilirubin takes longer to elevate and decline than AST and ALT


 

Dr Brims :

I would also recommend you have a blood test called an INR, which is very sensitive for liver damage


 

Customer:

I will suggest that to my physician.


 

Dr Brims :

I also think you need to have the bilirubin retested 4 -8 weeks after the last test


 

Customer:

Military websites.....so slow! let me check my previous


 

Customer:

Here is one from April, before I started the Tysabri.


 

Customer:










Comprehensive Metabolic PanelChemistry/Hematology18 Apr 2012 @ 0822























































































































Test NameResultUnitsReference Range
Albumin4.2gm/dL(3.4-5.0)
Bilirubin1.7 Highmg/dL(0.0-1.1)
Calcium9.2mg/dL(8.5-10.1)
Carbon Dioxide29mmol/L(21-33)
Chloride105mmol/L(98-107)
Creatinine1.2mg/dL(0.8-1.3)
GFR Non-Black>60mL/Min
GFR Black>60mL/Min
Glucose103 Highmg/dL(70-99)
Alkaline Phosphatase118Units/L(36-136)
Potassium5.4 Highmmol/L(3.5-5.1)
Sodium143mmol/L(136-145)
Alanine Aminotransferase49Units/L(25-65)
Aspartate Aminotransferase15Units/L(15-37)
Urea Nitrogen12mg/dL(6-19)
Protein7.0gm/dL(6.4-8.2)
Ordering Provider: 18058 GROFF, JENNIFER M

Ordering Location: 42nd Medical Group


 





Customer:

Possibly liver damage due to years of Copaxone (Interferon)? I was started on Avonex for about two years after diagnosis.


 

Customer:

Excuse me....Avonex was the interferon NOT Capoxone.


 

Dr Brims :

These results are similar


 

Customer:

Copaxone is a glatimer acetate


 

Dr Brims :

Ok


 

Dr Brims :

You should have the liver enzymes retested in 6 weeks, along with the direct and indirect bilirubin


 

Customer:

Very close. But a slight increase nonetheless. Thank you very much for your consult. You have been very helpful. I will do as suggested.


 

Dr Brims :

You're quite welcome


 

Dr. Brims, U.S. Licensed Physician
Category: Health
Satisfied Customers: 9206
Experience: U.S. Licensed Physician, general surgery and internal medicine experience
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Dr. Brims
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U.S. Licensed Physician, general surgery and internal medicine experience