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Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
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Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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liver enzymes elevated, high white blood cell count, kidney

Resolved Question:

liver enzymes elevated, high white blood cell count, kidney damage from diabetes. Recently diagnosed with fibromyalgia and bulging l4/l5 disc to the right. last A1C was 8.1, but blood sugars are starting to stable out now. Had epidural steroid injection in the back 2 weeks ago, still dealing with major pain that 20mg of percocet every 4 hours and 10mg valium every 8 hours. Lupus tests neg. as well as rheumatoid arthritis.

Should I be concerned about a more serious illness than what I am already facing and what questions/tests should I ask my primary care for at my next visit?
36, overweight, non smoker, non drinker, no drug use, female, also dx with Polycystic Ovary Syndrome.
Submitted: 3 years ago.
Category: Medical
Expert:  Dr. D. Love replied 3 years ago.

Do you have the actual lab results?

Have these abnormal labs only recently been discovered?

 

Customer: replied 3 years ago.
I do not have the actual results, just rec'd a call from the dr. office saying that when I came in again on the 9th they were going to redo the test.

The first set of abnormal labs (kidney/liver) was in January. This is the second set of those being abnormal and the first for the white blood cell count being high.
Expert:  Dr. D. Love replied 3 years ago.

There are several possible causes of these lab results, but the pattern of abnormal labs may give a suggestion of the cause. One of the common causes of elevated liver enzymes and white blood count is a viral infection. Therefore, in someone that no other worrisome findings, it is common to simply repeat the blood tests to see if the elevations resolve. There are many other types of infections that can raise the white blood count. There also are a variety of conditions that can cause an elevation in liver enzymes. It can be related to a primary infection of the liver (hepatitis). There can be fatty infiltration of the liver, which is more likely to happen in someone with obesity and poorly controlled diabetes. It can be due to inflammatory conditions that affect the liver. It can occur due to gallbladder or pancreatic disease. There also can be liver irritation from a variety of medicines, but one of the common irritants to the liver is in someone that is chronically using high doses of acetaminophen, such as in the Percocet.

 

It is reasonable to first simply recheck the labs, as your doctor has planned. It is also important to achieve better control of the diabetes. If the liver enzymes remain elevated, then the next step is partly determined by the pattern of liver enzymes, but may involve specific blood tests for hepatitis infection, an ultrasound, or a CT scan of the liver. It also may require adjusting the medicines to lower the exposure to acetaminophen. If the white count remains elevated, then there should be investigation for an infection, which also may involve looking at the liver or gallbladder, particularly if the liver enzymes remain elevated.

 

Customer: replied 3 years ago.
Gallbladder was removed in 2005. I've also been trending with low grade fevers in the evening. My blood sugar tests are in the 79-125 range, depending on fasting or after meals.

I have been vaccinated against hep A and B in 1999.

I have been cleared medically by a cardiologist for the chest pain I have been experiencing over the last several months, including a PET scan, EKG, Echo, halter monitor, and cath.
Expert:  Dr. D. Love replied 3 years ago.

If there is no gallbladder, then that obviously could not be the cause. A viral infection would still be the most likely and could cause the low grade fevers. The blood sugars are improving, but the goal of treatment of diabetes includes achieving a HgbA1c at least <7.0 and some recommend a level of <6.5.

 

Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 13134
Experience: Family Physician for 10 years; Hospital Medical Director for 10 years.
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