Medical Questions? Ask a Doctor Online!
Do you have the actual lab results?
Have these abnormal labs only recently been discovered?
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.
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.