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Answered in 11 minutes by:
6/7/2010
Dr. Randy Peters, Doctor
Category: Medical
Satisfied Customers: 57
Experience: General Practice for 16 years, member of the American Society of Bariatric Physicians
VerifiedLiver enzymes in an RA patient getting treated aggressively can be elevated for many reasons.
But by far the most common reason would be a side effect of the medications themselves. Modest elevations of certain liver enzymes like AST or ALT can occur even with appropriate use of many medications (not just those for RA). Generally, the treating physician will be watching these, and if they get beyond a certain point, make changes as indicated. Different liver problems (like hepatitis) are diagnosed by looking specifically at the numbers and seeing characteristic patterns of changes in several enzymes at a time, usually by a large amount. Slight elevations if a few liver enzymes here and there usually don't have much significance and can be safely followed.
The most important thing about a slight changes to liver enzymes is to just follow them and keep an eye on them, which is already being done in this case.
But by far the most common reason would be a side effect of the medications themselves. Modest elevations of certain liver enzymes like AST or ALT can occur even with appropriate use of many medications (not just those for RA). Generally, the treating physician will be watching these, and if they get beyond a certain point, make changes as indicated. Different liver problems (like hepatitis) are diagnosed by looking specifically at the numbers and seeing characteristic patterns of changes in several enzymes at a time, usually by a large amount. Slight elevations if a few liver enzymes here and there usually don't have much significance and can be safely followed.
The most important thing about a slight changes to liver enzymes is to just follow them and keep an eye on them, which is already being done in this case.
There are several different liver enzymes. Based on the reference range you have given me, you are probably talking about the AST and ALT (also called SGOT and SGPT in some labs). With these enzymes, a two- or three-fold elevation is usually an indicator of medication side effect. Acute hepatitis would have more like a 50-100-fold elevation (so AST of 2000, for example).
This mild elevation does not look concerning to me, and yes, it should return to normal after the completion of treatment (provided she does not need ongoing medications that continue to affect it). If it remains persistently elevated for several weeks after stopping all medications, then your doctor would probably recommend further investigation at that time.
One important caveat is that I am assuming your grand-daughter does not have underlying liver disease already, but you did not mention this, and at age 3 it seems unlikely.
This mild elevation does not look concerning to me, and yes, it should return to normal after the completion of treatment (provided she does not need ongoing medications that continue to affect it). If it remains persistently elevated for several weeks after stopping all medications, then your doctor would probably recommend further investigation at that time.
One important caveat is that I am assuming your grand-daughter does not have underlying liver disease already, but you did not mention this, and at age 3 it seems unlikely.
Dr. Randy Peters, Doctor
Category: Medical
Satisfied Customers: 57
Experience: General Practice for 16 years, member of the American Society of Bariatric Physicians
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