Abnormal Liver Function Tests: Causes and Concerns - Gastroenterology and Hepatology

Q: Abnormal Liver Function Tests: Causes and Concerns

Hello： 1. <br>If the values are greater than normal, it can be classified as acute hepatitis. <br>However, if it is accompanied by jaundice and coagulation dysfunction, it indicates hepatic decompensation, which poses a risk. <br>2. <br>There are many causes of hepatitis; if you

Abnormal liver function test results?

Hello Doctor,
I have a few questions.
I have not been very healthy regarding my gastrointestinal system since middle school, experiencing recurrent issues such as duodenal ulcers, gastric ulcers, and gastroesophageal reflux disease.
I usually alleviate the stomach pain by pressing on my abdomen and curling my body.
However, since early 2015, I have been experiencing severe pain that radiates to my lower back, accompanied by cold sweats and vomiting.
The first time this happened, I was pregnant and could only visit an obstetrician.
The doctor suggested it might be gastric spasms and prescribed medication, which provided relief.
After giving birth, these episodes continued to occur sporadically.

On September 28, 2015, I was in excruciating pain and went to the emergency room, expecting to receive some gastric medication.
However, my blood tests showed GOT and GPT levels over 1000, leading to immediate hospitalization for acute hepatitis.
Tests for hepatitis B, A, and C were negative, and an ultrasound showed no abnormalities.
After five days, my condition improved, and follow-up tests showed normal results.
Four months later, I was tested again for hepatitis A and C, which also returned negative.
In November, I underwent a health check, and all my results were normal.
Now, on July 7, 2016, I started experiencing stomach pain again, feeling unwell all over, and vomited twice during the night.
I saw a doctor in the morning, who drew blood and suggested it might be acute gastritis.
Given my history of acute hepatitis, they checked my liver enzymes, and on July 11, the doctor informed me that my GOT was 637, GPT was 474, and bilirubin was 1.6, advising me to return for an urgent follow-up.
During this time, I have not been taking any long-term medications or consuming alcohol or tobacco, but I do take gastric medication whenever I experience stomach pain.
I would like to ask a few questions:
1.
What are the enzyme levels that define acute hepatitis?
2.
Besides liver issues, could abnormal liver enzyme levels indicate other problems?
3.
If these symptoms recur frequently, should I see a doctor immediately whenever I feel unwell?
4.
Is it necessary for me to have regular follow-ups at the hospital?
Thank you for your hard work, Doctor.

CHINGCHING, 30~39 year old female. Ask Date: 2016/07/11

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello: 1.
If the values are greater than normal, it can be classified as acute hepatitis.
However, if it is accompanied by jaundice and coagulation dysfunction, it indicates hepatic decompensation, which poses a risk.
2.
There are many causes of hepatitis; if you have not been evaluated for the following areas, please seek medical attention promptly for clarification.
For example: cardiac function (cardiology), thyroid function/blood glucose (metabolism), and autoimmune issues.
Additionally, avoid inhaling volatile gases from organic solvents.
==> Your liver enzyme levels have exceeded ten times the normal range; it is recommended to determine the cause as soon as possible and not to take it lightly.
Alternatively, consult a hepatobiliary specialist first to investigate the cause, and if it cannot be identified, then seek other specialties.
Changhua Hospital cares about your health.
Dr.
Tsai An-shun.

Reply Date: 2016/07/11

More Info

Understanding abnormal liver function tests is crucial, especially for individuals with a history of gastrointestinal issues like yours. Your concerns are valid, and I will address your questions based on the information provided and general medical knowledge.

1. What is considered a high level for acute hepatitis?
Acute hepatitis is typically characterized by a significant elevation in liver enzymes, specifically AST (GOT) and ALT (GPT). While there is no strict cutoff, levels above 100 U/L are often indicative of liver inflammation. In severe cases, such as yours where levels exceeded 1000 U/L, it suggests a more serious condition, possibly acute viral hepatitis or drug-induced liver injury. The degree of elevation can vary based on the underlying cause, but levels above 300 U/L are generally concerning and warrant further investigation.

2. Could liver enzyme abnormalities indicate issues beyond the liver?
Yes, elevated liver enzymes can be indicative of various conditions beyond liver disease. For instance, muscle injury can lead to elevated AST levels, as this enzyme is also found in muscle tissue. Conditions such as hemolysis (breakdown of red blood cells), myocardial infarction (heart attack), and even certain infections can cause elevated liver enzymes. Additionally, metabolic disorders, autoimmune diseases, and certain medications can also affect liver function tests. Therefore, it is essential to consider a comprehensive evaluation of your health status.

3. Should you see a doctor immediately when feeling unwell?
Given your history of acute liver issues, it is prudent to seek medical attention whenever you experience significant discomfort, especially if it is accompanied by symptoms like severe abdominal pain, vomiting, or jaundice (yellowing of the skin and eyes). Early intervention can be critical in preventing further complications. Your symptoms of severe pain and vomiting, particularly if they are recurrent, should not be ignored, as they may indicate a serious underlying condition.

4. Is regular follow-up necessary?
Yes, regular follow-up is essential, especially considering your history of acute liver inflammation. Monitoring liver function tests periodically can help detect any changes early and allow for timely intervention. Your healthcare provider may recommend follow-up blood tests, imaging studies, or even referrals to specialists, such as a gastroenterologist or hepatologist, depending on your situation. Regular check-ups can also help manage any chronic gastrointestinal issues you may have, ensuring a comprehensive approach to your health.

In conclusion, your history of gastrointestinal problems, coupled with the recent abnormal liver function tests, necessitates a thorough evaluation. It is essential to maintain open communication with your healthcare provider, adhere to follow-up appointments, and report any new or worsening symptoms promptly. Lifestyle modifications, such as a balanced diet, regular exercise, and avoiding alcohol, can also play a significant role in maintaining liver health. Always prioritize your health and seek medical advice when in doubt.

Similar Q&A

Understanding Abnormal Liver Enzymes: What You Need to Know

Dear Dr. Lin, I hope this message finds you well. Recently, the company sent out the health check report for April, and I noticed some abnormalities in my liver function tests, which has caused me some concern. I would appreciate your assistance in addressing this matter. The r...

Dr. Lin Minghui reply Gastroenterology and Hepatology
Abnormal liver function tests, although not significantly elevated, require investigation to determine the cause and to monitor for chronic Hepatitis B or C. Common causes of liver function abnormalities include fatty liver, alcohol consumption, metabolic syndrome, weight gain, e...

Understanding Liver Function Tests: Normal Results with Elevated Bilirubin Levels

Doctor, I received my lab results today: G.O.P = 21, G.P.T = 31, and albumin = 4.4, all of which are normal. I am a carrier of hepatitis B, but why is my total bilirubin level 1.88 under these normal conditions? What could be the reason for this? What should I pay attention to, a...

Dr. Lin Minghui reply Gastroenterology and Hepatology
1. (1) Hepatitis B carriers should undergo regular monitoring of GOT, GPT, AFP, and abdominal ultrasound. (2) Elevated total bilirubin can be attributed to three main causes: 1. Excessive destruction of red blood cells leading to the release of too much hemoglobin; 2. Liver dysfu...

Understanding Abnormal Liver Function: Essential Tests and Recommendations

Hello, doctor... This month I suddenly feel extremely fatigued, and during most of my working hours, I often feel very sleepy. Additionally, my previous health check indicated abnormal liver function... Therefore, I would like to undergo further tests to confirm whether there is ...

Dr. Xiao Jingqin reply Internal Medicine
The standard tests for abnormal liver function include liver biochemical function tests, which consist of AST (aspartate aminotransferase) and ALT (alanine aminotransferase). These are the most basic tests. If there are abnormalities in these function indices, further testing for...

Understanding Elevated Liver Function Tests: Causes and Symptoms Explained

1. Recently, the military service health examination report indicated that two liver function indices were elevated, one at 195 and the other at 317. What could be the potential issues with the liver? 2. Can liver dysfunction cause symptoms such as nausea and unexplained anxiety...

Dr. Chen Jianhong reply Gastroenterology and Hepatology
Hello! 1. There are many causes for elevated liver function tests, which may include viral hepatitis (types A, B, C, D, and E), alcoholic liver disease, drug-induced liver injury, obesity, fatty liver, and autoimmune diseases. Any of these factors can lead to increased liver enzy...