Your Blood Test Results: What Elevated ALT and Lymphocytes Mean

Ask the doctor some questions?

Hello doctor, my health check report shows an ALT level of 45, and it seems my lymphocytes are elevated at around 60, while other values are slightly low and abnormal, prompting the recommendation to see a hematologist.
At that time, the doctor asked if I had a fever.
I thought I didn’t, but I felt a bit cold in the morning, which I guessed was due to the strong air conditioning.
I measured my ear temperature at 36.1-36.5°C, but after lunch, it might rise to around 37.0-37.3°C.
Is that abnormal? The doctor also asked if I had a cold, and I said yes.
I often experience post-nasal drip that leads to a sore throat, but I haven’t felt much of that in the past few days.
I had blood drawn about ten days ago, and I wasn’t sure if I had recovered, but I went ahead with the test.
The doctor then asked me to get more blood tests done.
I’m unsure if my cold has resolved since I haven’t taken any medication.
I have allergies and frequently have a runny nose.
The doctor said not to worry and to come back next week to review the report, suggesting it might just be some virus.
Hearing the word "virus" sounds quite alarming; was the doctor really saying it was nothing serious? When I got home, I started to worry if it could be something like leukemia or HIV.
Regarding the latter, I discovered a small lesion on the glans during a shower last year, and after seeing a urologist, the doctor was unsure what it was.
After a biopsy and cauterization, it was identified as a wart.
I didn’t understand how I could have contracted it since I haven’t had sexual intercourse, but the doctor mentioned it could be from using public towels in hot springs.
This February, I also got tested for HIV because I was anxious, and the result was negative.
Now, with this abnormal blood report, I’m uncertain if it suggests I should be tested again.
Previously, the doctor told me I was safe and didn’t need to test again, but I’m not sure what the symptoms of HIV are or if it could be contracted similarly to warts from hot springs.

Ming, 10~19 year old female. Ask Date: 2020/08/19

Dr. Hong Yuanbin reply Internal Medicine

Hello,
1.
Based on your description of general discomfort along with elevated liver enzymes and increased lymphocytes, it is indeed more likely to be a viral infection.
However, the viruses referred to here are common viruses, such as respiratory viruses, commonly known as "cold," and not the HIV virus.

2.
HIV is primarily transmitted through sexual contact.
If you have had no unsafe sexual encounters, and your symptoms do not resemble those of HIV, the likelihood of having HIV should be very low.

3.
Regarding genital warts, they are also transmitted through sexual contact.
If you have already undergone cryotherapy, you only need to monitor for any recurrence.

In summary, you are likely experiencing a cold.
It is recommended to drink plenty of water and get ample rest, and your symptoms should improve subsequently.
Thank you for your inquiry.

Reply Date: 2020/08/19

More Info

Understanding blood test results can be a daunting task, especially when faced with elevated levels of certain markers like ALT (alanine aminotransferase) and lymphocytes. Let's break down what these results might indicate and how to interpret them in the context of your overall health.

Elevated ALT Levels
An ALT level of 45 U/L is slightly elevated, as normal ranges typically fall between 7 and 56 U/L. ALT is an enzyme primarily found in the liver, and elevated levels can indicate liver inflammation or damage. Common causes of elevated ALT include:
1. Fatty Liver Disease: This can be due to alcohol consumption or non-alcoholic fatty liver disease (NAFLD), which is often associated with obesity and metabolic syndrome.

2. Hepatitis: Viral infections, autoimmune diseases, or drug-induced liver injury can lead to elevated ALT levels.

3. Medications: Certain medications can cause liver enzyme elevations, so it's important to review any medications you are taking with your healthcare provider.

4. Other Conditions: Conditions such as hemolysis (breakdown of red blood cells) or muscle damage can also elevate ALT.

Elevated Lymphocytes
Lymphocytes are a type of white blood cell that plays a crucial role in the immune system. A lymphocyte count that is significantly elevated (such as 60% of total white blood cells) can suggest several conditions, including:
1. Infections: Viral infections, such as the flu or COVID-19, often lead to increased lymphocyte counts. Since you mentioned having symptoms of a cold, this could be a contributing factor.

2. Chronic Inflammatory Conditions: Conditions like autoimmune diseases can also lead to elevated lymphocyte levels.

3. Lymphoproliferative Disorders: In rare cases, significantly elevated lymphocyte counts can indicate more serious conditions, such as leukemia or lymphoma.

Interpreting Your Symptoms
You mentioned experiencing some cold-like symptoms, such as nasal drip and throat discomfort. These symptoms, combined with your elevated lymphocyte count, suggest that your body may be fighting off a viral infection. The slight fever you noted (37.0-37.3°C) is not unusual and can be a normal response to infection.

Concerns About Serious Conditions
It's understandable to feel anxious about the possibility of serious conditions like blood cancer or HIV, especially after experiencing symptoms and receiving abnormal test results. However, it's important to remember that many factors can contribute to elevated blood markers, and not all of them indicate severe illness.
1. HIV: Since you tested negative for HIV earlier this year, and given that you have not engaged in high-risk behaviors, the likelihood of HIV being the cause of your symptoms is low. Symptoms of acute HIV infection can include fever, fatigue, and swollen lymph nodes, but these typically occur within a few weeks of exposure.

2. Blood Cancer: While elevated lymphocytes can be associated with blood cancers, they are also commonly elevated in response to infections. Your doctor will likely consider your complete clinical picture, including symptoms and other lab results, before making any conclusions.

Next Steps
1. Follow-Up Testing: Since your doctor has recommended further blood tests, it’s important to follow through. These tests can provide more information about your liver function and immune response.

2. Monitor Symptoms: Keep track of any new or worsening symptoms, such as persistent fever, significant fatigue, or unexplained weight loss, and report these to your healthcare provider.

3. Lifestyle Modifications: Consider lifestyle changes that support liver health, such as reducing alcohol intake, maintaining a healthy weight, and eating a balanced diet rich in fruits, vegetables, and whole grains.

Conclusion
While elevated ALT and lymphocyte levels can be concerning, they are often indicative of more common and less severe conditions, particularly infections. It’s essential to maintain open communication with your healthcare provider, who can guide you through the next steps and help alleviate your concerns. Remember, early intervention and monitoring are key to managing your health effectively.

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