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Elevated liver enzymes in a 4 year old - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Child Health
Answered by

General & Family Physician
Practicing since : 2005
Answered : 1720 Questions
User :   My 4-year-old son has been waking up with hives occasionally for 5 months now. We've been to an allergist and regular visits to his pediatrician. The only "abnormality" we can find is that his AST liver enzyme is coming back as slightly elevated after blood work. The range has been: 73, 62 and lastly 63. The pediatrician has advised us to wait 6-9 months and retest since the levels do not seem to be increasing. Waiting makes me nervous and I'm just looking for some reassurance that it's safe to "wait it out". Is is possible the hives are a cause or more likely a reaction to the elevated enzyme? Thank you for your time!
Doctor :   hello
Doctor :   give me a min please, let me go thru your query
Doctor :   can you tell me what all tests were done by the physician ?
User :   "Full blood work up" as the allergist referred to it. All enzymes (except AST) and thyroid, cell count, etc. came back normal
Doctor :   and is your child on any medications >?
User :   We give him a daily multi vitamin, 1 tsp. claritan daily for the hives and Nasonex nose spray. We held off the vitamins for 1 week and the claritan for 4 days prior to the last test
Doctor :   ok
Doctor :   now his levels are moderate and yes its correct that since the levels are stable
Doctor :   wait and watch is the correct protocol to be followed
Doctor :   allergic reaction can cause a a slight increase
Doctor :   is your son healthy otherwise ?
User :   He truly seems healthy otherwise. Great eater, sleeper, and active. Has seasonal allergies and has seemed to have 1 cold after the next this past winter, but nothing unusual that I can see.
Doctor :   well dont worry
Doctor :   its right to wait and watch at this stage
User :   After this "wait and see" approach, if enzyme is still elevated. What would the next step be...what are the major concerns here. I'm worried about a chronic condition. Have we most likely ruled out some of the really scary possibilities the allergist initially said we needed to evaluate for like lukemia (sp?), etc?
Doctor :   yes thats true but right now the levels are not alarming, i can assure you that physicians are very particular in such conditions, if there was a slightest concern things would have been different
Doctor :   more over the tests coming normal is a positive thing
User :   So in other words, if we were looking at a very serious condition, most likely some of his other tests or ranges would have been out of range?
Doctor :   thats correct
User :   Any idea what might be the cause of an elevated AST enzyme? I've only found info for ALT and AST combined and most of it shows much higher ranges.
Doctor :   yes the range thats alarming are in hundreds and even thousands
Doctor :   in this case its mild elevation so not a concern
User :   That's good to know. I guess we'll just wait it out and hope the tests come back normal in 6 months.
Doctor :   dont worry i am sure things will be all fine
Doctor :   take care
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