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9 month old has slightly large liver and elevated alt. What does this mean?

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my 9 month old daughter has a slightly large liver and elevated alt what does this mean? went to cohens hospital about 2 months ago to gi specialist they dint find anything then went to a genetic specials and her liver was back down in size and alt went make to normal limits also had soon done should no masses
Posted Wed, 27 Feb 2013 in Liver and Gall Bladder
Answered by Dr. Shoaib Khan 2 hours later

Thank you for writing to us.

It appears that your daughter had what we call 'prolonged jaundice'. Jaundice is a liver disease which is common in newborns. It is associated with yellow color of skin and the white part of your eyes. In mild cases the yellow coloring is not very obvious. This causes the liver to get slightly enlarged and the liver enzymes to get elevated.

Being common in newborns, this jaundice disappears itself (without treatment) within 2 weeks from birth (in a term baby) and 3 weeks (in a pre-term baby). If this jaundice continues to persist for longer than 2-3 weeks, it is called 'Prolonged jaundice'. Although this also disappears without any treatment, it rarely leads to more serious conditions (if it persists).

As your daughters latest liver investigation reports that the liver is back to its normal size and the liver enzymes have also returned to normal, you have nothing to worry about. This was most probably 'prolonged jaundice' - that has now subsided.

Congratulations on your beautiful daughter. Wishing you and your family a long healthy life. Feel free to write back to me for any further clarifications.

Best wishes.
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Follow-up: 9 month old has slightly large liver and elevated alt. What does this mean? 13 hours later
thank you for responding, however they did test her bilrubin and it was fine she was jaundice and in nicu for 2 days after birth. but she is going on 10 months now and the liver is once again about 3cm and alt is a 75 what should i do with this new info? do i go to yet another hospital to look into it or will she be ok? she seems healthy to me a little on the heavy side that about it.
Answered by Dr. Shoaib Khan 9 hours later

Thank you for your follow up query.

The normal liver size for a 9-10 month old female size is approximately 4-8 cms; it appears as though your daughter's liver is a little small in size - which should not be much of a worry, as this does normalize with age. But her ALT does seem to be elevated.

ALT is used to evaluate extent of injury of liver cells and liver life. But, ALT is also found elevated in other conditions like heart failure, diabetes, bile duct conditions, infectious mononucleosis, etc. It can also be elevated in choline deficient, strenuous physical activity. There can also be fluctuations at time, without any existing medical condition.

Please also note that an elevated ALT does not necessarily mean a medical problem exists. Thorough blood work up and measuring other enzymes should help in finding a problem, if it exists. Request your doctor to check all other enzyme levels like creatinine kinase, alkaline phosphate, etc.
If her bilirubin was found to be normal, we should rule out all other conditions. Thus a doctor will have to look into this. If you are unhappy with the current one treating your child, then please visit another doctor who should be able to help.

Please write back to me for any further clarifications. I would be glad to help.

Best wishes.
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