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Elevated ALT, Accutane Usage, Ultrasound, Hemangioma Detected. Treatment ?

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Posted on Thu, 24 May 2012
Question: male, 44 yo, 5'11" 152 lbs, elite athlete, vegetarian. Elevated ALT in 1998, returned to normal in one month. No other medical issues, except Accutane use as teenager. For physical in XXXXXXX 2011, AST 43, ALT 22. March 2011 AST 41, ALT 22. April 2011 AST 35, ALT 22. XXXXXXX 2011 AST 47, ALT 22. Ultrasound today revealed hemangioma. Dr. wants to do MRI to better determine size and involvement. He also wants to send me to a gastroenterologist. Why would he do that?
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Answered by Dr. Dr. Rakhi Tayal (1 hour later)
Hello.

Thanks for writing to us.

Your values of AST and ALT are on a bit higher side. Both the liver enzymes raised might indicate a mild chronic liver disease (liver cell inflammation) which can only be ruled out by further test that can be done under guidance of a gastroenterologist.

These raised levels of liver enzymes when associated with jaundice or raised other enzymes is more concerning. But I still encourage you to consult a gastroenterologist for evaluation.

In your case the complete coagulation profile also needs to be checked to see the posssibilities of any excessive bleeding. So, go ahead with consulting the gastroenterologist.

Presence of small Hemangioma is probably incidental and I agree with your doctors that it needs to be confirmed by further tests.

I hope my answer and recommendations are adequate and helpful. Waiting for your further follow ups should you have any.

Regards.
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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Dr. Rakhi Tayal

OBGYN

Practicing since :2001

Answered : 14041 Questions

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Elevated ALT, Accutane Usage, Ultrasound, Hemangioma Detected. Treatment ?

Hello.

Thanks for writing to us.

Your values of AST and ALT are on a bit higher side. Both the liver enzymes raised might indicate a mild chronic liver disease (liver cell inflammation) which can only be ruled out by further test that can be done under guidance of a gastroenterologist.

These raised levels of liver enzymes when associated with jaundice or raised other enzymes is more concerning. But I still encourage you to consult a gastroenterologist for evaluation.

In your case the complete coagulation profile also needs to be checked to see the posssibilities of any excessive bleeding. So, go ahead with consulting the gastroenterologist.

Presence of small Hemangioma is probably incidental and I agree with your doctors that it needs to be confirmed by further tests.

I hope my answer and recommendations are adequate and helpful. Waiting for your further follow ups should you have any.

Regards.