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Test showed sgpt and sgot mildly elevated. What is causing this?

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Gastroenterologist
Practicing since : 1996
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My sgpt and sgot mildly elevated of no apparent reason, all workup negative till today what is the reason for elevation
Posted Thu, 20 Dec 2012 in X-ray, Lab tests and Scans
 
 
Answered by Dr. Ratnakar Kini 52 minutes later
Hi XXXXXXX
Thanks for posting your query.
I am Dr.Ratnakar Kini, Gastroenterolgist and I am pleased to answer your query.
SGPT and SGOT are elevated in many conditions like viral infections, alcohol intake, liver function test done? Please send the complete report.

2. Are you obese?

3. Do you consume alcohol?

4. Are you on any medications?

5. Was ultrasound scan of abdomen done? If so what was the report?

6. What all tests have been done in this regard? Please send the reports.

Kindly get back to me with the answers and reports and i would give my opinion.

Regards,
Dr.Ratnakar Kini
Above answer was peer-reviewed by
 
Follow-up: Test showed sgpt and sgot mildly elevated. What is causing this? 3 hours later
1. 1989 Gallbladder surgery in Chennai Apollo Hospital, That time SGPT and SGOT are just 1.5times normal but Serum biluribin 18.4 and Alkaline phosphate more. After the surgery I recovered well but SGPT and SGOT raised to 400's, The have done viralogy test and other test all are negative so they asked about my food intake I used to take heavy food after immediately the surgery so they said reduce fat food intake for some time.

2. 1994. SGPT and SGOT 1.5 times the normal. All other parameters except un conjugated biluribin are normal. again left to Chennai Apollo hospital, the retested for HBV,HAV both negetive. Endoscopy normal. Finally they have taken liver biopsy. Liver biopsy result is quite normal. They said it is XXXXXXX but not answered for elevated enzymes.

3.2002. SGPT and SGOT 1.5 times the normal. All other parameters except un conjugated biluribin are normal. This time XXXXXXX hospital Bangalore. Again checked for Virology HBV, HAV, anti HCV, HEV all are negative, Antibody to HBV negative. XXXXXXX disease negative, all other possible things normal. Ultra sound normal.

4.2002 October. One night I had heavy chicken meal, for the same I developed gastritis, I have admitted in XXXXXXX hospital for the same. With in the span of one hour they have given me 6 injections few of them are pain killers. Most of the injections are mixed and given. With in span of 3 hours jaundice developed.

Sgpt 1500
Sgot 1800
SB 14
Gama GT 80
Alkaline Phosphate above the normal
after second week albumin become 3 or 3.5

They repeated all the tests again, all are normal Like Virology, Auto immune and etc.

Then the case refereed CMC Vellore, They repeated all the tests including Auto immune but all are negative. could not able to conclude.

After two months LFT become normal except Indirect biluribin.

2006, St XXXXXXX Medical collage SGPT and SGOT 1.2 normal could not able to find anything.

2008 LFT normal except Indirect biluribin.

2012 met with serious accident, head injury, concussion which resulted in serious vascular migraines and IBS, Colonoscopy and Gastroscopy normal.

30-9-2012, SGPT 90 normal is upto 65, SGOT 50 normal is upto 45

Repeated all the tests in Fortis Hospital all workup negative. Almost all they have done all negative. Ultrasound normal.

25-11-2012. SGPT 72 normal is upto 65, SGOT 59 normal is upto 45. Albamin 4.8, Glublin 3.1. and others are seriously normal. PT time normal 11 secs.

Non of these docs could able to conclude, if you take my case as a special case I am very great to you.

 
 
Answered by Dr. Ratnakar Kini 19 hours later
Hi XXXXXXX
Thanks for the additional information provided.

First of all I would like to tell you that only if SGPT and SGOT are more than two times the upper limit of normal, we consider it as significant and that liver is involved. This is because there are many sources other than liver where SGPT and SGOT are found. This includes skelatal muscle, heart and kidneys.

The slightly high enzymes during GB surgery could be due to passage of a gallstone through the common bile duct. It is usually transient.

Whetever might be the cause, if the high SGPT and SGOT are due to disease involving the liver, then the liver biospy would have given some clue regarding that.
Since the liver biopsy was normal, it is unlikely that there was any significant liver disease causing it.

In 2002 you had enzymes in thousands. Conditions that can increase the liver enzymes to levels above thousands include viral hepatitis, drugs and toxins, ischemic hepatitis ( when blood flow to liver is affected) and autoimmune hepatitis.
Viral markers were negative in your case and also the autoimmune markers. So the most likely cause of very high enzymes during 2002 was drug toxicity. Since no more drug was given it returned to normal.

Everytime it was only the indirect component of bilirubin that was high with enzymes not significantly raised which is a feature of XXXXXXX syndrome. You can do tests like rifampicin test for confirming it. Indirect component can sometimes increase along with raised liver enzymes in XXXXXXX disease and it is negative in your case.

You have not mentioned whether you are obese and whether you consume alcohol.
These can cause fatty liver disease which again can increase liver enzymes.
But you have said ultrasound scan of abdomen was normal which rules out fatty liver.

My final opinion -
Since viral markers were negative, XXXXXXX workup and autoimmune work up are all normal and ultrasound of abdomen was normal and that the enzymes raised LESS THAN TWO TIMES THE UPPER LIMIT OF NORMAL, I consider it as insignificant and would not order for any more tests for that.
You have features of XXXXXXX syndrome which you can confirm with Rifampicin test.

I hope that answers your question.

If you have no more questions, kindly accept this answer and rate this service.

Regards,
Dr.Ratnakar Kini
Above answer was peer-reviewed by
 
Follow-up: Test showed sgpt and sgot mildly elevated. What is causing this? 36 minutes later
Dear Doctor, I am not obese and will not consume alcohol. I am 5.8 and weight is 57. By the way where do you practice? So what is the etiology for mild elevation, if you feel no matter of concern I will leave it. It should not become over night problem that all.
One final question, Is there any effective treatment for IBS. It is troubling me. How do I consult you in person Thank you.
 
 
Answered by Dr. Ratnakar Kini 2 days later
Hi,
As said earlier, the elevation is insignificant except for once during 2002. So you can just ignore it.
I practice at Velammal Hospitals in Chennai.
IBS is a functional gastrointestinal disorder. The symptoms can only be controlled and it can recur.
I hope that answers your question.

If you have no more questions, kindly accept this answer and rate this service.
Regards,
Dr.Ratnakar Kini
Above answer was peer-reviewed by
 
Follow-up: Test showed sgpt and sgot mildly elevated. What is causing this? 16 hours later
Dear doctor, My Family doc who is MD suggested me to take sylimarin 140mg twice daily is it necessary in my case if so how long I have to take. This is my final question and I will not trouble you further.
 
 
Answered by Dr. Ratnakar Kini 3 hours later
Hi,
Silymarin is nothing but an extract from milk thistle.
It is usually prescribed for individuals with liver disease.
Since your liver biopsy did not show any evidence of liver disease, I dont feel you require to take silymarin.

I hope that answers your question.
If you have no more questions, kindly accept this answer and rate this service.
Regards,
Dr.Ratnakar Kini
Above answer was peer-reviewed by
 
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