Brief Answer: More testing needed indeed but perhaps outpatient Detailed Answer: Dear patient, Thanks for the query. Indeed, the transaminsase or XXXXXXX function test is elevated 3 times above reference, there are many causes: infections like Hepatitis B and C, medications including acetaminophen, toxins like alcohol, or metabolic causes such as fatty liver infiltration. Fatty liver is the most common cause of elevated liver tests in XXXXXXX As you can see, more testing is done, but those can be ordered and discussed in clinic perhaps. Now, an elevated white count usually suggests stress, inflammation, infection, side effect of medications or a primary abnormality in the blood. Again, if an infection is suspected then blood, urine and other samples according to your history can be obtained. At a minimum, you should get such a basic blood work to better understand where those are coming from. Hope this helps, wish you the very best, Dr Brenes-Salazar MD Mayo Clinic MN

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