Hello and welcome to HCM,
Elevated liver enzymes
along with spontaneous bruises over body in a four year old indicates a problem in liver and biliary tract.
The involvement of liver can be secondary to the biliary tract disease.
Have you got the coagulation profile consisting of bleeding time
, PT, aPTT
, TT and INR.
If you haven't consult your doctor for these tests.
Spontaneous bruising indicates deficiency of coagulation factors in body.
There are four coagulation factors which are required vitamin K for complete activation.
A deficiency of Vitamin K can also lead to similar picture.
A complete nutritional assessmenmt also needs to be done by the pediatrician
Thanks and take care.
Dr Shailja P Wahal