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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Have Lupus With Liver Involvement. Ultrasound Shows Hematology With Fatty Infiltration. Next Steps?

I have recently been diagnosed with lupus (systemic not discoid), and there seems to have been organ involvement - namely my liver. A recent ultrasound showed severe hematology of 184 mm with fatty infiltration. My blood tests showed an elevated AST of 55 (normal 30) and an ALT of 72 (normal 39). This is not alcohol related since I rarely drink (I have had 3 drinks so far this year). I eat very well and up until I became sick last year, rode 100 miles per week on my bike. I m waiting for a referral to an Gastroenterologist but that will take a few weeks, if not months. What do you think next steps would be? Liver biopsy? And since this doesn t seem to be diet related, what can I do to get healthier? Thanks in advance.
Sat, 4 Jan 2014
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Gastroenterologist,  's  Response
Hello! Thanks for putting your query in HCM. I am a Gastroenterologist (DM).

It may be due to lupus itself an autoimmune disease or may be due to some other cause like:
1. If you are obese or overweight you need to reduce your weight
2.Other common and treatable causes like Hepatitis B and C virus, Serum ceruloplasmin for wilson disease especially if you are young, ANA and SMA for autoimmune disease
3. Lipid profile for NAFLD

I will advise you to visit a Gastroenterologist who will advise you for above tests. If they all are negative then he may advise for liver biopsy to see for autoimmune hepatitis.

Meanwhile I will advise you to take tablet ursodeoxycholic acid and vitamin E and do regular exercise which I found very useful in my patients with fatty liver

I hope I have answered your query and this will help you. If you have any further query I will be happy to answer that too. Remain in touch and get-well soon.
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Have Lupus With Liver Involvement. Ultrasound Shows Hematology With Fatty Infiltration. Next Steps?

Hello! Thanks for putting your query in HCM. I am a Gastroenterologist (DM). It may be due to lupus itself an autoimmune disease or may be due to some other cause like: 1. If you are obese or overweight you need to reduce your weight 2.Other common and treatable causes like Hepatitis B and C virus, Serum ceruloplasmin for wilson disease especially if you are young, ANA and SMA for autoimmune disease 3. Lipid profile for NAFLD I will advise you to visit a Gastroenterologist who will advise you for above tests. If they all are negative then he may advise for liver biopsy to see for autoimmune hepatitis. Meanwhile I will advise you to take tablet ursodeoxycholic acid and vitamin E and do regular exercise which I found very useful in my patients with fatty liver I hope I have answered your query and this will help you. If you have any further query I will be happy to answer that too. Remain in touch and get-well soon.