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Elevated bilirubin, LFT normal - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Liver and Gall Bladder
Answered by

General & Family Physician
Practicing since : 2004
Answered : 40 Questions
User :   adf
User :   hello
Doctor :   Hi
Doctor :   I am Dr. xxxx
User :   I have some concerns about liver disease
User :   I am a 20yr old otherwise healthy male
User :   bilirubin levels have reached 81umol previously
Doctor :   Ok
Doctor :   Please go ahead I can help you with answers
User :   I have had negative MRI scan, ultrasound, urinalysis, copper depository
User :   But my LFT at one point has shown stomatocytes
User :   target cells
User :   and atypical lymphs
User :   i am very worried that i have liver disease
User :   The bilirubin is unconjugated
Doctor :   Can you tell me the exact value of bilirubin with units
Doctor :   and when was this tested?
User :   the last time i had it tested was a few weeks ago
User :   and it was 41umol
User :   umol/l
Doctor :   Ok
Doctor :   So the peripheral smear of the blood has stomatocytes and target cells
Doctor :   Is it not?
Doctor :   What about the other Liver function tests? AST, ALT, GGT, Alk phosphatase?
User :   In my blood count yes
User :   they are all normal
Doctor :   Ok
Doctor :   So now your concern is Bilirubin raised and the peripheral smear has target cells and stomatocytes
User :   yes
Doctor :   Now I have few more questions for you
User :   ok
Doctor :   Why did you get these tests done?
Doctor :   Did you repeat the Bilirubin again recently?
User :   yes numerous times
User :   but that is latest
Doctor :   Why did you get the first test done, were you ill?
Doctor :   Did you have yellowish discoloration of eyes or skin?
User :   no not ill at all
Doctor :   Did you have yellowish discoloration of eyes or skin?
Doctor :   Do you have tiredness or fatigue at the end of the day?
User :   tiredness yes
Doctor :   do you take alcohol and smoke?
Doctor :   *Do
User :   no never
Doctor :   Do you have family history of any disease?
Doctor :   especially liver related?
User :   no
User :   no
User :   is there a possibility i have liver disease?
Doctor :   Since the liver function tests are normal, I do not think so
User :   i do have very mild discolouration
Doctor :   Ok
Doctor :   Is it eye or skin or urine?
User :   eye and skin
User :   very very mild
Doctor :   How is the appetite and color of the stool?
User :   appetite very good stoll normal
Doctor :   Ok
Doctor :   Since it is only mild eleveation of the bilirubin
Doctor :   You should not be worried
Doctor :   However you should not fall ill
Doctor :   You may ask your doctor about AAAAAAA
User :   ok
Doctor :   I just want you to make you aware of a condition called XXXXXXXX syndrome
User :   what are the symptoms of liver disease
Doctor :   I do not say that you have ti
Doctor :   it
Doctor :   In this, there is mild elevation of bilirubin
User :   yes i do know about Gilberts
Doctor :   and no symptoms at all
User :   is the stomatocytes, target cells and atypical lymphs worrying?
Doctor :   The symptoms are more pronounced when you catch infections or go on starvation
User :   and can gilberts cause these
Doctor :   No, in medical science the peripheral smear has less importance when there is no symptom
Doctor :   If you are worried about liver disease, my opinion is not liver
Doctor :   There are mild enzyme deficiencies which cause elevation of unconjugated bilirubin
Doctor :   one of them is Gilberts
Doctor :   Target cells and Stomatocytes are seen in many other conditions
Doctor :   and they do not actually derive a diagnosis
User :   ok
User :   my consultant has sent me for annual blood tests
User :   would this seem appropriate
Doctor :   Yes
User :   what is the reason i should have annual tests?
Doctor :   Is ur consultant concerned after final evaluation
User :   she says: User :   "in view of the fact that at one point he had stomatocytes, target cells and atypical lymphs on a blood count, i have some minor concerns that there might be chronic liver disease and this is not just simple unconjugated hyperbilirubinaemia, i will review him on an annual basis"
User :   that was the letter to my GP
User :   hence why i am very worried and cannot wait a year to find out whether i am dying or not
Doctor :   ok
Doctor :   Don't worry
Doctor :   Since the LFT are not deranged and ultrasound is normal I am not concerned as ur GP
User :   ok. what symptoms should i look out for
Doctor :   Symptoms to look for are loss of appetite, increased tiredness, frequent infections
User :   sometimes i feel sleepy during the day, but it has got better recently
User :   could this be a symptom
User :   i do get adequate sleep
Doctor :   No that is not i meant
User :   and stay hydrated
Doctor :   Difficulty in day to day activities can be considered tiredness
User :   ok i understand
Doctor :   Thats good
User :   so overall you feel i need not worry
Doctor :   Sure
User :   ok thankyou very much for the reassurance
Doctor :   Is there anything else i can help you with
User :   no thankyou that is
User :   all
User :   have a good day
Doctor :   Its my pleasure
Doctor :   Bye for now
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