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Toddler has elevated liver enzymes, passing yellow urine and stool. What's wrong?

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My one month old son is jaundice direct of 6 indirect of 9. Normal abd ultrasound and elevated liver enzymes. Urine is yellow and stool is abundant and yellow. What's wrong? Normal PKU at birth. Normal albumin. Liver enzymes are alt and as? Both are in the 100's. baby eating well,sleeping well, not sluggish and is overall healthy and happy.
Posted Mon, 11 Mar 2013 in Liver and Gall Bladder
Answered by Dr. Shoaib Khan 1 hour later
Hi. Thank you for writing to us.

Jaundice is a commonly seen self-resolving condition in newborns. Jaundice lasting more than 3 weeks is called ‘prolonged jaundice’.

As mentioned by you, the abdominal ultrasound was normal (liver enlargement is seen with prolonged jaundice), and your son is healthy and active (sick and weak child in prolonged jaundice); these are indications that the jaundice is subsiding. Yes alt and as are liver enzymes.

Normal levels:
Direct bilirubin level is: 0-0.5 mg/dl; indirect: 0.6-10.5 mg/dl
Alt (alanine aminotransferase): 8-78 units/L
Ast (aspartate aminotransferase): 18-74 units/L
Except for indirect bilirubin, all other levels are elevated in your child, which proves the presence of prolonged jaundice, but are close to the upper limit, which could mean they are all settling. The best thing to do now, would be to wait and recheck the values, and if they are returning to normal, this is a settling case of prolonged jaundice, which does not require any treatment.

If they are still rising, then you should discuss the following conditions with your sons doctor: urine tract infection, hypothyroidism, galactosemia or cholestasis.

In the meantime the best thing to do would be to breast feed/supplement feed your child regularly, this removes the bilirubin from the digestive tract.

I hope this information helps. Please write back to me for any further information. In my opinion, your son should settle down soon.

Best wishes.
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