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What causes high protein in urine and elevated liver enzymes?

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Posted on Fri, 31 Oct 2014
Question: Hi, I have high protein in my urine 23.8mg/dl, +4 ketones, liver emyenes AST (SGOT) 60 IU/L and ALT (SGPT) 63 IU/L. I went to a RA after being diagnosed with Lupus, I am missing both those test, plan on called the lab for one and going to the DR for the other pages. I was told by 3 Drs I have Fibromyalgia, 2 Drs said I have Hashimoto's, also have nodules and a 4mm cyst on my thyroid, my great aunts all had thyroid problems, and my paternal grandmother had a goiter the size of a grapefruit, 1 Dr says no to Hashimoto's, 1 Dr said I have Lupus and 1 Dr said I do not have Lupus. Are these test results related??? I also have IC, had 3 bladder surgeries and 4 or 5 ovarian surgeries, last surgery they finally removed the bad ovary. Also had my interstines fixed 10 years after a car accident, complained of pain, dr said it was a muscle. Have passed 5 kidney stones, surgery on 1 and maybe surgery on each surgery on my kidneys for 2 big stones. I'm 39, grew-up vegan, some fish and chicken. Had Scarlet Fever at 19.
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Answered by Dr. Binu Parameswaran Pillai (2 hours later)
Brief Answer:
SGPT/SGOT and Urine protein may be due to SLE

Detailed Answer:
Good day,
Noted your concern.
Lupus ( SLE) can cause number of problems which may affec liver/kidey/joints/skin etc. Hence Urine proteins and altered liver functions can be explained. However, a biospy may be required to confirm lupus nehritis ( involvement of kidneys).

Hashimoto's disease can cause hypothyroidism and you didnt provide a thyroid function test unfortunately.You may also get nodules in hashimoto's disease.

Fibromyalgia is diagnosed when someone present with bodypain and joint pains after ruling out all other possible causes.

Regards
Binu


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Binu Parameswaran Pillai (19 hours later)
Thank you for your quick response, my Thyroid Peroxidase (TPO) Ab is 132, good range is 0-34. My Thyroglobulin with Anti-TG AB is 1.1, good range is 0.0- 0.9. I'm working on getting my resent blood work, one Dr did not include the last 2 pages, and one Dr says they could not find it. I called the lab company and had them faxed to the RA I went to, and see said she did not see them, and will not look at them. I asked the lady if they received them, she sais yes, hole punched them. 2 Drs thought I had celiac disease, because I have low everything, but I don't eat a lot. I'm 5'3 and now 122. I was always 110 until happened and my hair comes out in clumps, I should have more numbers for you tomorrow. So a new RA, go to an Endo???I also have a ton of nodules on the leftside of my thyroid and a cyst 4mm x 4mm on the right side of my thryoid. I'm had a lot of kidney stones since 22. My urologist says it is not Lupus related if I have that. I will be asking the tests results from both Drs, the one missing the Lupus numbers and the other one from my GY, the lab spelt my last name wrong. Sadly I agree with you about Lupus and the Hashimoto's diagnoses. I'm not sure who to go to know. My adrenal glands when I do the spit test, my cortisol peaks at 7:00pm, my Endo dr said they don't believe in that test, so I have the injection and then blood draw done. He said my adrenal glands performed to a stress situation. I just don't sleep. My internist tried me on all kinds of stuff, on Ambien I drove myself to the store, so I can't take anything in that family. She says there is nothing I can take. I take Advil PM, bottle of wine, and Xanax. Or I'm up for 3 or 4 days. I'm wayyyy anxious and always think the worst on top of this all. My dad a year ago got diagnosed with melanoma, so of course I worry to that. I was his driver and came taker many times when he has had surgery. Anyway hope I get numbers you need. Thanks for your response. Feel like I'm going crazy.
doctor
Answered by Dr. Binu Parameswaran Pillai (10 hours later)
Brief Answer:
Hashimoto's Thyroiditis

Detailed Answer:
Good day. Sorry for the delay in response. Was pretty busy in hospital. Anti TPO and Anti TG antibodies are high. You have mentioned that there are many nodules in neck. How big are they?? Anti TPO and Anti TG would go with a diagnosis of hashimoto's thyroiditis. However, we need to do a TSH and Free T4 and only then a treatment can be decided.
Your endocrinologist have ruled out Adrenal fatigue.
The proteins in urine could be from stones itself ( if your urologist is confident that there is no Lupus).
Ketones in urine could be due to dehydration.
Please relax. I think you must meet the endocrinologist and discuss further

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Binu Parameswaran Pillai (7 hours later)
Hello,

Always busy at the hospital! Yes the Endo ruled out adrenal fatigue, other Dr had me do a spit test, and said my cortisol is peaking at 7pm, why my sleep is a mess? I'm looking for a new Endo Dr now. I've had kidney stones since early 20s, I drink water all day, that urologist said my oxulate level is 4 times the normal. No other test have been done. I can never catch them. Drs can't agree on Lupus or Hashimoto's. My T4, Free (direct) was .95 ng/dl, TSH 2.460uIU/mL. These test are from April. The RA Dr forgot to copy the last 2 pages of my test report. Since I sleep during the day, I can't get there. I try to flip flop my sleep by doing an all day stay awake ha ha.
Thank you for your responses! Forgot the nodules are to small to biopsy, I just have a lot on one side of my thyroid. Cyst 4mm on the right side of my thyroid
doctor
Answered by Dr. Binu Parameswaran Pillai (4 hours later)
Brief Answer:
Repeat TSH and Free T4 after 5-6 months

Detailed Answer:
Hi,
Good morning.
If the nodules are smaller than 1 cm and if the ultrasound shows no suspicious features of malignancy, please do not worry. No need of FNAC.

Your Ft4 and TSH are normal. So now you have hashimoto's thyroiditis, but no hypothyroidism. Thyroiditis will also explain the nodules in thyroid.
However, since the Anti TPO and Anti TG are high, it is better to repeat Thyroid functions ( Ft4 and TSH) after 5-6 months , as there are chances of developing hypothyroidism in the future.

I hope your new Endo doctor will be able to deal in a better way. Wish you good health
Regards
Binu
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Binu Parameswaran Pillai

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Practicing since :2003

Answered : 1435 Questions

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What causes high protein in urine and elevated liver enzymes?

Brief Answer: SGPT/SGOT and Urine protein may be due to SLE Detailed Answer: Good day, Noted your concern. Lupus ( SLE) can cause number of problems which may affec liver/kidey/joints/skin etc. Hence Urine proteins and altered liver functions can be explained. However, a biospy may be required to confirm lupus nehritis ( involvement of kidneys). Hashimoto's disease can cause hypothyroidism and you didnt provide a thyroid function test unfortunately.You may also get nodules in hashimoto's disease. Fibromyalgia is diagnosed when someone present with bodypain and joint pains after ruling out all other possible causes. Regards Binu