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What Does This Blood Report Indicate?
Question: Hi Dr. XXXXXXX
You have answered some questions for me before regarding my daughters health.
Been five months since she was diagnosed with liver failure (bilirubin was 680). Today her bilirubin is 39, so somehow she has managed to almost beat that.
More recently she was admitted to hospital with Sepsis. Her bloods were shocking, but they also managed to find the UTI and EColi infections that had got into her blood so they were able to appropriately treat it and she survived that too.
Today she had her bloods done for the first time in four weeks, and whilst the bilirubin is down to 39, her blood doesn't seem to be recovering so well.
Her liver enzymes are some of the highest they have ever been even since the very first diagnosis of liver failure (alcoholic hepatitis). She has not had a drink for more than two weeks now (yes she had a few celebratory drinks when her Dr told her that she was "out of the woods" - stupid i know).
I'm just really concerned over the blood counts etc. They seem to be almost as bad as when she went into hospital for Sepsis recently. She says she feels ok, but she does have a high tolerance for pain.
She does need to eat more, particularly protein, and now weighs only 56kg, down from her usual of around 64kg.
Are the following blood results something we should be concerned about? Particularly her ALP, AST & ALT that have all increased quite dramatically in the last four weeks since leaving hospital for Sepsis infection.
Also her platelets, red and white cells don't seem to be very good?
Thank you for your assistance, once again.
Protein (Total) 55
Albumin 35
Globulin 20
Bilirubin (Total) 39
Bilirubin (Conj). 19
Alkaline Phosphatase 153 (increased from 88 in last 4 weeks)
Gamma-GT 198
Alanine Transaminase 59 (increased from 24 in last 4 weeks)
Aspartate Transaminase 160 (increased from 68 in last 4 weeks)
Lactate Dehydrogenase 251 (increased from 161 in last 4 weeks)
Calcium 2.16
Calcium (Alb. Corr.) 2.26
Phosphate 1.13
Magnesium 0.69
Haemoglobin 101
White Cell Count 3.1
Platelet Count 126
Haematocrit 0.31
Red Cell Count 3.01
MCV 102
Neutrophilis 1.07
Lymphocytes 1.54
Monocytes 0.37
Eosinophils 0.06
Basophils 0.03
You have answered some questions for me before regarding my daughters health.
Been five months since she was diagnosed with liver failure (bilirubin was 680). Today her bilirubin is 39, so somehow she has managed to almost beat that.
More recently she was admitted to hospital with Sepsis. Her bloods were shocking, but they also managed to find the UTI and EColi infections that had got into her blood so they were able to appropriately treat it and she survived that too.
Today she had her bloods done for the first time in four weeks, and whilst the bilirubin is down to 39, her blood doesn't seem to be recovering so well.
Her liver enzymes are some of the highest they have ever been even since the very first diagnosis of liver failure (alcoholic hepatitis). She has not had a drink for more than two weeks now (yes she had a few celebratory drinks when her Dr told her that she was "out of the woods" - stupid i know).
I'm just really concerned over the blood counts etc. They seem to be almost as bad as when she went into hospital for Sepsis recently. She says she feels ok, but she does have a high tolerance for pain.
She does need to eat more, particularly protein, and now weighs only 56kg, down from her usual of around 64kg.
Are the following blood results something we should be concerned about? Particularly her ALP, AST & ALT that have all increased quite dramatically in the last four weeks since leaving hospital for Sepsis infection.
Also her platelets, red and white cells don't seem to be very good?
Thank you for your assistance, once again.
Protein (Total) 55
Albumin 35
Globulin 20
Bilirubin (Total) 39
Bilirubin (Conj). 19
Alkaline Phosphatase 153 (increased from 88 in last 4 weeks)
Gamma-GT 198
Alanine Transaminase 59 (increased from 24 in last 4 weeks)
Aspartate Transaminase 160 (increased from 68 in last 4 weeks)
Lactate Dehydrogenase 251 (increased from 161 in last 4 weeks)
Calcium 2.16
Calcium (Alb. Corr.) 2.26
Phosphate 1.13
Magnesium 0.69
Haemoglobin 101
White Cell Count 3.1
Platelet Count 126
Haematocrit 0.31
Red Cell Count 3.01
MCV 102
Neutrophilis 1.07
Lymphocytes 1.54
Monocytes 0.37
Eosinophils 0.06
Basophils 0.03
Brief Answer:
Further evaluation advised
Detailed Answer:
hi.
thanks for your direct question.
i thoroughly read your question and undestood your concern.
i will try to answer in best of my capacity.
regarding Blood cells, values are NOT worrisome.
patients is recovery phase and values will return to normal (as in normal subjects) with passage of time.
secondly, patient should avoid alcohol completely as alcohol (ethanol) is mitochondrial poison ( damages liver as liver metabolizes it).
as patient AST, GGT, ALP are elevated simultaneouly i advise to have following tests:
you may consult with treating physician as well:
1. ultrasound / CT (esp focus on hepato-biliary system)
2. anti mitochondrial antibody
3. liver (auto antibodies)
4. anti ds DNA antibody
liver biopsy maybe advised by later if valuesndo not decrease followingbfew weeks.
best regards
wish patient good and sound health and speedy recovery.
Dr Tayyab Malik
Further evaluation advised
Detailed Answer:
hi.
thanks for your direct question.
i thoroughly read your question and undestood your concern.
i will try to answer in best of my capacity.
regarding Blood cells, values are NOT worrisome.
patients is recovery phase and values will return to normal (as in normal subjects) with passage of time.
secondly, patient should avoid alcohol completely as alcohol (ethanol) is mitochondrial poison ( damages liver as liver metabolizes it).
as patient AST, GGT, ALP are elevated simultaneouly i advise to have following tests:
you may consult with treating physician as well:
1. ultrasound / CT (esp focus on hepato-biliary system)
2. anti mitochondrial antibody
3. liver (auto antibodies)
4. anti ds DNA antibody
liver biopsy maybe advised by later if valuesndo not decrease followingbfew weeks.
best regards
wish patient good and sound health and speedy recovery.
Dr Tayyab Malik
Above answer was peer-reviewed by :
Dr. Yogesh D
Hi Dr XXXXXXX
Many thanks again for your prompt reply.
But I am now quite concerned regarding your suggestion to ask for more tests.
We spoke to the Doctors yesterday and they said things are 'on track' and dont plan on doing any further investigations. We were told to do another lot of blood tests in four weeks time.
I've attached my daughters full blood tests from yesterday, and her full blood tests results from when she was admitted into hospital with Sepsis from 1st to 8th August and also a copy of her Abdomen CT undertaken on 1st August.
Could I ask you to have a look at all these to see if there is anything that stands out to you please.
Could the Sepsis have changed something? Because a few of her blood results only seem to have increased dramatically since she was discharged on 8th August.
After review of the attached, should I be demanding further tests that you suggested above? or at least have further blood tests earlier than four weeks time?
Thanking you in anticipation of your reply.
Kind Regards
XXXX
Many thanks again for your prompt reply.
But I am now quite concerned regarding your suggestion to ask for more tests.
We spoke to the Doctors yesterday and they said things are 'on track' and dont plan on doing any further investigations. We were told to do another lot of blood tests in four weeks time.
I've attached my daughters full blood tests from yesterday, and her full blood tests results from when she was admitted into hospital with Sepsis from 1st to 8th August and also a copy of her Abdomen CT undertaken on 1st August.
Could I ask you to have a look at all these to see if there is anything that stands out to you please.
Could the Sepsis have changed something? Because a few of her blood results only seem to have increased dramatically since she was discharged on 8th August.
After review of the attached, should I be demanding further tests that you suggested above? or at least have further blood tests earlier than four weeks time?
Thanking you in anticipation of your reply.
Kind Regards
XXXX
Brief Answer:
patient may wait for few weeks to have the blood tests
Detailed Answer:
hi.
its a pleasure to answer your concerns.
i went through the attached blood reports.
most of the blood values are satisfactory.
doctors are right and may have advised to wait for four weeks as increased liver enzymes are NOT high enough prompting immediate investigation.
patient bilirubin value is pretty much good and patient has NO presenting symptoms.
therefore, there is NO harm in waiting for four weeks time to get the blood tests done which i advised earlier ( and if the values of AST, ALP, GGT ;after four weeks; do NOT decrease). tests were advised to rule out any hepatobiliary disease. however, it can wait.
...."the four weeks"...
in addition, patient is advised to strictly abstain from alcohol, so after four weeks time, blood results may give a better picture of liver function.
also avoid junk food and soft drinks.
oily food maybe use with caution.
fresh sugarcane juice maybe ingested ( if available) ...
secondly, you may ask treating physician as to how long the patient should use the drug "bactrim"? is it necessary to use now?
hope to answer your concern.
regards
DR Tayyab Malik
patient may wait for few weeks to have the blood tests
Detailed Answer:
hi.
its a pleasure to answer your concerns.
i went through the attached blood reports.
most of the blood values are satisfactory.
doctors are right and may have advised to wait for four weeks as increased liver enzymes are NOT high enough prompting immediate investigation.
patient bilirubin value is pretty much good and patient has NO presenting symptoms.
therefore, there is NO harm in waiting for four weeks time to get the blood tests done which i advised earlier ( and if the values of AST, ALP, GGT ;after four weeks; do NOT decrease). tests were advised to rule out any hepatobiliary disease. however, it can wait.
...."the four weeks"...
in addition, patient is advised to strictly abstain from alcohol, so after four weeks time, blood results may give a better picture of liver function.
also avoid junk food and soft drinks.
oily food maybe use with caution.
fresh sugarcane juice maybe ingested ( if available) ...
secondly, you may ask treating physician as to how long the patient should use the drug "bactrim"? is it necessary to use now?
hope to answer your concern.
regards
DR Tayyab Malik
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Above answer was peer-reviewed by :
Dr. Nagamani Ng
Answered by
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