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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Should The Fluctuations In Liver Enzymes Be Referred To Hematology?

Hi, can I answer your health question? Please type your question here... My daughter 18 years old had AST 448, ALT 264, ferritin 186, TIBC 383, FE 144, last Thursday. She has had non descript sx of intermittent Nausea, ABD pain, fatigue, does have excessive sweating. She does not have a hx of any conditions. She did have an episode 2 years ago which was thought to be due to Parvo virus, but was asymptomatic other than fever of 104 x 7days, platelets 88,000 and WBC of 2.1, which recovered without further issues. Repeat of her liver enzymes today Ast 100, ALT 50, hepatits panels all negative. She had a cousin with lymphoma in the chest and has a brother and aunt with celiac dx. She had a celiac panel in the past which was negative. How persistant should I be with follow up testing? I would like a chest/ABD CT and sed rate, ANA, AMA, Immuglobulins, Pt/INR and possible referral to hematology. Is this unreasonable?
Tue, 21 Oct 2014
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General & Family Physician 's  Response
At her young age and with her low platelets and WBC and fevers I agree that a referral to hematology is warranted. I would also consider referral to a live specialist because of her elevated liver enzymes. I agree that some form of imaging of her abdomen is a good idea.
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Should The Fluctuations In Liver Enzymes Be Referred To Hematology?

At her young age and with her low platelets and WBC and fevers I agree that a referral to hematology is warranted. I would also consider referral to a live specialist because of her elevated liver enzymes. I agree that some form of imaging of her abdomen is a good idea.