Elevated labs?

[kernelmom3]

Both my kids had their Remicade infusions yesterday (I'm happy they're synced up!) and DS labs look great. DD labs look "stable" but her liver tests are slightly elevated (normal for one test was up to 17 and the other was up to 24 and her levels were around 54). She has a cold right now and doctor said that could be why they're elevated. Since everything else looks good, and she feels good, doc wants to repeat labs in 2 weeks. But as I was looking I noticed that although her sed rate is normal, that has gone up too. I'm just wondering if any of you have had experience with high liver enzymes and/or fluctuating sed rate. I don't want to be freaking out for the next two weeks if I can help it! Thanks in advance everyone

 

[malorymug]

My 15 year old has been on Remicade for a little over a year. We've had our ups and downs with labs but his liver enzymes were always normal/low until last week. His AST was above normal limits. I'm not worried because he has been sick with a virus and we just did a huge bump in his remicade dose and frequency. I'm guessing it will take his body to adjust. ::crossing fingers::

I hope that is all it is for your daughter as well.

 

[crohnsinct]

Yep! Crazy high and weird liver numbers one infusion and perfectly normal when repeated. Also O's sed rate recently went from 9 to 28 (normal up to 20). No call from doc and wouldn't you know it back down to 18 at next infusion.

Lots of things can affect these numbers. I have learned with O that dehydration will scew lots of things so I try to make sure she is adequately hydrated before blood draws.

Sed rate just measures inflammation in the body but isn't specific to the GI tract so I try to stay calm on that one also. Tesscorm has a nifty recounting of her son's sed rate and how the GI was never concerned and all was fine.

Docs know what they are looking at and when to freak and what trends mean what...we just have to trust them and give up a teeny tiny part of control.

I hope it is all a big fat nothing!

 

[my little penguin]

^^^^ yeah that

Ds had blips with liver enzymes more than once abx will raise it as well
Gi never blinked
Now when Ds was on 6-mp
His numbers doubled like your child
Next blood drawn was a few weeks later
Blood was drawn at 3:30 pm
Gi was on the phone telling us to stop 6-mp right then
At 5 pm same say
Apparently his liver numbers were up to 200-300
So yep if it's bad they let you know
And fast

Sed rate Ds is an 8
Four plus years of 8
Sometimes it creeps up but only a few random times
Bad ear infection for week and went to almost 70
Got a call from Gi then as well
So again
Docs know when to get concerned and when it's OK to watch
Hugs

 

[sagette]

My liver enzymes keep coming back elevated as well. Looking over the results of my last blood work, everything was "normal" except the liver enzymes. GI ordered another round of blood work this week. It will interesting to see the results.

 

[Tesscorm]

Yes, S has had fluctuating numbers as well...

During the week he was inpatient, when he was diagnosed, his sed rate (ESR) was taken four times - 26, 63, 53, 43. After being on EEN for six weeks - 9. Over the next 1.5 years, while on supplemental EN only, it ranged from 4 to 35 (some of these were when he had a flu, hockey injuries, etc.). Over the first six months on remicade, it ranges from 2 to 33. GI no longer tests ESR, uses CRP instead. Also, there wasn't always a direct correlation with CRP, even though they are both inflammatory markers. CRP is a more immediate indication of inflammation, ESR takes longer to rise and to lower.

As a reference point, his GI wants his CRP to be below 5. Since being on remicade, it has fluctuated between 0.2 to 2.9 - so again, fluctuation - not a straight line up/down, just up one test, down the next.

Re liver numbers, not sure if you're referring to ALT (normal <50) and AST (normal <36), S has also had fluctuating numbers - however, they have been consistently in the normal range since starting remicade. But, before remicade, within one six week period, they jumped from ALT 61 to 100 and AST 43 to 62. There was no reason to explain the jump, no sickness, no new meds, etc. And, with no treatment for it, they just dropped down to normal levels even before starting remicade.

So, absolutely keep an eye on them, yes GI will know when they are of concern (although I kept my own records and specifically questioned when numbers were off) but numbers do fluctuate and it's not always an immediate concern. :ghug:

 

[DanceMom]

A seems to have a finicky liver so her numbers fluctuate often, particularly if she's taken Tylenol or Ibuprofen. Her doctors don't get concerned unless they are at least 3x the normal limit. For example, on 6mp her AST was 92 (12-32) and ALT was 327 (8-24). She was symptomatic (itchy rash, headache, fatigue) and the GI made the call to stop the medication. It took months for her numbers to return to the normal range, and since then her liver numbers rise from time to time. It happens.

 

[Maya142]

My daughter's liver numbers have gone up and down too. They were once pretty elevated because she'd been on antibiotics but her rheumatologist and GI just said to recheck in two weeks and by then they were down.

Her ESR tends to be normal, but does go up and down. Her CRP has recently started rising, and when it was significantly high (19, range is 0-4) we heard from her rheumatologist.

A cold could definitely make her inflammatory markers rise - we have seen that too.

Hope everything checks out in a couple weeks!