Help! Elevated liver enzymes.

[xs11ax]

Hi.

First time poster, but been lurking for a while. My son was diagnosed with Crohns about 6 months ago. We have managed to bring him into symptomatic remission through LDN and diet alone. Nothing else. His inflammatory markers are still high, but it's early days yet. Currently he is only going to the toilet once a day, no blood, stools are normal, and he is slowly gaining weight. It has been like this for about a month. On a couple of days he has missed a bowel movement. Currently he has been 2 and a half days without a bowel movement. This is quite concerning.

But my main concern is his elevated liver enzymes. They are as follows...

Alkaline Phospate - Went from 589 to 940
ALT - Went from 198 to 266
Gamma GT - 840

Apart from the high numbers he is not showing any symptoms at all. He is completely symptom free. He is currently being tested in hospital. His ultrasound scan showed everything was fine with his liver, gallbladder, and bile ducts. It did show that his liver was slightly enlarged, but the doctors didn't seem to concerned about that.

Anyone had any experience with something like this and has an idea what's going on?

Thanks.

 

[Scipio]

In Crohn's patients elevated liver enzymes are usually associated with a spike in inflammation from the disease and/or liver toxicity from the drugs used to treat the disease.

Is LDN the only drug he is taking? Some "natural" herbal remedies and supplements can also damage the liver.

How high are his CRP and fecal calprotectin? And have they also increased along with the liver enzymes?

Unfortunately, in Crohn's the symptoms do not always correlate very well with the true state of the disease, which is why we can sometimes feel pretty good even when the disease is still out of control and the other way around.

 

[xs11ax]

In Crohn's patients elevated liver enzymes are usually associated with a spike in inflammation from the disease and/or liver toxicity from the drugs used to treat the disease.

Is LDN the only drug he is taking? Some "natural" herbal remedies and supplements can also damage the liver.

How high are his CRP and fecal calprotectin? And have they also increased along with the liver enzymes?

Unfortunately, in Crohn's the symptoms do not always correlate very well with the true state of the disease, which is why we can sometimes feel pretty good even when the disease is still out of control and the other way around.

He is only taking LDN. Nothing else.

ESR was 80
CPR was 50

I don't know if it has gone up or down.

 

[GirlwiththeCurl]

Hi!

Those are not insignificant numbers for his liver function tests! Has your son had a liver biopsy? Some liver diseases, particularly in their early stages, may not be caught except by biopsy. My daughter's liver diseases (autoimmune hepatitis and primary sclerosing cholangitis) were only found by liver biopsy. Like your son, every freaking lab and scan came back normal except for her VERY elevated liver function tests (her AST, ALT, Alk Phos, and GGT were way up, similar to your son's numbers), and her liver was slightly enlarged. The only reason we knew about her liver function tests was because she had bloodwork for increasingly bad diarrhea. So we had her IBD, AIH, and PSC diagnosed all at once. PSC is relatively strongly associated with ulcerative colitis (about 5% of people with UC will eventually be diagnosed with PSC) but less so with Crohn's. Also, there is a strong overlap of AIH with PSC in the pediatric population. If your son's GI/hepatologist has not suggested a biopsy, I would certainly at least ask if they thought it was warranted and if not, why not. Also, NONE of my daughter's inflammatory or autoimmune markers came back elevated or positive. So...just saying that good bloodwork is not an absolute guarantee that some of these things aren't going on.

Also, if you want to look up PSC, go to PSC Partners Seeking a Cure. Don't just Google, there's a lot of terrifying and outdated information out there.

This was probably a depressing post. I hope it helps, though.

 

[GirlwiththeCurl]

MRCPs are also used for imaging the bile ducts within the liver. PSC has both large duct and small duct types. An MRCP can show stricturing in the large bile ducts, but small duct PSC is diagnosed by biopsy.

 

[GirlwiththeCurl]

ALSO--I am NOT saying your son has these diseases, but given his numbers I think you should be finding out what is going on. A pediatric hepatologist might be a better bet than a general GI.

 

[Guerrero]

I think you should very seriously consider to give him standards medication for crohn's.
Symptoms are not sufficient to consider he is going ok. High inflammatory markers are not a good sign, he is probably not in remission... I have no idea if iver test are related to crohn's inflammation but it could be. It's important he get monitored and see a good ibd specialist for his health and his growth.
I hope he'll be fine soon