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  • High Liver enzymes

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    Old 08-04-2008, 10:21 PM   #1
    clb3457
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    High Liver enzymes

    I just had surgery 3 weeks ago for renal cell carcinoma. My liver functions test were fine before the surgery. While in the hospital they kept telling me that my liver enzymes were high. They had a hard time controling my pain so I was on a wide variety of meds. I was in the hospital 8 days. Three days after I was released I had to go back in for more blood work. My AST level was 232 and my ALT level was 262. Does anyone know what this means. I had an ultrasound of my liver and I go back in for more blood work soon. Since having the surgery I feel light headed and fatigued. I don't know if that has to do with recovering from my surgery or if it may be a symptom of what is going on with my liver. I rarely drink, I am 47 and have been healthy until this all started happening. If anyone has any info on what this tests mean I would appreciate it.

     
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    Old 08-05-2008, 11:28 AM   #2
    harka
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    Re: High Liver enzymes

    Hi there,

    I'm sure you've gone through quite a bit with that last surgery. I hope your recovery is going well.

    The cause of high liver enzymes is a VERY loaded question because there are many many things that can cause it. First off, just to explain WHAT it is: the liver cells of the body contain a bunch of enzymes which are employed to do various biochemical tasks. In health, these enzymes seep out of the liver cells at a constant rate, and can be detected in the blood. EVERYONE has some amount of the enzymes present in the blood (the enzymes measured are AST, ALT, GGT and ALP). If the liver is being damaged for some reason, the liver cells burst and more of those enzymes leak out and can be detected in the blood. The enzymes themselves don't do anything, but the presence of more enzymes in the blood is suggestive of something happening to the liver.

    So now what can cause these problems. The list is VERY long and can be divided in to acute processes or chronic processes. The most common things to cause liver damage acutely are infections and medications. Infections that cause acute hepatitis include: Hepatitis A, B and E as well as CMV and EBV. Certain bacteria can cause it too, but these are rare. Drugs such as large amounts of tylenol, certain antibiotics and heart medications can also cause hepatitis in the acute phase. Additionally, if you have something which is indirectly affecting the liver like a gallstone blocked duct, you will also get a rise in liver enzymes.

    More chronic grumbling causes include: Hepatitis B & C, Autoimmune Hepatitis, Wilson's Disease, Hemachromatosis, Non-alcoholic fatty liver disease, Alpha-1 antitrypsin deficiency, alcohol, certain long-term medications etc.

    In your case, a very important thing to rule out is a metastasis to your liver from the renal cell carcinoma--though on the initial CT scan I'm sure they did on you, they probably didn't see any mets so this is much less likely.

    Are you on chemo right now (i.e. sutent or sorafenib?) are you on any other medications? Do you have any risk factors for blood borne infections such as high risk sexual behaviour, tattoos or IV drug use?

    In any case, your doctor will likely send off a barrage of bloodwork as well as an ultrasound to delineate the more common things I have mentioned above. S/he will take a second look at your medications and inquire about your alcohol intake to see if there are any reversible insults to your liver.

    Last edited by harka; 08-05-2008 at 11:30 AM.

     
    Old 08-06-2008, 07:44 AM   #3
    feelbad
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    Re: High Liver enzymes

    really great info up there matis,really good. i just wnated to add something that i was not really aware of myself about just having surgery done(and i have had to have six since 01,with kidney and liver disease) and how the anesthetic can affect your liver. it just does to a certain degree in some people more than others,then you factor in all the nasty meds that you are also given and it can create some problems just within the surgery itself on both kidneys and liver,but for some reason,it does hit the liver much harder. i don't think this would explain the really very high numbers you are having tho. what did the ultrasound come up with? anything out of the norm? marcia

     
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