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Pathology/liver test results

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QUESTION: just in case u need to know-25 yrs ago Ihad a bad gallbladder and many stones removed-and alongthe way a huge , swollen bad appendix-a liver biopsy was done also becasue my liver enzymes before surgery were is the 20,00-40,000 range-the surgeon afterward said my gallbladder was so bad it had oozed on my liver and he seen scar tissue meaning I "once had non A non B hepatitis and with my age (then 28) that he thought I could bet it...Now I am 53 , female, non rinker, diabetic and in 2011 an abdominal US showed :moderate fatty liver" and last June 2012 I had a month long 102-103 fever for a solid month that could not be explained and after it finally disappeared the (both) liver enzymes were30- 40 points each higher than the range--all Hep tests were negative(I never remember to tell my Dr the story of 25 yrs ago). ANyway here I am with liver enzymes still mildly up and terrified-I am afraid it will kill me...Zocor 40 mg was stopped a year ago after many years of use and still enzymes are same and today my Dr is halving my 2000mg Glucopahe a day to just 1000mg to see if it is the culprit(been on ALL meds about 10 yrs) I weigh 215, lost 20 while sick but gained back).I am on Nexium ,Glucopage, Glucatrol xl-10mg, Lantus ,Tranxene. I seen the gastro MD and he did huge labwork I never heard of and 13 vials at that--all was normal...can u offer me any insight and do u think the 25 yr ago thing could be it-BUT I THINK my Dr did a test telling IF I ever had hepatitis and it said NEGATIVE--which confuses me...

ANSWER: Hello RC:

A gastroenterologist is the best person to handle this question. However just to ease your anxiety, "moderate fatty liver" can cause mild elevation in liver enzymes as you have. Non -alcoholics can have fatty liver due to various causes, in your case being diabetic can definitely contribute to this.

The month long fever may be unrelated to the liver.

The Hepatitis tests all look for presence of antibodies, these decrease with passage of time. For remote history of hepatitis in 20's its likely that your antibodies have fallen below the range detected by the tests done.

However, your blood sugar should be controlled and have follow up liver enzymes done in a couple of months, if they are going up further evaluation will be required.

---------- FOLLOW-UP ----------

QUESTION: okay thanks; so do I understand right--that my test results that are negative for all types of Hepatitis COULD be wrong becasue the incident 25 yrs ago when my surgeon tested a sample of liver during a gall bladder removal-said my liver WAs sscared but healed and the gallbladder had oozed onto the liver casuine NON A NON B HEPATITIS, but he thougth with age I could be at it. I was 26 now I am 53-did I understand that right? The Dr wants to do another ultrasound of the liver-one was done near 2 yrs ago showing the "moderate fstty liver".  I have yet to go back to the gastro--I WIL have the colonoscopy though I dread it I have never had one and colon cancer is on my mothers side of her family and I alwasys fear that due to stomach issues of unknown origin...can you please tell me one more thing...I do know my dobates in an auto immune disease-right?  Is thereothr specific tests for other auto immune diseases-like I haev been tested over again a lot for ra AND LUPUS BUT THEY ARE ALWAYS NEGATIVE-WSA TESTED BECASUE OF FA FEW FIRST COUSINS HAVING THEM BOTH AND i HAEV SYMPTOMS-BUT NEGATIVE RESULTS.(sorry for caps on).I feel my Dr is not doing all he should-and I find it odd the liver thing ahs resurfaced after 25 yrs but all Hep tests negative and I aslo think the May 2012 month long high fever someway casued the liver enzymes to go up-after all they went up in June 2012 and have never been back to normal...also during that fever-2 CBC tests were done-one had low platelets, one had high, one had high WBC, one had low---was very confusing...and sound so bad--RBC always on borderline low/high...so is iron..

Answer
Hello:

If 25 years ago no serology was performed for hepatitis it is hard to confirm diagnosis of hepatitis.

Diabetes is an autoimmune disorder of the pancreas. There are tests for other types of auto immune disordes, some are specific to a disease and others are screening tests to diagnose the general category of auto immune disorders.

The CBC parameters measured are dynamic and vary every time the test is done. The high or low values have to be interpreted in context with all signs and symptoms.

During infection WBC increase, and later they decrease and revert to normal change. Platelets also fluctuate and as long as they are in normal range it's okay

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Neha Dahiya MD

Expertise

Help patients understand the medical terminology of their lab results and / or tissue biopsy reports.

Experience

I am a pathologist and director of clinical laboratory services. I have been a practicing pathologist for last 9 years in a 350 bed multi specialty hospital laboratory in India.

Organizations
Indian association of pathologists and microbiologists.
International Academy of Cytology
International association of Pathologists - Indian division
Indian association of Cytology

Education/Credentials
MD (pathology) MBA

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