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Gastroenterology (Expert Forum)
elevated alt after isoniazid with frequent nsaids
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elevated alt after isoniazid with frequent nsaids
by TK, Nov 11, 1999 12:00AM
I am 40 years old, in good health, with a history of excessive ETOH in college, who was recently treated with INH for TB test conversion. I rarely drink these days, never to excess and use Nsaids for headache pain several times a week as well as drixoral daily for sinus allergies.
During INH treatment my ALT elevated to the 90's, medication was d/c'd and the level corrcted to 42 in 30 days. The normal at our lab is 36 max. Follow up test was stable at this level after one additional month.
Do I need to be concerned about this test result, should I follow? I understand implications of Hep C, Very low risk sexual history, no known exposures..
Please comment
During INH treatment my ALT elevated to the 90's, medication was d/c'd and the level corrcted to 42 in 30 days. The normal at our lab is 36 max. Follow up test was stable at this level after one additional month.
Do I need to be concerned about this test result, should I follow? I understand implications of Hep C, Very low risk sexual history, no known exposures..
Please comment
Doctor's Answer
by HFHSm.D.-Gastro-rf, Nov 30, 1999 12:00AM
Dear Tk,
INH treatment is frequently associated with elevated liver tests and for some can be associated with serious liver disease. It may take time until the liver tests return to normal after the INH has been stopped.
Given that your tests are still elevated I would stop the alcohol completely until normalization occurs. You certainly could be checked for hepatitis C infection. Finally, there are many conditions that can cause elevated liver tests. You may want to discuss with your physician whether there is any reason to test for these possibilities based on previous liver test elevations or other aspects of your medical history
INH treatment is frequently associated with elevated liver tests and for some can be associated with serious liver disease. It may take time until the liver tests return to normal after the INH has been stopped.
Given that your tests are still elevated I would stop the alcohol completely until normalization occurs. You certainly could be checked for hepatitis C infection. Finally, there are many conditions that can cause elevated liver tests. You may want to discuss with your physician whether there is any reason to test for these possibilities based on previous liver test elevations or other aspects of your medical history
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Effects on diagnostic tests: Elevated liver function study results occur in about 15%; most abnormalities are mild and transient, but some persist throughout treatment.
Adverse reactions: hepatitis (occasionally severe and sometimes fatal, especially in elderly patients), jaundice, elevated serum transaminase levels, bilirubinemia.
Does your doctor plan to retest you in another month? Did you have tests done before starting on the INH and how do they compare? I think I would want to have another test done in a month just to be sure. What does your doctor suggest?