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Gastroenterology  (Expert Forum)
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Extremely high liver enymes
Answered by
Kevin Pho, MD - Internal Medicine
Kevin, M.D. Boston - MA
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MedHelp Member's Question

Extremely high liver enymes

by brennie, Nov 12, 2003 12:00AM
Admitted to emergency ward a week ago with extreme and frightening pressure in upper abdominal area,sternum and below rib cage), enormous bloating, very scary...felt the way I had heard a heart attack might feel.  They checked heart...everything fine, but did give me a nitroglycerin and Pepsid as well.  Blood tests taken in emergency showed such high liver enzymes that the Dr. asked if I was a heavy drinker.  I responded that I drink maybe 2 glasses of wine a month! but that that weekend (2 days earlier) I had attended a wedding and had 2 glasses of wine, a beer, and a very very old cognac within 24 hours. I was very dehydrated as well (never drink water, unfortunately)..just soda and coffee. They admitted me, and the following day my enzymes had risen to over 500...they said I had an hepatic liver and quizzed me on sex, drugs, transfusions, etc. My answer to all is that I am monogamous, not a drug user, had blood transfusions more than 10 years ago, none since.  An ultrasound did reveal that I had gallstones, but my symptons did not include any PAIN and I believe the gallstones are totally not involved.  I had hepatitis as a child, but the hospital tells me that my blood tests show that I do not have hepatitis A or B.  I am wondering if the cognac combined with dehydration could have caused the attack? could I have ingested some sort of poison?  Blood tests taken one week before the emergency admission showed completely normal, and blood tests taken 2 days after the admission showed normal.  Very confused and worried.
Doctor's Answer

by Kevin Pho, MD, Nov 13, 2003 12:00AM
Surgeon has kindly addressed your question in his comments below and I agree with his assessment.  



Followup with your personal physician is essential.



This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.



Thanks,

Kevin, M.D.

Member Comments (7)

by surgeon, Nov 12, 2003 12:00AM
it may not be "pain" but your description of frightening pressure is certainly consistent with gallstone issues. With such high enzymes, one would consider a stone in or passing through the main bile duct as one of the possible causes of what happened to you; with, or without pancreatitis as well. Hepatitis or other liver inflammatory problems are certainly on the list as well, but intense pressure as you describe is less commonly seen in primary liver inflammation than with gallstone problems.

by surgeon, Nov 12, 2003 12:00AM
I'd add that the rapid resolution of the abnormalities is also highly suggestive of having passed a gallstone. I think seeing a surgeon and/or a gastroenterologist is the next move.

by krisg, Nov 12, 2003 12:00AM
Your experience certainly suggests a further look into the biliary tract.  Sounds like surgeon "hit the nail on the head". With my prior experience, sounds like you passed a stone.  Good Luck

by brennie, Nov 12, 2003 12:00AM
In reading other comments re liver enzymes in this Forum, doesn't having liver enzyme reading of over 500 seem "unbelievably" high?  The doctor told me that "normal" was 60...is this reading of over 500 not truly excessive?

by nurse12hr, Nov 12, 2003 12:00AM
a link for you:



http://cpmcnet.columbia.edu/texts/guide/hmg22_0005.html

by surgeon, Nov 13, 2003 12:00AM
"unbelievable?" Not at all. Consistent with what I said above. In severe hepatitis, in certain poisonings, etc, numbers in the several thousands can be seen. In addition, there are several liver enzymes; simply giving a number without knowing which enzymes doesn't tell the whole story. But, to repeat: severe pressure, transient elevation with rapid resolution, gallstones. Highly suspicious for passing a gallstone.

by brennie, Nov 13, 2003 12:00AM
Thank you so much for the information.  I feel relieved and have a much better understanding!
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