Liver tests

[matildamillicent]

I'm in my early 20s and haven't been given a diagnosis of Sjogren's because my SSA/SSB and lip biopsy are negative, but I have the dry eyes, dry mouth, joint pain/swelling/stiffness, fatigue, rashes, Raynaud's. My rheumatologist has mentioned Psoriatic Arthritis with secondary Sjogren's, but I haven't got an official diagnosis. I'm on Plaquenil. I also have Celiac Disease.

For the past 6 months my liver function tests have been up, first mildly but now they're creeping up there. For about 6 weeks I had constant nausea, vomiting, fatigue, liver pain, weight loss (more than 22lbs) etc. I ended up in hospital three times with dehydration. I'm now feeling much better but my liver tests aren't improving.

I'm negative for Epstein Barr, CMV, Hep A/B/C. My ALT, AST, GGT and something else is elevated. My ALK phos is low. CBC, ESR, CRP etc all normal. I'm having them retested on Monday and seeing my GP on Wednesday. I've also spoken to a hepatoxicologist and she's said she doesn't believe my medication is responsible for my results

I've found stuff online about liver involvement in primary Sjogren's, but nothing about secondary. I'm slightly worried about the possibility of autoimmune hepatitis.

Anyone had any experience with this or any suggestions?

Thanks.

[Joe S.]

What is your AST/ALT?

[matildamillicent]

I don't have the numbers on me I just peered across the screen at the doctors the other day. I know my last two ALT readings have been 118 and 192, anything under 35 is normal. My AST has been around the 80-100 mark, anything under 40 is normal.

[Joe S.]

Ask for a copy. This is a record that you should have access to. I have to make an appointment to check get mine rechecked as they may indicate a form of hepatitis.

[matildamillicent]

I'll ask my GP on Wednesday for a copy. I'm just curious what sort of liver conditions this could indicate and if it's related to Sjogren's. Thanks.

[Scottietottie]

Hi

A liver condition that is sometimes connected to sjogren's is Primary Biliary Cirrhosis (sp?) I think it can only be confirmed via a liver biopsy.

Plaquenil and tramadol can both lead to higher than normal liver readings.

I hope you get the answers you need soon.

Take care - Scottie 

[matildamillicent]

Thanks Scottie, that's helpful. I did a little bit of research into Primary Biliary Cirrhosis but I see it's usually characterised by having an elevated Bilirubin and I think mine has been normal or just slightly elevated.

I'm not on Tramadol, just Plaquenil and my LFTs were up before I started on Plaquenil.

[engy]

Ask for a copy of your records. You should also ask your doctor about starting silymarin or milk thistle. It's for your liver, research & ask dr. good luck

[Diane54]

I have Autoimmune Hepatitus and my liver enzymes were all over the place for about 2 years. At first the doctors just chalked it up to fatty liver, however after an ultrasound and liver biopsy I was diagnosed with AIH. The Plaqunil I am taking for SS has my liver enzymes in check!