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Abnormal ALT, AST levels with CROHNS DISEASE. REMISSION?

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Worried about my alt/ast levels. I have a mild crohn's disease that is now in remission. I have a liver ultrasound order by my GI doctor, but my general practitioner tells me not to worry. I recently went into acute renal failure after overexerting myself in a physical fitness test. My creatinine level reached around 7.8, but no signs of anything like rhabo, no hepatitis of any kind. After about two weeks all my levels are back to normal except now slightly higher alt/ast, which was normal during the renal failure. I have continued training for the next fitness test ( I have not consumed any alcohol for around two months prior due to training) My last CMP showed the following:

Alk Phos - 73
ALT/SGPT - 125
AST/SGOT - 52
Albumin - 4.0
Globulin - 3.2
Alb/Glob Ratio - 1.3
Bili Total - 0.6
eGFR MDRD >60
eGFR MDRD AFR AMR >60

During my hospital stay for the renal failure, my heart rate dropped to a rest 38ish and now is back to 70s but very fast during exercise reaching >180. I have had luck with this site and wondering what the doctors here thought.


Category: Gastroenterologist, Medical

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Category: Hepatologist
Dr. Ratnakar Kini is online now

Expert:  Dr. Ratnakar Kini replied 4 Days.

Hi,
Thanks for posting your query at DoctorSpring.com
I am Dr.R.K and I am pleased to assist you.
Please upload the ultrasound scan report and the previous CMP.
CPK done?
Regards,
Dr.R.K


Patient replied :

The ultrasound scan is scheduled for this Friday. I have attached the last CMP reports. The 5/21/15 date is the day I was admitted for the renal failure and the most recent two have been follow-ups. Also I made a mistake as I am only 28 years old patientold not 38


Expert:  Dr. Ratnakar Kini replied 3 Days.

Hi,
Thanks for providing the additional information.
I went through your CMP reports.
There is only a recent raise in the ALT levels.
The A/G ratio is more than 1 which means you do not have chronic liver disease.
Liver is not the only source of AST and ALT.
These enzymes can raise after strenuous exercise also.
I would advise you to get USG scan of the abdomen, PT/INR, Hep B, Hep C, autoimmune and metabolic disease work up and CPK done.
This would help you know whether the source is liver or muscle and if it is from liver what the cause it.
You can repeat the liver panel after four weeks.
Let me know if you have any more questions.
Regards,
Dr.R.K.


Dr. Ratnakar Kini
Category: Hepatologist
Experience: 
Fellowship - DM - TN Dr.MGR Medical UniversityResidency - TN Dr.MGR Medical University Medical School - Stanely Medical College, TN Dr.MGR Medical University
Dr. Ratnakar Kini and 4 other Medical Specialists are ready to help you

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