Q. How to treat autoimmune hepatitis with raised ALT and AST levels?

Hello doctor,

My mom was diagnosed by chance with the liver disease about three months ago when she did some routine blood tests. Her values then were:

ALT = 157 U/L.

AST = 106 U/L.

ALP = 727 U/L.

GGT = 575 U/L.

She had ultrasound and CT tests, but nothing wrong showed up with her liver at all. She had and has no symptoms. However, she was said to have autoimmune hepatitis. So she got treatment: with Ursodeoxycholic acid and other liver supplements, like Liv. Also, she started a healthy diet (no salt, no fat, no fries).

After a few weeks (about two weeks later), she repeated the blood tests, and the values were much smaller:

ALT = 49 U/L.

AST = 37 U/L.

ALP = 440 U/L.

GGT = 285 U/L.

We were very happy, and she continued the treatment. Now, after three months, she repeated the tests, but the values were a little strange:

ALT = 61 U/L.

AST = 41 U/L.

ALP = 339 U/L.

GGT = 195 U/L.

ALT and AST raised, while ALP and GGT dropped just a little. What could be the cause for these? We are so worried. Are there reasons for severe concern?

Hello doctor,

Thank you for your reply.

She does not drink alcohol at all. She never did. Also, the tests for hepatitis B and C were negative. The doctor said that it is likely to be autoimmune hepatitis. Unfortunately, I cannot send you the CT images because I do not have them. But I can tell you what the doctor wrote on the diagnosis paper. He wrote:

1. Metabolically normal hepatic steatosis (although, when he did the ultrasound, he said the liver was normal).

2. Chronic hepatopathy of unknown etiology.

He did not write ‘autoimmune hepatitis,’ but he said it is likely to be. I can send you all the blood tests.