Thought to have likely acute AIH for the past eight months. Currently, being treated with Prednisolone 8 mg to go to 5 mg and Azathioprine 50 much. My ALT/AST are within normal range last two months coming down from almost 2000. ESR has been steadily rising since past five months, commenced Azathioprine later, ESR was normal. Can you tell me your thoughts? I did not see the consultant for two months. I have been told all other blood reports are fine, ESR now is 52.
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In general, ESR is a very non-specific marker. It has no significance in isolation. However, in countries where tuberculosis is predominant, we always consider it while a person is on immunosuppressive drugs. So you can ask your doctor for a chest X-ray. It is however not essential if you do not have any symptoms in general. So go ahead with your treatment. If you have any symptoms like cough, weight loss, then we need to do work-up for tuberculosis.
Thanks for your answer. I just wondered, do you think the inflammation could possibly be in my liver and could it be the Azathioprine causing this, or would that be unlikely? Prior to this acute onset, I did not have any liver issues.
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No, Azathioprine would not cause a rise in ESR. Yes, possibly inflammation in the liver can cause a rise in ESR. But as I said it is a non-specific marker and does not help in any treatment protocol as disease progression guide.
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