Dr. Vivek Chail
General Practitioner
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Patient's Query
Hello doctor,
I am 29 years old with 180 cm tall and 62 kg weight. I was diagnosed with hereditary spherocytosis before five years, and my gallbladder was removed. Recently had an ultrasound to see the liver and spleen. I would have mildly elevated liver readings. Hematologist wanted to check that these organs were fine. He thought they would be. Do elevated liver readings mean liver damage? I do not drink and eat a very healthy diet. Please help.
Hello,
Welcome to icliniq.com.
Your spleen is enlarged in size (attachment removed to protect patient identity). The liver appears normal in size, and the echotexture looks normal. I would like to know which liver readings get elevated? Liver enzymes can get elevated when the hemolysis is not entirely compensated for. In severe cases, it can cause jaundice. It looks to me that still the hemolysis is being compensated by your system on most occasions and less frequently. The liver enzymes might be elevated. Please have a discussion with your hematologist regarding details of the compensatory mechanisms.
Patient's Query
Thank you doctor,
AST and ALT were elevated. From memory, they exceeded 49 u/l. I am sorry I do not have actual print out. Hemoglobin was under 95 u/l. Bloods were taken 6 weeks ago. I was concerned. Going off ultrasound and the specifications, am I considered overall to be with fine liver, kidney, pancreas and spleen? Is my spleen size concerning? Attached is what Hematologist wrote on ultrasound referral. The other attachment is for next blood work. I have been immunised for hepatitis B, I saw he had this on blood form to be tested. What does it mean if LDH is elevated? Can my blood condition raise this? Can LDH be reduced? I am just trying to gain some understanding.
Hi,
Welcome back to icliniq.com.
Thanks for writing in to us.
The spleen size is mildly on the higher side but not an urgent concern.
The Hematologist wants to get a general idea of liver function. The liver tests ordered will give an idea if the hereditary spherocytosis is being compensated for and not causing any stress to the liver.
The hepatitis B and C serology is to know your antibody levels and a part of liver screening. Please mention that you are immunised.
LDH levels give information on the hemolytic changes. The surgical option is splenectomy. Regarding treatment with medicines, a folic acid supplementation can control the cells from getting large and forming a megaloblastic change. This will decrease hemolysis and LDH levels.
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General Practitioner
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