Dr. Deepak Patel
Child Health
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Patient's Query
Hello doctor,
My 8-year-old daughter continues to have strong abdominal pains. A couple of months before, it was really bad and was also coupled with mono and fifths disease. At that time her levels were crazy high. AST = 1312, ALT = 1692. These levels freaked out the doctors so we went back the next week, still high but much lower AST = 394, ALT = 807, GGT = 84. We also did a sonogram at that point which was inconclusive. We went back two weeks later and not better AST = 532, ALT = 682, GGT = 71. Doctors have no answers and no idea about what was going on. The doctors seem to phone it in at that point.
My daughter started feeling better so we did not push it for a couple of months and went back in and the levels seem close to normal AST = 57, ALT = 42, GGT = 12. We were given no comfort as to what caused it. My daughter does complain a couple of times a week about her stomach hurting, but she is not in the extreme pain she was in until this week. She is back to waking up in pain, spending most of the school day in the nurse's office. So now we are heading back to the hospital for more blood as we did not get any answers from the first 37 vials of blood they have taken. Any clues on what might be causing this?
Hi,
Welcome to icliniq.com.
I can understand your concerns. This appears to be a case of obstructive jaundice. The main cause of obstructive jaundice is gallstones. Since GGT (gamma-glutamyl transferase) levels are raised more than 70 in the first report it suggests an obstructive cause. AST (aspartate aminotransferase) and ALT (alanine aminotransferase) can increase in both hepatic and obstructive causes.
In obstructive jaundice, the level of direct bilirubin increases more as compared to indirect bilirubin levels. Gallstones are easily visible on the ultrasound abdomen. It also causes severe acute abdominal pain. There are some syndrome like rotor syndrome which can also cause obstructive jaundice. Nevertheless, the enzyme levels are falling and the child is improving now. But, I suggest you to repeat ultrasound to look for gallstones. Review with ultrasound report and liver function test report especially bilirubin levels.
I hope this helps.
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Child Health
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