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What can be the reason for raised liver enzymes during fever?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

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Published At November 12, 2016
Reviewed AtFebruary 23, 2024

Patient's Query

Hi doctor,

The issue is from 39 years ago. When I was 13 years old, I was considered for the possibility of poisoning. I was admitted to hospital for 8 days and the diagnoses were cervical adenitis and viral syndrome. I had a fever of 103 degrees for several days before going to hospital. My throat culture grew Strep. On admission to hospital, CBC showed WBC 12,900 (normal range), Hb 13.2, Hct 38.7, 36 lymphocytes, 9 monocytes, 7 eosinophils and the platelets were adequate. The almond size lymph node on the left cervical chain and the right side lymph was golf ball size. The neck was supple, no rigidity and some restriction of movement. There is no mass or thyroid palpable. The rest of the physical examination is within normal limits. Total bilirubin 0.4, ALT or SGPT was 714 initially and on discharge it was 215. SGOT or AST was 426 initially and 202 on discharge. LDH was 297 and then 217 on the day of discharge and albumin 3.8. I am trying to figure out why my liver enzymes were so high initially and 8 days later they came down. I was treated with Keflex IV antibiotic, which cured the infection. Mono spot was negative. Urine and blood cultures are negative. From what I read, the liver cause could be toxic. But, at the of 13, I neither drink, nor had hepatitis.

Answered by Dr. Sadaf Mustafa

Hello,

Welcome to icliniq.com. As far as I know, Strep throat typically should not lead to transaminitis unless there is multi-organ system dysfunction, which could also involve deteriorating renal function. Another possibility could be the use of medications like Acetaminophen to reduce fever before admission. Certain viral syndromes can also cause elevated liver function tests, especially if Strep throat was a secondary infection, which is quite common. At this point, it's essential to check if your liver function test results are now normal.

Patient's Query

Thank you doctor,

I do not think I had Acetaminophen, but may be Aspirin. I also think the viral syndrome was just something that they could not pinpoint, which I guess is normal for that diagnosis. I have normal liver functions now. I am 52 years old. I have had my gall bladder removed a few years ago. I was wondering about poisoning, as my mother was always somewhat psychologically unstable and violent at times. I thought maybe there was a possibility that she fed me something or I drank something that she may have poisoned.

Answered by Dr. Sadaf Mustafa

Hi,

Thank you for the updates. It appears unlikely to be poisoning. We sincerely wish you the best of health and a swift recovery. If you have any further concerns or need any assistance, feel free to reach out. Take care!

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Sadaf Mustafa
Dr. Sadaf Mustafa

Internal Medicine

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