Talk

Advanced search

Blood tests show elevated AST liver enzyme in baby DS - does anyone have experience of this?

(36 Posts)
lowrib Thu 30-Jul-09 22:26:34

My DS had some blood tests, they came back with raised AST, a liver enzyme.

Apparently it could mean liver damage for a number of reasons, or it could come to nothing.

We have to test again in a month. I'm trying hard not to worry. My DS is 7mo and appears healthy.

He only had the blood tests as a precaution because he's large and it's standard for babies over the 99.6 percentile. Everything else came back normal.

Does anyone have any experience of AST / raised liver enzymes?

splodge2001 Thu 30-Jul-09 23:06:08

PLease do not panic - in all likeliness it will be nothing. DD was found to have raised ALT which is another Liver Enzyme after a prolonged jaundice screening.

AST can be a marker for liver damage but as it's found in other tissues it may point to something else. How high is it? Babies can have deranged levels of liver enzymes by comparison to adults, often it means nothing because hospital use reference ranges meant for adults. This is because reference ranges for babies sometimes dont even exist - they dont take blood from healthy babies routinely! There is some evidence to suggest that that the range of 'normal' for liver enzymes in babies is somewhat wider than the adult range. If you give me your email i will send you a very interesting paper on this.

I have done a lot of research on this and we are off to the specialist liver clinic at kings on tues. I really hope this helps.

remember if your baby seems well chances are he is.

Northernlurker Thu 30-Jul-09 23:28:45

I agree with splodge - if he seems well - good energy levels, developing normally? then the chances are he's fine. I won't say don't worry because I don't think there's much chance of that - but do try not to dwell on horrible scenarios.

lowrib Fri 31-Jul-09 11:02:25

splodge2001 and Northernlurker thanks for your responses and for the reassurance. I am trying my best not to worry.

splodge2001 that stuff about reference ranges is interesting. I'll try to CAT you my email address.

I can't say how high the level is as I haven't actually seen anything in writing - I spoke to my Dr on the phone. I got the impression the levels are not enormously raised but I would need to speak to him again to confirm this for sure.

Thanks smile

lowrib Fri 31-Jul-09 11:06:45

splodge2001 you're not set up for CAT, so I'm not sure how to get my email address to you. Would you mind maybe sending me your email address via CAT (click 'contact poster' by my name) and I can email you back?

My email address is my full name so if I post it here I'll completely out myself on MNET!

splodge2001 Fri 31-Jul-09 21:07:15

Here is one

http://www.clinchem.org/cgi/content/abstract/30/3/407

click view pdf on right to see the whole thing

here is the second

http://adc.bmj.com/cgi/content/abstract/92/12/1109

i cant do the cat thing im afraid

hope this helps

lowrib Tue 04-Aug-09 02:11:25

splodge2001 thanks for that I really appreciate it smile

Gambrosius Sun 20-Jul-14 23:41:58

I realize this thread is extremely old but upon searching for ALT/AST information for my newborn DD, I found your discussion and would love to hear how all of your babies made out?? My DD had some remaining jaundice in her eyes at her one month checkup and doc requested the bili be rechecked along with liver panel. Bili is still low (coming down slowly from a 4), and AST was elevated. Since then, retested several more times...levels continued to come down from a 69. Recently however both AST and ALT shot up to 89 and 103. Have stayed there since last test- with no symptoms whatsoever... She's seen a specialist who suspects breast milk jaundice? We're in limbo just waiting and worrying from one test to another (with a perfectly healthy baby otherwise). Any resolutions or discoveries you made with your own experiences with this would be greatly appreciated! I keep thinking the worst... Thank you!

lowrib Wed 24-Sep-14 22:33:05

Goodness, I had totally, completely forgotten about this.

DS is now 5.5, and a picture of health!

We've had no issues related to that AFAIK.

However, we have had a series of blood tests done recently. DS was complaining his legs were hurting, which lead to a blood test. The test showed low Vitamin D, Low Mean Cel Volume (that means small red blood cells if I've understood correctly) and low white blood cells. He's been given a Vit D supplement + multivits + iron. After a few months we've tested again, Vit D is fine now, and white blood cells still low but not as much, so we were sent to a haematologist.

The haemotologist was very reassuring. Vitamin D deficiency very common apparently (much more so that people previously realised), and he suspects he must have had an infection the first time, which accounts for the white blood cell being low.

We're happy with that. DS seems perfectly healthy. The occasional pain in his legs is still a mystery however, but he seems to be complaining of it less now. (It wasn't that often in the first place).

Not sure why I mentioned all that! I don't think it's related, but you never know I guess ...

I hope you get some good results soon. Please try not to worry too much! I know it's easier said than done, but the chances are in your favour.

What is Breast Milk Jaundice by the way? Are you in touch with any breast feeding experts like La Leche League ?

lowrib Wed 24-Sep-14 22:35:49

Sorry that sounds like I've contradicted myself above, by saying DS is a picture of health and then going on about blood results!

But DS is rarely ill. He's a solid child, strong and full of energy and joy.

walnutlemon Thu 09-Oct-14 05:08:29

I'm going through a similar situation as Gambrosius with my daughter. I thought I'll post here so I can share my experience too. My daughter is 4 months old - at her 6 week check, her paed noted she looked jaundice and ordered blood tests to check her bili levels. Her bili levels were high (173) but they came down over time and are in a normal range now. However the test picked up elevated AST and ALT levels which at 6 weeks were very marginally high (around 50+) but they were obliged to repeat the blood tests and track the AST and ALT levels since they were an anomaly. We have been doing blood tests every 2 weeks since then (we've done 7 by now) and her levels have steadily increased every time (now at around 150-170). We did have one instance where there was a slight downturn (when she was 3 months old) from 129 to 120. But it went up again after that which is what's puzzling the doctors. She's exclusively breast fed, and feeds well.

We've tested for CMV, muscle disorder and both came back negative. We were referred to a specialist paed gastroentrologist who we just saw last week and she ordered up tests for inborn errors of metabolism (which as I understand are a broad spectrum of disorders). She said these are very rare - for a baby to have metabolic disorders, she must receive a faulty gene from BOTH parents (one faulty gene each). Luckily, the results just came back and she is all clear of metabolic disorders. So the course of action now is the repeat the blood test again in 3 weeks and hopefully see the AST and ALT levels come down. In her experience, she said these mildly elevated levels are usually from a viral infection that will resolve itself over time. We've more or less tested for everything else that could cause the elevated AST/ALT (CMW, muscle disorders, metabolic disorders). She said if AST/ALT levels continue to rise, she might consider testing for even rarer disorders like autoimmune disorders. However she seemed inclined to feel that we will be able to see the AST and ALT levels come down. She said our daughter looks very well upon physical examination, no swollen liver, stomach or spleen and is putting on weight (doubled her birth weight at 4 months old), but she will continue to monitor her physical well-being at the next blood test visit (3 weeks' time).

So, we're waiting now, hoping that the levels will go down. This has been and is still stressful, not knowing and waiting, and just having your mind go wild thinking about every possible scenario. We're focusing now on the present, enjoying our baby girl and not let worry and anxiety take away from our enjoyment of our precious little girl. I'll give updates as and when I know.

If any one of the moms from the original posts (5 years ago!) have an update on how their kid is doing now, 5 years later, and what was eventually the outcome of the elevated AST/ALT, that would be really helpful! Thanks so much!!

ioaname Sun 23-Nov-14 15:57:35

I found this looking for elevated levels for AST and ALT. My doughter is 9 weeks old and we also have breast milk jaundice. Her billi level is 4 and AST/ALT are 83/60. Our doctor said that we can help her liver to "get started to work" and she gave us a syrup LIV52 for a month....
I am positive that everything will be fine because they are so perfect little creatures but theyr bodies are adjusting to this life now...
All the best and please let me know how your analyses are now.

Gambrosius Sun 23-Nov-14 17:36:41

My daughter's numbers remained elevated until 6 months (when we recently re-tested her again). Her numbers are completely normal now and all she needed was time. She has been the picture of health all along but we still had "specialists" trying to intervene; formula supplement, perform a biopsy, complete an ultrasound, etc.. we did not do the supplementing or biopsy and I'm so glad we didn't! I've spent so much time worrying over this and we incurred many more medical bills on top of delivery costs. While not always the case, often these tests are unnecessary and shouldn't be ordered in the first place. I wonder how many babies (including my own) have had elevated numbers in their early months as their little systems learn to operate properly? Most babies aren't tested outside of the typical bilirubin tests so it's possible many babies have "abnormal elevations" that just naturally resolve over time...

My advice is to trust your own instinct and judgment when observing her every day and to give it more time (unless you're seeing unusual symptoms). Our family found peace and answers through praying and trusting God. It took some time to resolve but we are so grateful that it did! Praying for you and your daughter!

ioaname Mon 24-Nov-14 11:21:37

thank you so much for your answer. it means a lot to me to see that you were in the same situation and everything is fine now. I wish you and your little one all the best in the world. smile
yes, I agree that babies so little shouldn't be tested if they seem ok. I am upset because I gave her phenobarbital at my dr advice for lowering the billi level. And it worked but it is a strong drog and I am positive that it would have been fine over time without takeing it.
Your dr didn't prescribe anything for lowering the billi level?
It is so stresfull with the first baby...
May God give us wisdom to make the right choices.

Hannahlatay1210 Sat 10-Jan-15 20:14:21

Well some of these post are little old! Hope someone reads and gives me peace of mind!
My daughter will be 4mo the 16th of this month, we recently have seen her pedo, which due to her small size insisted on blood work. My husband and I are pretty small people. As well as his entire family! None of the men are over 5'7 and the woman are all 5' if that and very petite. His sister weighed 18# on her first birthday and 20# he second birthday, but was very healthy! So my LO is a tiny thing. Anyways, her liver enzymes appeared to be elevated. Normal her dr said is 60 hers were 113. She eats good, I am now supplementing beCause

Hannahlatay1210 Sat 10-Jan-15 20:19:27

Sorry it posted before I was done!
....because I do believe maybe I was not producing enough. She's been strictly breastfed till last couple days. Dr loves her energy and her smile and feels she is developing great she is just a little smaller then he'd like but otherwise he has no complaints. However because of the number he is referring us to childerns hospital in Seattle. We live 3 hours away. I am freaking out! To me she is fine and healthy. Never had any odd symptoms. We struggle with acid reflux but that's it! I am so stressed! We will see them in a couple weeks. They are to call to set the appt up. They have not yet. I am happy to read some of the other posts! But I'm still stressing out!

Chelckins56 Wed 14-Jan-15 19:55:48

Hannahlatay1210, I'm curious how your LO's situation turns out. We're going through practically the same situation and it's honestly freaking me out a little. I'm waiting for liver enzyme test results as I type this. My LO started out very chunky (9 lbs, 1 oz) and had lost a pound between her 4 and 6 month checkup. We had labs done Friday and had to repeat this morning due to high liver enzymes and high blood acidity. I doubt they would have worried though before weighing her! She is on track developmentally, happy as can be, and eats a ton. She is breastfed too though, so I'm wondering about the connection? She's on solids now and since her last checkup, I added a bottle of formula, but she still isn't gaining weight according to the growth curve. Me and my husband's families are both tiny too though (I'm 5'1", he's 5'10" but his dad is a jockey). I would love for it to be just a plateau in growth and she is just turning out to be smaller than they thought, but these tests are freaking me out.

sunnimama Mon 26-Jan-15 02:07:29

So glad I found this thread! My 6 week old also has elevated enzymes, he's been monitored since they were picked up accidently 3 week ago and have been steadily rising. I keep finding info about 'mildly' and 'highly' elevated results but I can't find info on what is high and what is mild! Would be very curious to know others results - my boys are ferritin 1693, total bilirubin 63, direct bilirubin 16, alk phosphatase 510, alt 230, ggt 430, ast 282. He seems completely happy and healthy with no jaundice, but like you all I'm freaked out!

metisprincess Sat 21-Feb-15 01:30:21

hello my grandson is 10 weeks old with elevated liver functions, he was born at 9lb 12oz 23 inches long. He dropped down to under 8lbs and when weighed last night at 10 weeks he is only 9lbs 4oz..... He has elevated levels and does not appear to be thriving. He is breastfed only. He was admitted to children's hospital yesterday...we r concerned....did anyone else have significant weight loss?

sleekgirl Sat 21-Mar-15 08:32:17

My 7 week old has been jaundiced since 1 week, but bili levels did not concern drs. Yesterday blood work confirmed elevated liver enzymes. I have now been advised by her paediatrician to cease bf for 1 week and the enzyme levels will be tested again to see if breast milk jaundice, or my medication (5mg Cipralex) is causing the problem. It is so worrying when there is so little research on new borns and effects of medication, even though I have been advised by my pharmacologist that bf would not be a problem. Would love to hear if anyone ekse is taking Cipralex whilst bf?

Linzismith30 Fri 27-Mar-15 19:41:09

My littlen has had similar to all this at 5 weeks she wasn't gaining much weight after having jaundice I was not bf tho and she was referred to the peads who said they think she's dairy intolerant so changed her milk accordingly and done blood tests and her gamma gt were up, so repeat bloods done and they were going down then all of a sudden around 3-4 months her ALT levels were going up so more bloods done (meanwhile she's suffering with reflux and not gaining much weight) my consultant referred us to a liver specialist hospital and we had a scan and more tests done and the scan come back with fat on the liver so they took loads of blood for metabolic and auto immune disorders and I got a phone call today saying her ALT were over 200 and they are sending her to have a biopsy and a sweat test my LO is nearly 6months and only weighs 11.12 she's little and apart from being a bit grumpy with her reflux and fussy with her food she's normal not as advanced as my other 2 but she's good and happy I found this post and found it interesting has anyone had any answers with similar to my story thank you

seahorsewahine Tue 31-Mar-15 19:24:56

My daughter is in the same boat. 9 weeks old...was 7lbs 6ozs at birth, is just back to 7lbs 11ozs now at 9 weeks. Very active, alert, smiley. No signs of jaundice. Not gaining weight so they did bloodwork and found elevated liver enzymes. They are hospitalizing her over night tonight to monitor, and then do an ultrasound tomorrow. Anyone else have any results yet? I know my supply is on the lower end...but they all keep saying it is fine since she has tons of wet diapers daily.

jchanme Wed 01-Jul-15 09:05:25

Over the past month, my 3mo old daughter has received several blood tests for liver functions. At first, it was the jaundice that alerted the doctor to order blood tests and ultrasonic, ultrasonic came back good, but the blood test results showed bili level is a little high and AST is 3x higher than referenced highest value, Total Protein is a little low, GGT is about 2x higher. ALT is twice higher.
Today we had the blood tests done again and the ALT and AST is more or less the same level, while the bili is in normal range now. We don't know what the causes are, but last time I presented the test results to the doctor, she asked me if I wanted to give her medicines to protect her level from damaging and for me, it is a no to give my 2mo baby medicine. I don't see any symptoms from my baby, she's beautiful and active, she's perfect. I have no reason to believe anything is wrong with her, besides, the jaundice is gone now.
How do things turn out for your LOs? I'd love to hear from you guys. My wife is very worried because we don't know that exactly is wrong.

walnutlemon Mon 06-Jul-15 14:47:16

I've not looked back on this thread for a few months and I'm surprised to find it so active! It looks like this issue with elevated AST/ALT levels are more common than we realize. Our regular paed doctor also mentioned that she has seen an increase in elevated AST/ALT cases this year.

I wanted to post to give an update. My daughter is now 13 months old and her ALT/AST levels are completely normal. All clear!!

We had our visit with her specialist paed gastroenterologist last month when she was 1 and that's when she got the all clear. It has taken her longer than expected to reach the normal levels - her specialist was inclined to feel that this was something that would resolve itself over time (because we had tested for everything under the sun including rare inborn errors of metabolism, and the tests all came back negative) although she mentioned that usually it resolves within 6 months but some might take longer. The diagnosis is neonatal hepatitis - a passing viral infection - although why she had it, how she got it, we haven't a clue. And reading all these recent posts, it seems to be more common than we think.

I wanted to give an update to hopefully give some of you parents some peace of mind. It is a extremely stressful situation to be in, not knowing what it is. The not knowing is particularly hard because you keep wondering is there really something seriously wrong? Or do you trust your gut when you see your child healthy, happy and behaving perfectly normally. Not knowing means not being able to say, ok here's what the issue is, and here's how we can so to solve it, to make it better. There is no action plan to take, no end point to say, ok if we did all these things/ treatment options, etc - we can get to this point where it is better.

The worrying and not knowing and not seeing the signs of abating, of the downward trend despite months and months of repeated blood tests did topple me. And I hope that for those of you who are struggling too, please know that you are not alone. Hold on to hope, and know that you are stronger than you realize.

I'm so incredibly grateful that we can say this chapter is now closed. We got through with hope and faith and prayers, and I'm keeping all of you and your little ones in prayer!

Sani1234 Sun 06-Aug-17 06:48:50

Hi I know no one has posted here since 2015. But I am going through a similar situation. My lo had physiological jaundice in day 3. And now she is 9 weeks and the jaundice is still there. It is now 7.6. The doctor thinks it's breast milk jaundice but her liver enzymes are elevated. Repeat test in 3 weeks. Wanted to find out what turned out after all these years? The liver enzymes came back to normal? If yes, when?

POLLYMURPHY Fri 08-Sep-17 10:42:42

Hi Sani1234
I have a one year old who had raised liver enzymes ast and alt since she was first blood tested at 4 weeks. She went on to have endless tests scans done and everything has come back normal. She is due back in to get bloods in the next few weeks to see if the results are now normal I will let you know how we get on. Please God they are normal now.

JP1824 Mon 11-Sep-17 06:40:57

Hi all! I'm glad I found this thread because it has been a very stressful time for me and my family. My daughter who is 7 weeks old has been having elevated liver enzymes as well. At first her pediatrician said that this was common in Asian babies and that he felt that it would go away in time but her levels have continued to rise. Initially her direct bili was 2.1 but it has been rising and the latest is direct bili= 4.2, ALT= 80, Alk phos 530, Total bili 8.3. Her stools are normal color and she's gaining weight. She was born at 7.2 lbs and at her last appt was 10 lbs. If it weren't for her lab work, she appears to be very normal. She just has a hint of being a little jaundiced and we notice a change in her skin tone from time to time. So far she's had an Ultrasound which was negative and then had a HIDA scan which the GI specialist says he does not think she has biliary atresia or neonatal hepatitis. We are still concerned bc he did not 100% r/o BA or hepatitis. He just prescribed her Ursodiol, which she has been taking for a few days and will repeat labs again tomorrow. Hoping and praying the labs will be ok. The GI specialist says that if they are increased then it would be up to us if we want to continue with a liver biopsy or cholangiogram. Anyone else with a baby that they gave Ursodiol to? Any advice or insight will be helpful. We really do hope everything normalizes. The wait and not exactly knowing what is causing the elevated liver enzymes is so agonizing.

saranade97 Sat 30-Sep-17 14:23:16

Hello all, I hope this thread is still active and I could get an update from any of you as I'm going through the same situation. I have a almost 5 month old premature baby who's lost weight/hasn't been gaining weight in the past month. I'm typing from Rady's children hospital as we speak because she's failure to thrive. She is breastfed and eats a jar of fruit purée a day only and still hasn't gained any weight and she breastfeeds a lot. Her lab work just came back and her liver enzymes are high and the doctors are perplexed as to what might be wrong (why she's not thriving). She's such a happy, easy to take care of baby and she's not lacking in any developmental milestones. Absolutely nothing is out of the ordinary except her not gaining any weight. Her father and I are skinny but I'm short and he's very tall and my baby is really long as well. Wondering what your guy's explanations were

michellesebastian Tue 31-Oct-17 06:28:44

hi @sunnimama, how's your baby doing? Your description of ferritin and liver enz reading fits my 5 months baby boy exactly! We are going through endless testing (poor baby) but so far nothing is found. Just wanted to know if you have any update on the health of your boy?

kutti1988 Tue 01-Jan-19 13:40:44

My male baby prolonged jaundice bilirubin total 1.21 ast 128 alt 175 aalkaline 460 baby is active feeding well what to do iam very much worried about this

idlipera Wed 06-Mar-19 11:09:48

Hello mommies,
I join this group to share with you our experience with this elevated liver enzymes. I want to say thank you to all the mums especially @Gambrosius who replied here and gave me reassurance that everthing will be fine in nature’s time.

At 1 week old, my baby shows sign of Jaundice and it linger up to 2 months. We did 3 blood test. At the 3rd test @2mos, our pedia advised us to test for liver profile just to be sure that jaundice is not a symptom of something else. We got elevated liver enzymes with AST started at 90U/L. At 10 weeks, it went up again at 140U/L, this was when our pedia refer us to another pediatric gastroenterologist. This was the time I began researching about this liver topic.
The pedia explained to us what we can do is to eliminate possible diseases - we did ultrasound to check liver structure and it was normal, we did a detailed liver function test, hepatitis profile test, hematology (blood profile) test and the only issue is the elevated AST, ALT and biliburin. We test again at 3 mos and its still elevated. The last test that we did @5mos was the TORCH test (to test wide spectrum of infections) which showed some history of the cause — we got positive for IgG CMV — meaning I got an infection when I was pregnant but it was already gone. This test was very expensive but it will only gave little assurance cause there are a lot more unknown infections.
This is the last test that we did that I decided to stop. Even if the doctor advise us to keep checking every month. Cause when i discussed this with the doctor even if we found out the infection, we cannot do anything but to wait until the baby is mature enough to fight it.

i just went back today @16mos just to check if his liver is ok now. And it is fine now. My son was born weighing only 2.5kg. I think his organ was not mature enough during that time. He was also colic so I also suspect that his stomach is also not mature enough to process milk and food. It did get better at 5mos. So as what other moms said, i think some babies have this cause their organs are not mature enough but will get better in time. Cause we have eliminated all important causes that we should detect early like his organ structure is functioning well, he has no hepatitis, he has no blood count issues, and no wide spectrum of infections, It only goes down to what unknown infection did he got. So its better to wait and trust that his little body will grow.

Sarahthompson0630 Thu 17-Oct-19 02:31:04

@sunnimama I know this thread is old, but if you still check this I'd really appreciate an update on what happened with your situation. We are dealing with a similar situation with my 9 week old and I'm a nervous wreck. Elevated AST and ALT levels but otherwise very healthy and wouldn't know anything was wrong. Thank you so much.

Sarahthompson0630 Thu 17-Oct-19 02:32:55

@michellesebastian if you still check this thread I'd really appreciate an update on what happened with your LO. We are facing a very similar situation right now with my 9 week old and I'm a nervous wreck.

sunnimama Thu 17-Oct-19 09:04:13

Hi @Sarahthompson0630 - I got a notification from this thread in my email! My little boy is now almost five and is completely happy healthy and gorgeous. His levels continued rising for a few more weeks baffling the drs and they were considering biopsies. We did a heap of blood tests and all were normal. The levels eventually plateaued and I decided I had had enough of the blood tests and would pursue a diagnosis if any symptoms showed - he was totally happy and healthy the whole time. None ever did! I hope your little one is the same and everything works out well for you xx

Sarahthompson0630 Thu 17-Oct-19 09:38:55

@sunnimama thank you SO much for your response. I really appreciate it. Do you by chance remember what your son's levels were at the plateau? I'm so glad to hear he is doing so well. smile We are headed to specialist next week so I assume the tests are in our future as well.

sunnimama Fri 18-Oct-19 06:49:33

I'm sorry, I wish I did! It's so long ago, I can't even remember how old he was when it plateaued. I hope all your tests come back negative and your wee one is fine, it's such a scary time xxx

Join the discussion

Registering is free, quick, and means you can join in the discussion, watch threads, get discounts, win prizes and lots more.

Get started »