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

(36 Posts)
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!!

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.

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 ?

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 Tue 04-Aug-09 02:11:25

splodge2001 thanks for that I really appreciate it smile

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 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!

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

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.

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.

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?

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