Has anyone's child had an enlarged liver?

[Nogodsnomasters]

Hello,

My son was ill last week and ended up dehydrated, we took him to a&e where they gave him a drip but said his liver enzymes were really raised, they admitted him on the Friday night. They thought the dehydration might be causing it but another blood test 48hrs after fixing the dehydration showed one enzyme had lowered by 23(not enough) and the other not lowered at all. On Monday they did an ultrasound of all his organs, today we've had the results to say his liver is enlarged but the other organs were all okay.
They've tested for hepatitis but the results have not come back from the labs. They also tested his stool, wee and nasal secretions for infection which came back normal. He has a slight lingering cough from a chest infection few weeks back so they also did a chest x-ray just in case but it was also fine.
The enzymes that are raised are AST and ALT. I can't remember which one has which figures but they said one was 120 and the other 310!! I am worried out of my absolute mind. Has anyone any experience with an enlarged liver? Google is telling me that hepatitis is rare in children.

Anyone at all?

You are probably best off contacting the team who looked after your child / whoever is following you up and ask for a plain language letter explaining their thinking so far. Even if you get responses on here it's quite likely they will be nom-representative and may not be relevant for your child.

Is COVID involved at all? At the other end of the spectrum my elderly dad had odd blood results for liver after COVID. Drs said no real studies on this but they also wondered. It self-resolved. Unlikely to be relevant. Hope he's well soon

He had COVID in December. We've had results back to say he's negative for Epstein Barr virus and viral hepatitis.

How is you son now?
They knew since 2020 that covid can affect the liver, especially if it follows covid and a chest infection (caused by what, what virus or what bacteria, did they test him and told you if it was viral or bacterial pneumonia?) and a cough. Chest infection isn't a diagnosis: it can be bronchitis, pneumonia, bronchiolitis- which one was it, what tests did they do to find out what caused the 'chest infection', knowing that pneumonia is the most common complication after covid? Did they test for long covid, known to affect the liver, especially following covid?
''Severe acute hepatitis associated with COVID-19 is rare, but has been described.
In a large retrospective study out of New York City, levels of aspartate aminotransferase (AST) were frequently higher than levels of ALT, suggesting that AST may be a useful indicator of COVID-19 infection'' https://www.ccjm.org/content/early/2020/08/25/ccjm.87a.ccc061#:~:text=Severe%20acute%20hepatitis%20associated%20with,indicator%20of%20COVID%2D19%20infection.
Did they test for covis induced hepatitis, the new hepatitis affecting children caused by covid, with one of the highest number in the uk: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9782959/#:~:text=During%20reinfection%20with%20SARS%2DCoV,damage%20and%20acute%20liver%20failure.&text=Hepatitis%20is%20common%20in%20children,infection%2C%20resulting%20in%20liver%20sequelae.

Im currently recovering from a liver "injury" they call it. Im not a child, obvs, but, I had what they think was a liver infection, caused by "a virus", they cant tell me what virus, of course. But Myself, I think it was covid, i tested negative but the only other time i felt that shit, was when i did have it a year ago.
Anyways, i see the enzymes are 310, while of course you are worried, Let me just reassure you a bit. Mine were 2200 when it peaked, and my ER doc said my liver was "ginormous" along with hand gestures to match.
I was put on steroids for 8 weeks and im on an auto immune tablet for maybe 2 years, and my bloods, 4 months later are now 100. Ive not been "sick, I am absolutely Shattered but Not "sick".
the liver is a wonderful organ, it throws a tantrum when its not well and tells us its not well, its not silent, this is a good thing. And it regenerates itself, which is bloody amazing and V important for you to remember now.
How is he in himself? How is is poo, what colour is it? Pale poo is an indication of a sick liver, and how is his colour. I went a lovely shade of yellow.
Im not trying to say its the same as your son, id rather i was sick than any of my kids, but im an old lady of 54 compared to him, and even my liver regenerated with lots of rest and food and decent meds.
Dont panic yet, honestly.

Your son had covid, covid pneumonia (I assume, if this is what they mean by 'chest infection'), followed by liver problems: how did they take covid into account?

Covid induced hepatitis has a different name somehow in the UK, because they don't want to admit the link, it's called adenovirus hepatitis, despite the adenovirus being an incidental finding and not found in all cases. Here you can see how UK tested children with the new acute hepatitis for current covid infection, instead of past covid infection, despite knowing that it takes time for the virus to affect the liver, it doesn'r happen during the acute phase. This is why what was important was to test for past covid infections, as America & Israel did, but UK refused : ''SARS-CoV-2 has been identified in 18% of reported cases in the UK and 11 (11%) of 97 cases in England with available data tested SARS-CoV-2 positive on admission''(Lancet) - these children were only tested for current covid infections, despite being well documented that covid takes time to affect the liver, it doesn't happen during the acute phase of infection. CDC in America couldn't now believe when UKHSA refused to test children for past covid infection, which was vital for proving the link. So now this hepatitis has a different name in the UK comparing with the rest of the world
Also the most grotesque reality is that UK refused to vaccinate children against covid, doing the exact opposite from the rest of the world: US and the rest of the world vaccinated children against covid. Uk fought against vaccines as soon as they were approved by MHRA .
Here in the UK they were all happy saying there isn't a direct link between the new acute hepatitis affecting children (most or all of them unvaccinated against covid) and covid, when the reality is that the link is indirect, the same as with any other virus causing complications, the link is rarely direct. HIV complications are not direct, it doesn't mean they don't exist, because what's important is the LINK ITSELF, not whether it's a direct or indirect link
https://gut.bmj.com/content/69/Suppl_1/A22
''Conclusion Covid-19 Induced Hepatitis (CIH) is a new clinical syndrome, which can be defined as a ‘benign new transient hepatitis in a SARS-CoV-2 patients which icharacterized by the following; Gradual onset, elevated AST and ALT,''
This condition, despite being in the British Medical Journal, it doesn't appear on NHS website, so it doesn't exist for NHS

And even if it isn't hepatitis, the fact that covid affects the liver is well known, especially when it follows covid infection and covid pneumonia, I assume covid should be taken into account as the main culprit

It is well known that covid can cause liver injury: ''The etiology of COVID-19-related liver injury is divided into three categories: (1) The direct mechanism involves severe acute respiratory syndrome coronavirus 2 binding to angiotensin-converting enzyme 2 in the liver or bile duct to exert direct toxicity; (2) the indirect(!!!) mechanisms include an inflammatory immune response and hypoxia...'' How did they take this into account: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10075013/
.

Why they can't tell: did they admit covid can be a culprit, known by the rest of the world for years now? This is by now common knowledge, so why can't they say exactly? When HIV affects other organs, nothing can be proven with a certainty of 100%, but they admit the link, so why wouldn't they admit liver damage caused by covid, when it follows covid? Isn't this how medicine works: more cases proving the same think, more chances for the medicine to progress? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8527347/ Diabetes has many complications: they can't be proven 100%, so does it mean the link is simply ignored? Smoking causes an endless list of indirect conditions, when did they hesitate to take smoking into account, when a patient has asthma, lung cancer etc. The link with smoking is always indirect and not 100% proven, does it mean smoking is ignored when treated for lung cancer? How do they manage to ignore covid, knowing that covid can affect the liver and many other organs and link is mainly indirect? And if they are bothered by the link, then they would make sure patients are vaccinated against covid, the simplest step anyone can take since covid vaccines were discovered: did they make sure you are vaccinated against covid?

Because they cant tell for sure. And its 12 months since I had Covid, and I had been unwell before My liver got sick, but negative for Covid.
So its not a definite link.

Could it be Gilbert's syndrome?

@ForRoseExpert I think you are maybe misinterpreting the information. My son had covid in Dec, in January he was completely fine healthy and well, in February he got a chest infection (not pneumonia), he had an antibiotic for this which helped but the cough lingered due to my son having mild asthma, he was well within himself after the course of antibiotics until this new virus got him which was stomach orientated (he vomited, lost appetite, ended up dehydrated).
These are separate illnesses. I'm not saying the liver enlargement was not due to COVID or long COVID etc as I can't know for sure but nor could the doctors.
They tested for everything else they could think of, even the nasal swab tested for adenovirus - everything came back negative. As did the hepatitis screening.

Chest infection=? Chest infections are bronchitis (viral) or pneumonia (viral or bacterial)- so which one did your son have?
Doctors tested for everything, including long covid? Really? How? Covid can affect the immunity- how exactly was this taken into account when a child was diagnosed with 'chest infection'? Not related? Seeing the chain of medical conditions following covid, while covid can be ignored, because doctors aren't sure? When obesity is linked to diabetes, how exactly are they sure, when the link is not direct, but still they are sure - how? But covid followed by 'chest infection' doesn't raise any questions? Followed by enlarged liver in a child? Still no questions? Just coincidence? When they link cancer to environment, the link is very complex and difficult to prove, but still no doctor would question it. But when conditions known to follow covid, follow covid, then doctors are not sure, because what exactly? Didn't read the BMJ- packed with information, the NIH - packed with information? All normal? A child with 'chest infection' without a name? An enlarged liver without a cause? WHO said to take covid into account when medical conditions can't be explained, when they are not normal: how exactly did they do this? Or to you all these conditions affecting a child are actually normal?

When they blame cancer on environment, how exactly are they sure? They take into account research, they didn't have to contribute to it, be part of it, but they do take it into account, it wouldn't cross their mind to reject it. When obesity increases the risk of cancer, this is not a direct link, they can not prove the cancer was caused by obesity, still they wouldn't ignore the link, because raising awareness about the dangers of obesity is important. The same is about the dangers of covid, about which tonnes of research is readily available everywhere: how exactly were the discoveries about covid science included in medicine? 'liver injury' isn't even a diagnosis, what exactly was it? Past (not current) covid infection can injure the liver: did they test for past covid infection? Did they ask about past covid infection? Did they advise you to protect yourself against covid, with a very simple vaccine invented years ago, readily available anywhere else but the uk?

Taking into account your child has asthma and enlarged liver, had 'chest infection' (pneumonia or what exactly??), did they advise to vaccine against covid, known to aggravate or cause liver problems and pneumonia? If not sure what caused the enlarged liver, the fact that prevention against covid is accepted by the rest of the world, did they advise how to protect your child against future covid infections? NHS: ''A chest infection is an infection of the lungs or airways. The main types of chest infection are bronchitis and pneumonia.'' How come you don't know this? Bronchitis is viral, your child received antibiotics, this rules out bronchitis and leaves pneumonia. Didn't they tell you?

You are being bloody rediculous.
Ive been seen by the best liver specialist in the country.
He knows a lot better than you.

If he knows so much, how come you go on mumsnet to find out the most basic information about enlarged liver....didn't the specialist inform you?

Forroseexpert, The last section of this reply really highlights that you're not a medic and have limited understanding of what you're saying.

(Bronchitis can be many things e.g. allergic, viral, bacterial, related to 2nd hand smoke etc.
We can't garner anything from the fact the child received antibiotics, they're often given as a "just in case". Anyway, I digress)

You're clearly passionate about a possible COVID link, and this is a fair suggestion to make. But that's all it can be, a suggestion

Why you feel you know better than OP's doctor and OP on this is beyond me.

Why are you being so argumentative? What does it matter to you which type of chest infection he had prior to this illness? He was seen by a GP who heard a rattle when examined and prescribed antibiotics, the hospital did a chest x ray as a safety precaution due to the lingering cough even though the antibiotics treated the infection 3wks prior - this X ray was clear.

Did I say they tested for long COVID? I said "they tested for everything they could" - there is no such test for long COVID as you well know.

She's not the OP!!!! I am. Follow a thread correctly or piss off with your attitude.

Eh thats not me.
Dope.