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

[lowrib]

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?

[JP1824]

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]

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]

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]

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]

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]

@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]

@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]

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]

@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. :) We are headed to specialist next week so I assume the tests are in our future as well.

[sunnimama]

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

[BME2020]

Hi I am in exactly same situation with my little one. She is 8 months old and small for her age. Is generally healthy and eats well. Because of her slow weight gain doctor did blood test and came back as slightly elevated ALT two times. I am so worried. Can you give me an update about your little one, how it all turned out for you. Thank you. I am really hoping someone will respond.

[spel21]

Hi @BME2020

I found this thread as my little boy is going through a very similar situation and I was wondering how your little girl is?

My little boy was born at the end of January this year and was referred to hospital for blood tests at 3 weeks old due to prolonged janudice. Results came back showing elevated bilirubin and liver enzymes. We have been back to hospital many times for repeated blood tests, his bilirubin has finally normalised however liver enzymes are still raised. He has been tested for various different genetic conditions / viral infections but so far all have come back fine. He feeds well, gaining weight and seems like a very healthy baby.

It’s been a very worrying time so any information would be greatly appreciated. Many thanks.

[spel21]

Hi BME2020

I found this thread as my little boy is going through a very similar situation and I was wondering how your little girl is?

My little boy was born at the end of January this year and was referred to hospital for blood tests at 3 weeks old due to prolonged janudice. Results came back showing elevated bilirubin and liver enzymes. We have been back to hospital many times for repeated blood tests, his bilirubin has finally normalised however liver enzymes are still raised. He has been tested for various different genetic conditions / viral infections but so far all have come back fine. He feeds well, gaining weight and seems like a very healthy baby.

It’s been a very worrying time so any information would be greatly appreciated. Many thanks.

[HotMayo]

@spel21 I don't have any advice but here for support as we are in the same situation! My little boy is also in the same situation. Also born Jan this year (2021) was also tested at 3 weeks due to prolonged jaundice. Bilirubin is now fine and has been for quite a while but still having elevated liver enzymes. Like you all other test results so far have come back clear! We do have some issues with weight gain though, never lost any but not gaining quite as fast as he should. But not really any other symptoms apart from that just tends to be a bit more fussy and unsettled than other babies. It's so hard not to worry isn't it!

[spel21]

Hi @HotMayo it’s nice to hear from someone who is going through a similar thing and I know how hard it is not to worry, so I’m also here for support if you have any questions. My little boy is back at the hospital next week for repeated blood tests and an ultrasound to see how things are going.

[MintGreenLife]

Just wondering if anyone is still active on this thread/on Mumsnet? We are going through a similar situation to many of you - my son was born at 37 weeks and within 24 hours of his birth he had to have light therapy for jaundice. He rebounded twice and needed two more sessions until we finally got discharged when he was 9 days old. He’s been seen at the prolonged jaundice clinic and his most recent blood test came back abnormal for liver function and bilirubin levels still high. They didn’t tell me specifically what was abnormal, but we are going back in on Monday for a repeat blood test. I’m trying my best not to panic but am obviously very worried. Thanks in advance to anyone that replies x

[MintGreenLife]

I should have said - he is 5 weeks old on Monday, is Exclusively breastfed and otherwise well - gaining weight well etc

[MintGreenLife]

@spel21 @HotMayo @BME2020 please see my post above, am wondering how everything turned out for you? Hope your little ones are all well xxx

[spel21]

Good morning @MintGreenLife, I know what a worrying time this is for you so sending lots of love. My little boy was last seen by doctors at the end of May. His blood results were described as reassuring and I believe only one of the enzymes was still raised but improving. He had another ultrasound which showed his liver was normal, his bile ducts were slightly dilated and spleen slightly enlarged but were the same size compared to the previous ultrasound so described as stable and doctors didn’t seem concerned. They don’t want to see him now until December. My little boy has continued to be happy and healthy in every other way and has never shown any symptoms. I hope everything goes well for you and your baby next week. I’m no doctor so can’t really offer advice but happy to be here for support if needed. Take care xxx

[HotMayo]

@MintGreenLife I know that this is a worrying time, but please try to stay positive! We were in a very similar situation to you, and had the prolonged jaundice as well as the elevated AST and ALT. They originally thought that my LO had alpha-1 antitrypsin deficiency, but genetic testing for that came back clear, ultrasound on liver also came back clear. He is 7 months now, last seen in June and at his June appointment one of his enzyme levels had completely returned to normal and the other one was still slightly elevated but had reduced a lot compared to what it was. We're next seeing our consultant for a another test next month but they're hopeful everything will be back to normal by then. Since weaning, my son had a terrible reaction to eating gluten and raised liver enzymes can be a symptom of celiac so they're currently testing for that as it runs in the family so seems likely, so they think he may have been reacting to gluten through my breastmilk (which is uncommon) which caused the raised liver enzymes before we started weaning. Apparently other allergies such as CMPA can also sometimes cause similar results and we are also CMPA, so it seems that allergies are the cause of our raised liver enzymes. This may not be the case for you if your little one has no other symptoms but just trying to reassure you that it's not always something sinister, despite what Google tells you :) x

[MintGreenLife]

@spel21 thanks so much for replying. So good to hear things are going well for you and the raised enzymes seem to be improving! Do you have any advice regarding coping with the situation? I had pregnancy complications and then we had a bumpy start in general, so am now worrying about what’s to come and how I will cope with it all! Xxx

@HotMayo thanks so much for getting back to me. I really appreciate it. How quickly after the raised enzymes were found did you go on to have additional testing? I’m quite worried about this being dragged out and not knowing that’s going on for a long time. The appointment tomorrow can’t come soon enough, however I am upset at having to see my baby boy go through the blood tests again 😥 glad to hear your little one is doing well now. CMPA has crossed my mind anyway as my DS does have some symptoms of reflux, and before I was pregnant I had cut out dairy due to a sensitivity, but reintroduced it during my pregnancy and still have it now apart from actual milk, so that could be a possibility. I keep swinging between feeling like it’ll be ok and being completely terrified x

[spel21]

@MintGreenLife I think staying off google is great advice, personally I spent hours looking and there were so many things that can cause high bilirubin/liver enzymes I never really got any answers. I would talk to anyone that listened and found that really helped, especially talking to people who had been through something similar. If at any point you have any questions please don’t hesitate to ask. To answer one of your other questions, the doctors got the ball rolling with blood tests quite quickly with my little boy, although some of the results took a little while to come back. It can be a rollercoaster going though something like this, and I know it’s hard not to worry but do try and stay positive, enjoy the baby cuddles with your little boy 💙 xxx

[MintGreenLife]

@spel21 I tho I’ve exhausted google already and it hasn’t helped much like you say, hopefully I will get more info tomorrow. Our test tomorrow is to see if the enzymes was increased again in the short time since the last test. I have cried a lot today 😥 part of rusts upsetting me so much is him having to go through more tests and distress after we had so much of it in the first couple of weeks of his life, really thought we could move on from it all and just get on with our lives together. Thanks so much for your offer to ask questions, I’m sure I will take you up on that! Out of interest, were you referred to a liver specialist, and if so how quickly did that happen? Xxx

[spel21]

@MintGreenLife All the worry is exhausting and dealing with it while having a newborn baby too will sometimes be a lot to cope with. I certainly had days where I felt like that. But then I had good days too where I felt really positive that things were going to be ok, it really is a rollercoaster. I’m sure tomorrow can’t come soon enough for you. Although like you say, I hated seeing my baby be pulled about, but the nurses could tell I was struggling and were brilliant. I’ll be thinking of you tomorrow. The doctors at my local hospital were guided by the liver specialists right from the beginning, so they told them what tests needed to be done to get things started. We first saw the specialists when my little boy was 11 weeks old and then again for his last appointment back in May when he was 17 weeks old. We will be back there again in December. Xxx

[MintGreenLife]

@spel21 thank you, I was nervous about today but I’m too exhausted to be nervous now really. We are also battling silent reflux and DS can’t be put down at all so that’s very difficult. Thanks so much for answering my questions. Really hope we get some answers at our appointment today xxx