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Lipases, such as lipoprotein lipase and endothelial lipase, are enzymes that breakdown circulating triglycerides (tg). Specifically, lipases degrade tg rich lipoproteins including chylomicrons, very low density lipoprotein (vldl) and remnant particles produced by breakdown of chylomicron and vldl particles. Decreased lipase function leads to accumulation of ...Read more
Workup: If available, get a proper genetic workup even if no one else in the family is affected. If your amylase is high but lipase normal and there is nothing on imaging pointing to the pancreas, this may be macroamylasemia. If the pancreatitis is real, checking the cystic fibrosis and trypsinogen loci is indicated. This may be one piece in the puzzle. Be persistent. ...Read more
They may: It is not unusual for patients to have slight elevations in their liver enzymes with gall stones. This is probably caused by sub clinical inflammation in the gall bladder. Significant elevations are seen in acute cholecystitis and elevation of the bilirubin can be due due common duct stones with obstruction. ...Read more
History & physical: If the pancreas is inflamed or damaged, amylase and lipase are often up, and it's not subtle. If your pancreas isn't functioning properly, you'll be losing weight with no explanation and probably have diarrhea / steatorrhea. Your physician can check your stool for pancreatic enzymes. It's rare but with a suggestive history, a screen may show something that could respond to enzyme replacement. ...Read more
Work up : Ignore the MCHC. Reference ranges are set so a few percent of healthies fall outside on either end. Your physician will probably have you repeat the liver enzymes after two weeks off alcohol and meds, or perhaps proceed to a search for possible hepatitis, hemochromatosis, Wilson etc ...Read more
Calprotectin 95, ALT & AST chronically fluctuating elevated,sigmoidoscopy normal,MRCP normal, could it be IBD causing elevated liver enzyme ?
IBD complication AIH: The calprotectin level (I'm assuming it's a stool test) is rather high 4 ur age (normal is less than 51 ug/g stool), which seems confirm IBD but unfortunately didn't spare u a sigmoidoscopy. Caveat: proton pump inhibitors like Prilosec falsely elevate calprotectin. Nonetheless, a common complication of IBD is autoimmune hepatitis (AIH) which can cause fluctuating liver enzymes & damage. TTY GI do ...Read more
Normal pancreatic enzymes, normal liver enzymes, normal CBC, normal ESR & C-RP. does this rule out pancreatic and liver cancer?
Why do you ask?: Why would you think you have this stuff at age 20? You've written about this before. You owe it to yourself and those who love you to get with someone who can help you out these thoughts out of your mind and get on with studying, getting job skills and experience, perhaps finding romance and meaningful things to enjoy. To be brave, act brave. You're anything but helpless. ...Read more
Total bilirubin 2.5 (Elevated), Direct bilirubin 0.5 (Elevated), Indirect bilirubin 2.0 (Elevated) All other liver enzymes normal. What causes this?
Rerun test: All laboratory results need to be interpreted in the clinical context and the doctor who ordered the tests is usually in the best position to do that. Having said that, you need to re do the tests in non-fasting state. With the exception of elevated direct bilirubin, the findings are consistent with Gilbert syndrome, which is not a disease. See this site for more info: http://www.mayoclinic.org/diseases-conditions/gilberts-syndrome/basics/definition/con-20024904 ...Read more
I have elevated liver enzyme ast(sgot)412 ALT (sgpt) 317 GGT 186 dilation of the common bile duct 1 CM no gallbladder?
Liver issue: Enzymes ast and alt are inside liver cells. When liver is injured by disease or medication, enzymes leak out, resulting in elevation. Can be due to many reasons, including medications like statins. An elevated GGT suggest biliary problems, but is not that specific. The normal common bile duct measures less than 0.8 cm, but after the gb is removed, can be 1cm. Complete history needed for this. ...Read moreSee 1 more doctor answer
CBC, CMP, lipase, amylase,upper endoscopy, abdominal US all NML- upper right abdominal painWhat are chances cancer w/All NML tests?
Not ccommon: Most of the tests are of no value in defining disease. Some will suggest pancreatic inflammation. With US and upper endoscopy normal probably not gall stones but occasionally inflammation in the GB can cause the pain you have. An abdominal CAT scan should define any inflammatory or even neoplastic process. ...Read more
Lab:ldl:159, cholesterol:267, triglycerides:347, hdl:39, chol/hdl:6.8, tsh:9.79, free t4:0.80, testosterone:total:78/free:3.1, eosinophil:7.1.Recommendation?
Talk to your doc!: Your cholesterol & triglycerides are too high. Proper nutrition could help fix this. Your HDL is too low. Physical activity would raise this. Your TSH is too high so you may want to consider levothyroxine. Your total & free t are more difficult to interpret b/c you gave results w/o reference ranges. As i've noted before, there are many ways to check/measure testosterone so reference range is key. ...Read more
On ursodeoxycholic acid, transaminases chronically fluctuating elevated ALT 50-200 AST 40-80.ALP 90-107. MRCP normal,fibroscan normal,what could it be?
Difficult question: Why the ursodiol? If for blood cholesterol, there may be better options (I don't see CF or PBC on your history). Sounds like you're getting a work up for the elevated enzymes. Consider a virtual consult with GI specialist for a thorough review of lab and imaging results. ...Read more
Can be pancreas infl: Amylase: enzyme made by pancreas and salivary glands. Elevation can be seen with pancreatitis, mumps, vomiting/bulimia sometimes with other GI (gallbladder, ulcer), gyn issues. Lipase is a somewhat more specific pancreatic enzyme. Mild elevations non specific, very high more specific marker of pancreatic inflammation. Kidney disease screws up the values. Incr. In cystic fibrosis, celiac, . ...Read more
Lfts worsening-serum gammagt level 647u/l, serum alk phosphate 654u/l.Othr blood/heps normal.Mri &scans done. 3polyps large14mm in gallbladder-remove?
See specialist: The elevation in ggtp and alkaline phosphatase in the setting of gallbladder polyps that large mandates that you see a liver specialist before embarking on surgery. There are two types of specialists you should see, a hepatologist, a liver internal medicine doctor to make sure this is not some type of hepatitis or liver disease and then a liver surgeon to decide if the polyp is cancerous. Do asap. ...Read moreSee 1 more doctor answer
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