Dec 21, 2011
Hello. I've been having pain/tenderness in RtUpper quadrant with nausea/loss appetite. Labs showed 10x normal Sgot & Sgpt w/mildly fatty liver.Hep tests came back negative (B was positive but I've been vaccinated this year as a health-care worker. My BMI is not even close to obese and I'm far from Diabetic. I'm thin, 42, I don't drink (3/yr), have goodcholesterol (Hdl around 100) but I do take a few meds for depression and migraines (no narcotics/only triptans for rescue). How can this be and what next?
Response from Dr. McGovern
I am concerned about your tenderness in association with the elevated liver tests. It seems like you are getting a thorough work-up, but with everything coming back normal, I don't think your tenderness is related to fatty liver. Fatty liver can certainly be associated with liver disease, but I wouldn't expect this type of clinical picture.
I think you may need to see a liver specialist for further testing and consideration for a liver biopsy. I would also contact your psychiatrist to see if any of your depression medications could be a cause for concern. But I wouldn't stop any of your medications until you talk to your doctor tomorrow. I think you should definitely get testing for hemochromatosis, a prothrombin test, and more liver function tests to be certain they are improving.
Finally, if you are a health care worker, I would also be sure to see if they checked you for HCV RNA in addition to HCV antibody. If they didn't do this yet, this test is top of my list before anything else is done (including a biopsy).
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