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Crohn's Disease Forum » Parents of Kids with IBD » Elevated AST (SGOT)?


04-21-2014, 04:59 PM   #1
Jmrogers4
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Elevated AST (SGOT)?

Alright just had Jack's labs posted and I'm sure his GI will call me this evening. He usually calls after hours but his AST is slightly elevated 42 (range 10-36 U/L 37), RBC just by a titch 5.42 (range 3.90-5.30), hemoglobin just a titch as well 15.4 (12.5-15.0). Lymphocyte % as well just barely 49% (25-48%). Normally I wouldn't worry but it seems like a lot more red boxes this time (I highlight high numbers in red on my spread sheet). The AST has not been raised since 2011 and it seems like we were still messing with Imuran at that point.
The good news Alkaline phosphate is 380 it usually hovers about 180-190 and he is definitely growing if in small increments but he has gained another .25" in about 2 weeks.
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Jacqui

Mom to Jack (18) dx Crohn's 2/2010
Vitamin D -2000mg
Remicade - started 1/9/14; 7.5ml/kg every 6 weeks
Centrum for Him teen multivitamin
Past meds: Imuran/Azathioprine; allopurinol; methotrexate; LDN; Prednisone; Apriso; Pentasa; EEN

Husband dx Crohn's 3/1993
currently none due to liver issues
04-21-2014, 05:21 PM   #2
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No advice but isn't it amazing how they grow when they're well? Maddie grew a half an inch in the last WEEK. She's noticeably heavier too. It's awesome! I really need to get the spreadsheet thing going on - we don't usually get copies of her lab reports though. The ped or GI just goes over them with us.
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Medications: Imuran (2.5 mg/kg), Raniditine, multivitamin, iron and vitamin D.

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04-21-2014, 05:26 PM   #3
Jmrogers4
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I would definitely request them. I just use a simple excel spreadsheet but I like seeing when there are no colors on it (I use yellow for low and red for high). Although I did not the first year. I keep meaning to ask GI for copies. Mine start in Feb 2011 and he was diagnosed in March 2010. But I do have biopsy results and pictures/results form first colonscopy. It was interesting to compare with colonoscopy from last year 3 years later.
04-21-2014, 06:58 PM   #4
my little penguin
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I know DS had elevated ast while on 6-mp.
Gi was ok with that but once it was three time the normal limit he pulled the meds.
It has not gone up since he came off 6-mp
Good luck
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04-21-2014, 07:36 PM   #5
Mehita
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Maybe this is just confirming he's not an eight week kid?
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Mom of DS, age 17, dx Crohn's and Celiac Oct 2008
- Remicade, started Nov 2013, added Solumedrol June 2015
- added Methotrexate/Folate March 2016
- Multivitamins, Probiotics, Vit D
- Small bowel resection, Jan 2013
04-22-2014, 05:56 AM   #6
DustyKat
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When is Jack due to have bloods again?
With only slight increases it would be interesting to see with the draw if they have normalised again.

Also be aware that EN can elevate AST levels. As can excessive exercise if done within a day or so of bloods being drawn.

Dusty. xxx
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04-22-2014, 09:44 AM   #7
Jmrogers4
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He is not due until next infusion in 6 weeks. I'm kind of going off that it was some kind of fluke and I don't think his GI is concerned as he has not called yet. It was just a little weird to me because his labs are always in the normal range.
No EN since December.
Last time his bloods were even slightly off and then they were below normal levels was May of 2012 and we started LDN after that appt. I also think the GI looks at them and compares them to other kids he sees as opposed to comparing them to his past results kwim.
04-22-2014, 11:03 AM   #8
my little penguin
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Not to highjack the thread but can EEN raise ast and alt very high ?

I only ask since DS was on EEN and 6-mp the same time his numbers went up ...
04-22-2014, 11:13 AM   #9
Jmrogers4
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That's not highjacking. It seems to me it would be relevant information.
Just got an email from Jack's GI all it said was labs look good and it would take much longer of him not feeling well for his labs to be off.
Would allergies, the abuterol have any effect? since that is new for us.
04-22-2014, 11:21 AM   #10
my little penguin
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Allergies and asthma do not effect Ibd bloodwork -
Sed rate crp etc...
Allergies have a different immune system mechanism .
They tend to be IgE based so your total IgE value can increase when your asthma etc is flaring...
That said DS worst crohn's time correlates with bad allergies/asthma as well since they still produce inflammation just a different kind.
We feel its just too much for an over taxed system at once .
04-22-2014, 11:31 AM   #11
Tesscorm
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When S was on EN only as a treatment, his ALT and AST were always just slightly above normal. ALT normal is 0-50, his levels were 50-61, AST normal is 0-36 and his levels were 38-40. But, then with no changes in treatment or to EN dose, his ALT rose to 100 and his AST rose to 62. He was doing labs every two months at this time. His GI wasn't concerned and, at his next labs, they dropped down to 82 and 50, and next ones were normal. There was never any concern nor did his doctor ever try to find the reason for the fluctuation. I did question exercise because, at the time, S had just started to work out with weights???

FWIW, his levels have been trending down and are now well within normal, both at approx 16-24 since he started remicade and reduced his EN from 1500 cal/day to approx. 250-500 cal/day.
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Tess, mom to S, 22
Diagnosed May 2011

Treatment:
May-July 2011 - 6 wks Exclusive EN via NG tube - 2000 ml/night, 1 wk IV Flagyl
July 2011-July 2013 - Supplemental EN via NG, 1000 ml/night, 5 nites/wk, Nexium, 40 mg
Feb. 2013-present - Remicade, 5 mg/kg every 6 wks
Supplements: 1-2 Boost shakes, D3 - 2000 IUs, Krill Oil
04-22-2014, 11:31 AM   #12
DanceMom
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When A's asthma was undiagnosed/untreated she had very high eosinophils on her CBC. That was the first indication to the Pedi that something was going on. Her immunoglobulins were not tested at that time - though I wish they had been!
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Diagnoses: Immune Dysfunction, Hypogammaglobulinemia, Asthma, Allergies

Treatment: Privigen (IVIG), Flovent, Zyrtec, Cellcept
04-22-2014, 11:37 AM   #13
Jmrogers4
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So just looked at eosinophils and while in normal range they are usually a 1 but were a 3 this time.
04-22-2014, 04:01 PM   #14
DustyKat
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Not to highjack the thread but can EEN raise ast and alt very high ?

I only ask since DS was on EEN and 6-mp the same time his numbers went up ...
It can do if the formula being used is high in carbohydrates and would normally be considered the fault of overfeeding. I donít mean that as your fault mlp! but rather a regimen that has been overprescribed at the outset.

Of course what often muddies the waters with Crohnís is the addition of medication that also has the potential to cause liver toxicity. If ceasing the 6MP and continuing the same EEN regimen resulted in a normalisation of AST and ALT then you have to say it was the 6MP at fault.

@Jm. I was looking at Jack being on supplemental drinks but I donít really think it has played a role in the elevated AST in this case. More putting a thought out there if nothing else adds up.

Dusty. xxx
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