Elevated ALT and GGT, low WBC and Petechia

[Zuleiko28]

Hi all,

I've previously started a post when first notified of abnormal LFTs.

For the past few months I've been fatigued, it's affecting life at home and starting to interfere with work. I'm male aged 33 and was in good general health until about 2 months ago when fatigue kicked in. I went to GP who did some blood tests which showed elevated ALT (81) and GGT (180). My ALT has always been above 60 but recently it's gone up. Second round of bloods as same result but this time FBC was gone and my WBC is low (3.6). I had an ultrasound of abdomen which shows signs of fatty liver (no scaring). Which I guess is good news. I am waiting for a more detailed WBC test next Thursday but what is worrying the most is that I also have Petechia which I've had for around 10 years and the number of spots is increasing each year. On top of my fatigue I'm feeling achy and emotionally down. When googling these symptoms do hint at liver issues but also leukaemia. What can say to my GP to help my nerves and rule out both?

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Is there any chance you could have any symptoms of an autoimmune issue, I know you say your inflammatory markers are not raised but mine weren't to begin with whine I was diagnosed with an autoimmune disease and now I have early stage cirrhosis. I was interested to read about your blood spots as I get random small painful bruises appear, on my hands mainly, but everybody has dismissed them, I didn't know there was actually a name for it!

I hope you get some answers as I appreciate your worry having been through the anguish recently of having raised ALT levels and being sent for loads of other test without any information why. I don't think GPs realise the stress they put us through because of lack of information, it doesn't help the condition at all to be under extra stress. Or the waiting for appointments!

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Morning

Im not sure on anything related to leukaemia. But your Liver numbers indicate your Liver is swollen and irritated. Swelling is the enemy of the Liver, the body trys a rather feeble repair job of sending in white bloods to help, this results in scarring and eventually Cirrhosis and ultimately Liver failure.

Having your ALT at 60 for 10 years is somewhat of a concern, because this could indicate a swollen and irritated Liver for 10 years. The numbers are all elevated which indicates the whole Liver is swollen, i.e not just bile ducts (GGT comes from them) ALT is the rest of the Liver.

fatigue is a common complaint of Liver issues and so are the red marks, but again I would think leukaemia would make someone fatigued too.Low white bloods can also be a sign of Liver problems.

So I think you may need to look at ALL your previous bloods tests and get an appointment with a Liver Specialist as soon as you can. The elevated bloods and the fatty Liver are screaming out for attention. You could have N.A.S.H which can be controlled but diet changes and exercise.

Although the Ultrasound shows fatty Liver, with the long term irritation I would insist on more than an Ultrasound. For fat to show on an Ultrasound it has to be pretty well established and there could be scarring, an Ultrasound cannot rule it out. A test to measure Liver scarring is a Fibroscan, I would ask your GP about this test, the new ones also give a fat (CAP) reading.

[Bournemouth]

I think it's more a liver problem I have been having tests I feel really ill at present my alt has gone to 835 its hit the roof. They are now testing me for Wilson's disease which is too much copper. I think if it was lekeiuma they would of picked that up in bloods straight away thats what I was told. It's sounds as though the liver is irritated by something and hopefully find it out. All the best.

[SAMBS]

I was diagnosed with low white blood cell count in 2012, also I had thickened red cells. It may all have Have happened because of a swollen spleen after I'd been prescribed Metformin (borderline Type 2 Diabetic) one either is or isn't, but not Bordeline, Type. I was already on Levothyroxine for Hypothyroiditis which is now my 2nd autoimmune condition.

My white blood cell count kept dropping for 3 years, but last test in March this year they were much higher at 69,000 having got down to 45,000 Dec last year. My next test is due early June, so I'm hopeful they will be raised again, though I don't fight infections well. I have a persistent UTI.

I do have unspecified cirrhosis, diagnosed 2014. There is evidence of 2 (black holes) as I describe it on last copy I have from last year. My hepato/onco Specialist, is not interested at all in my previous and current health history - same that had the Haemo scuttling to his secretary to get my last Hep/onco appt b/fwd. So I can't really add any more than that. I feel fine, only have the Odd day of feeling unwell. I do take a couple of liquid natural ingredient supplements that I'm convinced helped start my bloods improve over last 2 blood tests and If they have continued improving over this longer period I'll know if I'm right or not. I had a bone marrow biopsy when the blood disorder was first found in 2012, MDS diagnosed by 1st Haemo. 2nd biopsy 16 months after via a different Haemo, he said I don't have MDS! It's all a waiting game and I'm grateful for not feeling ill, despite various proven by MRI and blood tests, health situations. Hopefully you'll know more for yourself soon, one way or another.

[Zuleiko28]

Thank you all for your kind replied. I finally got a my ultrasound results back and the report states 'hyperechonic liver'. My GP says I'm very likely that once I get my appointment with gastrologist I will be diagnosed with nonalcoholic fatty liver and given life style advise (what ever that means). Not sure what to make of this and I have another 16 weeks waiting list to see the consultant. My latest blood tests still shows low white count (3.6), specifically Neutrophil (1.9) and Lymphocyte (1.3). Again ive been told it's nothing to worry about. And as my platelet count is within normal range my GP is also not worried about chest and arms covered in red blood blisters and that consultant will advise more about it.

It's hard not worry about these results as I still get discomfort on right side and stomach area and generally feeling down which I'm not sure due to low immune or whether it's mental due to worry.

[isi123 in reply to Zuleiko28]

Did you do a test ferritin?