Minor but unwelcome surprise on lab test

Hi friends

Well my CBC was good, but my usually reliably normal liver enzymes unexpectedly were elevated.

It is likely nothing significant, but if you are interested in my longer rambling on my search for what to blame for this unwelcome change and what it all means, take a look at my blog: bkoffman.blogspot.com

Happy new year to all

Stay strong.

We are all in this together.



8 Replies

  • Hi Brian,

    On behalf of our community, many thanks for your incredible efforts last year in assisting CLL patients around the world, both personal and through you establishing the excellent and fast growing CLL Society on line resource cllsociety.org .

    Good to hear you've recovered from that distressing and likely norovirus infection and that your blood test results are encouragingly good, other than that hopefully temporary blip on the markers of liver injury (AST and ALT). Thanks for raising the importance of monitoring those tests to check that we are taking good care of our livers. I too have seen my AST and ALT results spike alarmingly, which I subsequently found was due to supplements I was taking. I'd encourage anyone taking anything 'for their health' - either natural or manufactured pharmaceutical to familiarise themselves with their normal AST and ALT values and ensure that they remain within the healthy range.


  • Thanks, Neil.

  • Hi Brian,

    I had hugely increased liver enzymes as well as pain under my breasts and thought I was having a heart attack!! It turns out that the cause of both problems was gallstones. I have since had the gallbladder removed (a month ago) and all is well in both the liver enzme figure as well as no pain.

    Previous scans for CLL purposes had shown stones but nothing is normally done unless pain or other indications come into play.

    Hopefully all is now well with you.

  • Glad your problem was solved. Doubt my issue is the same as I have no symptoms and my labs don't suggest obstruction with normal bilirubin and alkaline phosphatase, but only increased AST and ALT.

  • Hi Brian,

    Sorry to hear of your liver problems. I thought my experience might be relevant. I am in a clinical trial using Idelalisib and Ofatumumab as frontline treatment. It appears that transaminitis is fairly common in this trial. When my AST/ALT levels rose, they rose very rapidly (2-3 weeks from low normal to above normal) and the doctors told me it was important to act quickly. (The trial entails blood tests 2/week so I can track the weekly trend.). They started treating with oral steroids which have seemed to work quickly and I am now tapering off the steroids. AST/ALT levels back in normal range in less than 2 weeks. Maybe the jump was a blip that would have corrected without steroids, but we'll never know for sure.

    I read on your blog posting that you are planning to wait seven weeks to retest. Anyone on Idelalisib might want to ask about more frequent retest as I have heard (and experienced) liver inflammation is more common on Idela than Ibrutinib.


  • Agree. Frontline idelalisib is associated with a high incidence of severe transanimitis. Not so ibrutinib. Glad you are recovering. Happy new year.

  • Hi sorry that you have this problem but hope that it can be quickly brought under control. Best wishes and good luck

  • Thanks.

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