LIVER DISEASE AFTER PREDNISONE

[pugrescue]

I was diagnosed with GCA in March/19. No huge side effects of pred....I thought. Never had the moon face or gained weight at all. Started to feel pretty fatigued with muscle soreness around the 2mg mark of taper. Have been off pred for 3 months. No returning signs of GCA, but still sore, fatigued and terrible heartburn. Rheumatologist checked cortisol levels, and they were surprisingly good. However my liver enzymes (ALT & ALP) are quite elevated. Did more bloodwork a few days ago, and ferritin (blood iron level) is elevated too. Appt to talk with her on Monday.... From what I can find online, seems to be liver damage. Has anyone else had this after pred?

[HeronNS]

Maybe. Don't know yet. Is this because we take prednisone, not prednisolone, because prednisone has to be turned into prednisolone in the liver?

[SheffieldJane]

I am not familiar with this as a common effect of Pred. I have however got raised liver enzymes from Tocilizumab and nobody is getting excited, I just had to have another test in one month ( just completed, awaiting results). I am also tapering from 10 mgs of Pred..

[SnazzyD]

It can happen from high doses of Pred eg fatty liver from persistently high blood sugars. Have your liver results been ok until now or has there been a trend in increases, even if they have been within normal limits? It may be a completely different cause of course eg, viral infection, bile duct problems, even bone issues,other meds and alcohol to name a few. It needs to be assessed in context of the rest of you really to know what is the actual cause.

[PMRpro Ambassador]

They are also typical raised markers in PMR - ferritin isn't iron itself, it is a protein that stores iron and isn't normally found in blood. It being raised can also be a sign of inflammation. But as Snazzy says, the relationship of one to another together with other things like bilirubin is needed to work out which of a wide range of things it might be.

[pugrescue]

Thanks everyone for your input. Should have added that my ESR is 5 (range 0-20), CRP is 2 (range <5), and I don't consume ANY alcohol. Last drink was when I was 17.....more than 50 yrs ago. Have appt with rheumy Monday, and family dr on Tuesday. Have had ultrasound requisition in for over a month, no scheduling yet. Will post after the appts. Thanks again. Joan

[PMRpro Ambassador in reply to pugrescue]

Ferritin is the only marker that is raised for me too!!

[pugrescue in reply to PMRpro]

so that is your only marker for inflammation? I have also elevated ALT & ALP...liver enzymes. I truly don't feel as if I have PMR or arthritis. Mostly sore muscles, very fatigued, insomnia, look like I have 2 black eyes.....had none of these things on pred. Have not ever had liver tests done before so no known history there. I was so healthy before GCA, so may now be blaming everything on pred, instead of realizing (admitting) I am 2 years older now. To what do they contribute your high ferritin? I had never heard of that before, had to look it up. Have had a lot of senior pugs with chronic hepatitis, so very familiar with the ALT, ALP, GGT etc. Have to order the supplements we used on them, SamE and milk thistle. Such fun getting older. Thanks again for your replies as always.

[PMRpro Ambassador in reply to pugrescue]

Inflammation! Definitely not anaemic. I had raised liver enzymes in my mid 20s when I had something that nowadays would be classified ME/CFS - and they can also be raised in PMR. Is there a link? Who knows But there are several on the forum with a similar history.