Hi
I’m off all treatment currently and hopefully in GCA remission, however my liver function tests are showing quite worrying elevated levels. I’m also experiencing what may be a PMR flare but my rheumatology team don’t agree 😞they have requested further tests on my liver as they have agreed it’s not drug or condition related I’m just interested to know if anyone else has experienced this type of issue.
Which liver enzymes are raised? How long have you been off pred and how sure are YOU it is PMR raising its head again?
Certain liver enzymes can be raised in PMR and GCA - it was well known but not much appeared in the literature:
pmc.ncbi.nlm.nih.gov/articl....
I never fail to be surprised how ignorant a lot of rheumies are about what can be seen in PMR/GCA.
Hi
So it’s the ALT, ALP mainly raised I’ve been off Pred since April 24 and off Methotrexate since November 24. It’s very frustrating as I feel they’re not listening to me at the moment. My inflammatory markers (ESR/CRP) are slightly raised too.
Yep - those are the relevant ones!! And something is happening if the markers are starting to go up - what were they at their lowest when you were on pred? Did they ever listen to you?
They have been very stable with ESR 2 and CRP 1 up until November 24 and now they’re ESR 19 CRP 8 I know it’s not a massive increase but it is for me. I’m having to have bi weekly bloods done at the moment next due on Tuesday. The team just keep saying it’s not PMR but I’m struggling a lot with shoulder and arm pain but not so much with hip pain. It’s making me very anxious too 😞
It IS a big increase if YOUR personal normal markers are that low. I wish they understood "normal range" better - as I explain so often, the range is the range of results you will see in a large population of nominally healthy adults of all ages, not the range that is acceptable for a single individual. We each have our own much narrower OK range. Given the overall situation and that you DO have some PMR symtoms the obvious answer is that this is PMR that has been controlled by the MTX until now but without it is active again. Fair enough, these may be distracting factors but the most likely answer is PMR. And the patient knows more about their body than any team of professionals!!
Yes I agree I’m going to try and speak to the team again after my next blood test, I’m very tempted to try a low dose of pred just to see if it relieves the pain. But I’ll wait until after my blood test.
Many thanks for your reply it’s much appreciated.
h, just like you I am off all steroids, but take a very small dose of a Amlipodeneb for blood pressure, however I have raised liver ALP and apparently very high serum alkaline phosphate which the lab has suggested thyroid problem. I am due to see the dr on the 9th so will report on the outcome. Raised liver function test could be due to PMR.
Thank you that’s very interesting.
Hi, I had raised liver enzymes in 2020, before my PMR diagnosis, though my symptoms started in late 2020. It was gamma GT and ALP which were raised in June 2020. I cut out all alcohol but a repeat blood test in September showed no difference. It took until December for the levels to return to normal. I am still puzzled as to what caused it as since then all readings have been normal despite drinking alcohol again and taking statins and pred.
I had raised liver enzymes way back in my 20s when I developed what was then called yuppy flu, absolutely text book ME presentation. By the time I got to see a specialist it had resolved and I was improving so not a lot of interest shown. But I know a few people with PMR with a similar experience much earlier and I had raises liver enzymes when the PMR started. Which of course supported any allegations of alcohol problems when a hospital physician couldn't diagnose a TGA...
That's interesting. So in my case it could've been the start of things PMR - related then? And it follows that Graciejack4 's is PMR related also.
I have raised ALP and Gamma GT raised and am off all steroids but on low dose amlipodene. After visiting the dr on Thursday he said he wasn’t unduly worried, as he said in the past my left,s have fluctuated. I have another blood test in three months time. He said I have no sign of pmg on blood tests, but am still concerned why this is happening, any ideas from anyone in this group.
Thanks, useful to know. I wasn't on steroids either and previous replies seem to suggest there is a link with PMR. Maybe you're heading for a relapse? (Hope not) but it's worth keeping a eye on things. My PMR symptoms started around the same time as my liver readings were tested as normal again.
I was also on low dose amlodipine, then doubled, which had terrible effects on my sleep, so now back to 10mg amlodipine plus losarten, which seems to work. Maybe there's a link there.
"People who take amlodipine may experience a mild elevationTrusted Source in their liver enzymes. This usually goes away quickly and doesn’t cause any significant symptoms or effects."
Fatty liver with Leflunomide 
Abnormal liver markers
liver and blackPudding 
Liver problems
adrenal function poor after tests 
