1 Yr Old Has Elevated SGPT, SGOT. Obese, Has Fatty Liver. What Should Be Our Next Step ?
Thanks for the query.
Presuming her growth and development have been normal and she has no other major clinical symptoms apart from previous resolved renal tubular acidosis, obstructive sleep apnea / laryngomalacia, the cause of elevated liver enzyme and fatty liver is most likely to be related to being overweight.
Since the liver enzymes are elevated since birth, reduction of weight will only result in gradual decline of liver enzymes. So if I were to be her treating doctor, I would suggest the following:
1. Monitor her liver functions monthly for next 6 months to 1 year.
2. Plan to get a contrast enhanced computed tomography (CT) / magnetic resonance imaging (MRI) of abdomen.
If results are suspicious, I would refer her to a pediatric gastroenterologist. Evaluation to rule out congenital metabolic storage disorders is warranted.
Hope this answers your query. Let me know if you need any more information.
Regards
Hi and thanks again,
I understand your daughter has been investigated extensively to determine a root cause. With the number of consultation you’ve had I am sure you’d have researched and had many opinions regarding your daughter’s problem.
I wish I had an opportunity to examine your daughter, review her developmental milestones and review all the investigation reports. With the limited information available, I would be difficult to predict possibilities; so I shall answer your queries specifically
1. The medications when prescribed in therapeutic doses are not known to cause liver dysfunction so as to cause such significant elevated liver enzymes; besides other biochemical dysfunction.
2. Liver enzymes are more useful to monitor the present status of liver disease. It has not much useful in determining the prognosis.
A preliminary contrast enhanced CT / MRI abdomen scan and liver biopsy would be essential to know the current status of liver and thereby predict the chances of reversal.
Hope this answers your query. Let me know if you need any more information.
Regards