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Got Flu Shot In Shoulder. Test Showed High ALT, AST And Elevated Bilirubin. What Could Be The Cause?
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I understand that you must be somewhat shocked about the abnormal liver function tests when you weren't having any obvious symptoms related to it. It is indeed uncommon to have a liver function test show significant abnormality when there are no co-reating clinical manifestations.
It is not possible for the flu shot to have caused such a significant abnormality, that too within half an hour. The likely causes for your elevated liver enymes and bilirubin could be:
- Viral Hepatitis (sub-clinical), which may have been dormant without causing the usual symptoms. Hepatitis B and C are known to produce this kind of sub-clinical infections.)
- Long-term ingestion of anti-inflamatory / analgesics can also result in elevated liver enzymes. So, the Celebrex 200mg which you have been taking since 2 years could also be the potential cause.
- A number of other prescription medication (sometimes, even thyroid medication) and other systemic diseases can produce elevated liver enzymes.
In your case, I would think that the two most probable causes could be 1) a viral hepatitis and 2) medication-induced. However, in order to get a definitive picture, more detailed liver tests and other tests like those for hepatitis, etc. are required. Since your liver enzymes were very high initially and your bilirubin had normalized on the repeat test, this is more indicative of an transient external damage to the liver (like due to an infection or toxins, etc.) rather than any intrinsic liver disease. So, I think you don't have to worry too much; please wait for the additional lab tests to give you a clearer picture.
Best wishes,
Dr. Jonas Sundarakumar
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If your other additional tests and ultrasound are normal, your doctor may want to repeat your liver enzymes again. The extra caution is because the anaesthetic medication, post-operative pain-killers, antibiotics, etc. need to be metabolized by the liver, and hence, it is important that there is no impairment in liver functioning during the time of your surgery. If your enzymes have come down significantly and your bilirubin continues to remains normal, then I don't think there should be a problem going ahead with the surgery. If your abnormal liver function tests are due to a one-time or transient external insult to your liver (and not a chronic intrinsic pathology), then the liver enzymes should come down quickly.
Best wishes,
Dr. Jonas Sundarakumar
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