Hi Dr, Not Sure If You Remember Me, But I

Posted on Mon, 23 Nov 2020

Question: Hi Dr,

Not sure if you remember me, but I had spoke to you about my elevated bilirubin and ca 19.9 being 71.

Dr did not want to do a Eus as it is too invasive so we did a pancreatic protocol ct scan which is normal along with a us which is normal and a follow up ca 19.9 level and now negative at 35 thank god. I am to have a mrcp soon. My bilirubin unconjucated seems to still be muldly elevated apparently I have confirmed gilberts syndrome like you stated aftrr genetic testing.

Would any further workup be warranted once Mrcp comes back negative? Thank you Dr

Answered by Dr. Dr.P.Ratnakar Kini (2 hours later)

Brief Answer:
Answer is given below

Detailed Answer:
Hi,
Thanks for posting your query.
Yes, I do remember discussing it with you earlier.
I remember telling you that your elevated Ca -19-9 was most likely due to a benign cause.
Good to know that it is now negative at 35. Also good to know that the pancreatic protocol CT scan was normal.

You need not worry about XXXXXXX syndrome as it is a harmless condition. The bilirubin level will keep fluctuating in dehydrated state and fasting state.

No further workup is required.

Regards,
Dr.R.K.

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Dr.P.Ratnakar Kini (21 minutes later)

Thank you Dr.

Do you think at this point I still need mrcp?

Follow up: Dr. Dr.P.Ratnakar Kini (7 minutes later)

Dr,

Can I still have autoimmune pancreatitis with normal auto immune markers? Have you any idea of the ca elevation than down to normal. I am very grateful to god all tests are normal, but just curious?

Answered by Dr. Dr.P.Ratnakar Kini (35 minutes later)

Brief Answer:
Need more information

Detailed Answer:
Hi,
There is no need for MRCP.
Are you on any medications like steroids?
Regards,
Dr.R.K.

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Dr.P.Ratnakar Kini (25 minutes later)

No Dr I am not on steroids. However, test have fluctuated from normal to elevated for auto immund markers in my life as i have alopecia areata, fibromyalgia, and premature ovarian failure

Answered by Dr. Dr.P.Ratnakar Kini (18 minutes later)

Brief Answer:
Answer given below

Detailed Answer:
Hi,
Okay.
Just for the reason that you have a few autoimmune issues, it does not necessarily mean you should also have autoimmune pancreatitis.
But if you have pancreatitis and common causes are ruled out, then autoimmune pancreatitis should be considered as a possibility taking the other autoimmune issues in to consideration.
Regards,
Dr.R.K.

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Dr.P.Ratnakar Kini (13 minutes later)

Thank you Dr.

Answered by Dr. Dr.P.Ratnakar Kini (7 minutes later)

Brief Answer:
Welcome

Detailed Answer:
Welcome

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Above answer was peer-reviewed by : Dr. Nagamani Ng