
My Brother%E2%80%99s Case He Was Diagnosed In May 2018 By

Question:
My brother%E2%80%99s case
He was diagnosed in May 2018 by MM and Amyiliodosis , was subject to chemotherapy treatment for 4 months followed by bone marrow transplant in UK.
Since then he is undergoing maintenace chemotherapy treatment taking Darzalex and Ninlaro beside antivirus and anti bacteria: Zovirax and Trimidar since May 2019.
In last XXXXXXX his blood tests started showing unusual increase in liver enzymes APT (241) AST ( 69) and IGG(680) beside total bilirubin total at 1.68 .
His doctor stopped the Ninlaro for 5 weeks but still no improvement in liver enzymes.
Any clue
My brother%E2%80%99s case
He was diagnosed in May 2018 by MM and Amyiliodosis , was subject to chemotherapy treatment for 4 months followed by bone marrow transplant in UK.
Since then he is undergoing maintenace chemotherapy treatment taking Darzalex and Ninlaro beside antivirus and anti bacteria: Zovirax and Trimidar since May 2019.
In last XXXXXXX his blood tests started showing unusual increase in liver enzymes APT (241) AST ( 69) and IGG(680) beside total bilirubin total at 1.68 .
His doctor stopped the Ninlaro for 5 weeks but still no improvement in liver enzymes.
Any clue

My brother%E2%80%99s case
He was diagnosed in May 2018 by MM and Amyiliodosis , was subject to chemotherapy treatment for 4 months followed by bone marrow transplant in UK.
Since then he is undergoing maintenace chemotherapy treatment taking Darzalex and Ninlaro beside antivirus and anti bacteria: Zovirax and Trimidar since May 2019.
In last XXXXXXX his blood tests started showing unusual increase in liver enzymes APT (241) AST ( 69) and IGG(680) beside total bilirubin total at 1.68 .
His doctor stopped the Ninlaro for 5 weeks but still no improvement in liver enzymes.
Any clue
Brief Answer:
We need to rule out other causes
Detailed Answer:
Hi
Thanks for your query.
I understand your concerns.
Ninlaro can cause liver toxicity but it should improve on stopping the therapy. So we need to rule out other causes, like viral hepatitis and amyloid deposit in liver.
I recommend all viral markers like hepatitis b,c and CMV. Also an ultrasound of the liver. For the time being ursodexoycholic acid and vitamin E can be tried to bring down the liver enzymes.
Based upon the results of these, we can proceed further.
Hope this helps.
Regards
We need to rule out other causes
Detailed Answer:
Hi
Thanks for your query.
I understand your concerns.
Ninlaro can cause liver toxicity but it should improve on stopping the therapy. So we need to rule out other causes, like viral hepatitis and amyloid deposit in liver.
I recommend all viral markers like hepatitis b,c and CMV. Also an ultrasound of the liver. For the time being ursodexoycholic acid and vitamin E can be tried to bring down the liver enzymes.
Based upon the results of these, we can proceed further.
Hope this helps.
Regards
Above answer was peer-reviewed by :
Dr. Vaishalee Punj

Brief Answer:
We need to rule out other causes
Detailed Answer:
Hi
Thanks for your query.
I understand your concerns.
Ninlaro can cause liver toxicity but it should improve on stopping the therapy. So we need to rule out other causes, like viral hepatitis and amyloid deposit in liver.
I recommend all viral markers like hepatitis b,c and CMV. Also an ultrasound of the liver. For the time being ursodexoycholic acid and vitamin E can be tried to bring down the liver enzymes.
Based upon the results of these, we can proceed further.
Hope this helps.
Regards
We need to rule out other causes
Detailed Answer:
Hi
Thanks for your query.
I understand your concerns.
Ninlaro can cause liver toxicity but it should improve on stopping the therapy. So we need to rule out other causes, like viral hepatitis and amyloid deposit in liver.
I recommend all viral markers like hepatitis b,c and CMV. Also an ultrasound of the liver. For the time being ursodexoycholic acid and vitamin E can be tried to bring down the liver enzymes.
Based upon the results of these, we can proceed further.
Hope this helps.
Regards
Above answer was peer-reviewed by :
Dr. Vaishalee Punj


Thanks Dr. In fact CMV, Hepatitis b,c were done beside ultrasound of liver all were OK,
What can be the cause ?
What can be the cause ?

Thanks Dr. In fact CMV, Hepatitis b,c were done beside ultrasound of liver all were OK,
What can be the cause ?
What can be the cause ?
Brief Answer:
Need to see report of ultrasound
Detailed Answer:
Ok, if possible, please upload the ultrasound report.
We should also do a fibroscan of the liver to rule out chronic liver disease (chemo/BMT induced/fatty liver related)
Regards
Need to see report of ultrasound
Detailed Answer:
Ok, if possible, please upload the ultrasound report.
We should also do a fibroscan of the liver to rule out chronic liver disease (chemo/BMT induced/fatty liver related)
Regards
Above answer was peer-reviewed by :
Dr. Vaishalee Punj

Brief Answer:
Need to see report of ultrasound
Detailed Answer:
Ok, if possible, please upload the ultrasound report.
We should also do a fibroscan of the liver to rule out chronic liver disease (chemo/BMT induced/fatty liver related)
Regards
Need to see report of ultrasound
Detailed Answer:
Ok, if possible, please upload the ultrasound report.
We should also do a fibroscan of the liver to rule out chronic liver disease (chemo/BMT induced/fatty liver related)
Regards
Above answer was peer-reviewed by :
Dr. Vaishalee Punj


see US report attached

see US report attached

Dr I forgot to say that he was also taking azithromycin

Dr I forgot to say that he was also taking azithromycin
Brief Answer:
Usg doesn't reveal anything
Detailed Answer:
Hence I would recommend liver fibroscan and trying those medicines I mentioned.
You can discuss these with his doctor.
Regards
Usg doesn't reveal anything
Detailed Answer:
Hence I would recommend liver fibroscan and trying those medicines I mentioned.
You can discuss these with his doctor.
Regards
Above answer was peer-reviewed by :
Dr. Prasad

Brief Answer:
Usg doesn't reveal anything
Detailed Answer:
Hence I would recommend liver fibroscan and trying those medicines I mentioned.
You can discuss these with his doctor.
Regards
Usg doesn't reveal anything
Detailed Answer:
Hence I would recommend liver fibroscan and trying those medicines I mentioned.
You can discuss these with his doctor.
Regards
Note: For further queries related to kidney problems Click here.
Above answer was peer-reviewed by :
Dr. Prasad

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