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Suggest Treatment For Elevated AST Levels In A 5 Year Old

Posted on Tue, 23 Jun 2015

Question: Hi! My 5-year old son has been suffering from something difficult since last October. Numerous blood tests, over 6 months have shown consistently elevated AST levels, with the highest value of 110. My son initially presented with pretty severe lethargy, pain in joints, tingling in feet & fingers, strange balance sensations (says he feels like he is still sitting down after he gets up), severe stomach pain, no fever no diarrhea but all of these symptoms persisted for about 6 months. Then he seemed to get better for about 3 weeks & became ill again with very similar symptoms but without the tingling, mild lethargy but still with painful joints, so much that he needed to be carried everywhere after being on his feet for any longer than a couple of minutes. Because his stool had become pale and his spleen had been enlarged during the first bout we kept testing his liver but this time I insisted they test him for every major poison & metal & metalloid exposure and I also took him to a GI. It was the GI who ordered a test for a muscle enzyme and sure enough, 3 months after the last round of tests his AST is down to 40 but his CK is 587. Everything else is 'normal'. I am at my wits end. I have resisted not looking this up online but it is too difficult waiting for an appt with a specialist and wondering what damage might be taking place inside my child's body. The only thing I can connect these test results with and his symptoms and the textbook length of time we have 'wasted' so far with the wrong tests is muscular dystrophy. As far as I know there is no heredity but I am aware that about 1/3 is from gene mutation. Any words of wisdom? I am keeping it together pretty well considering how much time has gone by and how worried I've been about my youngest child every single day since he first became ill. I don't know how long before I have a complete meltdown stumbling in the dark like this

Answered by Dr. Dr. Erion Spaho (4 hours later)

Brief Answer:
Complicated case, you should wait for specialist opinion.

Detailed Answer:
Welcome to HCM.

I have read your query and understand your concerns.

Sorry to hear about what you and your son have been through.

Your son's condition is very complicated one.

In my opinion, muscular dystrophies don't correlate well with your son's symptoms.

All muscular dystrophies have in common muscles weakness and muscular wasting in a symmetrical fashion, in addition, lethargy is not a muscular dystrophies symptom.

There are metabolic disorders too, that may be related to your son's condition (Niemann-Pick eg.).

I find myself difficult to give you a straight answer about your son's diagnosis.

My advice to you is not to navigate into the web and search for possible causes, because this may lead to erroneous judgment and can increase your worries.

Best thing to do is to have appropriate clinical evaluation by a Pediatrician that deals with neurologic disorders and tests guided by clinical findings.

In my opinion, initial tests needed are: EMG ( neuromuscular conduction study) to evaluate/exclude dystrophies, genetic profile tests about metabolic disorders such Niemann-Pick, Gaucher's disease.

Hope I have been helpful in a way or another. Wishing good health for you and your child.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Dr. Erion Spaho (6 hours later)

Thank you Dr. Spaho. You have given me a small measure of relief in respect to muscular dystrophy. We have an appt to meet a neurologist one week from tomorrow, so hopefully soon we will have some specific answers. I thank you very much for your time and advice.

Best regards
XXXX

Answered by Dr. Dr. Erion Spaho (30 minutes later)

Brief Answer:
You are welcome.

Detailed Answer:
I'm glad I've helped you even partially.

Hope to hear good things about your son's condition soon.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj