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What Causes Auto Immune Disease?
Question: Dear Sir/Madam,
My name is XXXXXXX I'm 18.
About two years ago, I was diagnosed with high Gamma Gt (300), ALT (60) and AST (60) levels. After that, I was tested for every single thing that doctors could think of. We haven't get any result until this point.
I have done a liver biopsy, and apparently there is nothing there. What should I do?
PS: Relevant points:
They found anti-insulin and anti-nuclear antibodies in my blood.
My name is XXXXXXX I'm 18.
About two years ago, I was diagnosed with high Gamma Gt (300), ALT (60) and AST (60) levels. After that, I was tested for every single thing that doctors could think of. We haven't get any result until this point.
I have done a liver biopsy, and apparently there is nothing there. What should I do?
PS: Relevant points:
They found anti-insulin and anti-nuclear antibodies in my blood.
Brief Answer:
An auto immune disease producing multiple derangement.
Detailed Answer:
Hello XXXXXXX
Welcome to HCM and thank you for posting your unresolved problem.
The available results indicate that you have an auto immune disease which is attacking multiple sites including the biliary system and the insulin production in pancreatic endocrine cells.
There are rare conditions that do this.
Please let me know your symptoms - the reason for doing these tests and the changes that have occurred in the symptoms and tests over the past two years.
I shall help you work through the problem when I have all the information.
An auto immune disease producing multiple derangement.
Detailed Answer:
Hello XXXXXXX
Welcome to HCM and thank you for posting your unresolved problem.
The available results indicate that you have an auto immune disease which is attacking multiple sites including the biliary system and the insulin production in pancreatic endocrine cells.
There are rare conditions that do this.
Please let me know your symptoms - the reason for doing these tests and the changes that have occurred in the symptoms and tests over the past two years.
I shall help you work through the problem when I have all the information.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Sir,
Thank you very much for your quick reply.
Let me get into some details:
1- I have never had any symptom of any sort. The first blood test was done merely as a routine. After that, we started to follow up my situation(the one revealed by the blood exam) on a regular basis, trying to find what was going wrong with me.
If you look at me, I'm perfectly healthy.
2- My family and I are constantly talking to endocrinologists, hepatologists and general physicians. Even though they're references here in Brazil, they seem not to have a clue about what the problem might be.
3- My GGT variation range is 100-500.
ALT Variation range- 55-110
AST- 55-110
4-Bilirubin and alkaline phosphatase are normal.
5-Tryglicerides 109 mG/dL
Cholesterol 162 mG/DL
6- I'm in use of Metformin 500mg as an experience.
7-Vitamin D3- Low- 23,4 ng/mL
8- Metabolic functions: normal
9-Liver Biopsy:normal
10- Dozens of antibodies: normal result
(I can't even remember all of their names)
I can assure you that me doctors have already tested me for plenty of diseases. I'm feeling very much worried that now we seem to be running out of options.
You mentioned some rare conditions. Would it be possible for you to please name them? In that case, I can talk to my doctors about. I hope you can come up with something that they haven't already.
Thank you very much for your help. I truly believe and hope we'll be able to find a solution for this.
All the best.
Thank you very much for your quick reply.
Let me get into some details:
1- I have never had any symptom of any sort. The first blood test was done merely as a routine. After that, we started to follow up my situation(the one revealed by the blood exam) on a regular basis, trying to find what was going wrong with me.
If you look at me, I'm perfectly healthy.
2- My family and I are constantly talking to endocrinologists, hepatologists and general physicians. Even though they're references here in Brazil, they seem not to have a clue about what the problem might be.
3- My GGT variation range is 100-500.
ALT Variation range- 55-110
AST- 55-110
4-Bilirubin and alkaline phosphatase are normal.
5-Tryglicerides 109 mG/dL
Cholesterol 162 mG/DL
6- I'm in use of Metformin 500mg as an experience.
7-Vitamin D3- Low- 23,4 ng/mL
8- Metabolic functions: normal
9-Liver Biopsy:normal
10- Dozens of antibodies: normal result
(I can't even remember all of their names)
I can assure you that me doctors have already tested me for plenty of diseases. I'm feeling very much worried that now we seem to be running out of options.
You mentioned some rare conditions. Would it be possible for you to please name them? In that case, I can talk to my doctors about. I hope you can come up with something that they haven't already.
Thank you very much for your help. I truly believe and hope we'll be able to find a solution for this.
All the best.
Brief Answer:
There is no cause for undue concern
Detailed Answer:
Hi XXXXXXX
We live in two different time zones and it is 8 am here. Hence the delay in replying you.
First and foremost I am happy that you are in good health.
The fact that your GGT fluctuates and is not progressively increasing is good. It may mean the numerous conditions which may sub clinically affect the liver like taking alcohol containing drinks, medicines that affect liver, some toxic material in the food, certain non hepatic viral infections or even as a marker of vascular inflammation ( a Brazilian study).
Anti nuclear antibodies can be present in a number of conditions including vascular inflammation. What are your ESR and CRP values?
Does any one in your family have diabetes? How high was the anti insulin antibody titer. Are they suspecting Insulin Resistance in you and is that the reason why you are on Metformin? It is okay because it may reduce vascular inflammation also. Has there been any change in the lab results after starting Metformin.
Since you are asymptomatic and the GGT is not progressively increasing, the conditions I had in mind initially would not be relevant and your doctors would have thought about them.
So relax, I do not see anything you should be unduly worried about now.
Live a normal life, only take care to adopt good life style and avoid anything that may harm your liver.
Wish you a good day and good health.
There is no cause for undue concern
Detailed Answer:
Hi XXXXXXX
We live in two different time zones and it is 8 am here. Hence the delay in replying you.
First and foremost I am happy that you are in good health.
The fact that your GGT fluctuates and is not progressively increasing is good. It may mean the numerous conditions which may sub clinically affect the liver like taking alcohol containing drinks, medicines that affect liver, some toxic material in the food, certain non hepatic viral infections or even as a marker of vascular inflammation ( a Brazilian study).
Anti nuclear antibodies can be present in a number of conditions including vascular inflammation. What are your ESR and CRP values?
Does any one in your family have diabetes? How high was the anti insulin antibody titer. Are they suspecting Insulin Resistance in you and is that the reason why you are on Metformin? It is okay because it may reduce vascular inflammation also. Has there been any change in the lab results after starting Metformin.
Since you are asymptomatic and the GGT is not progressively increasing, the conditions I had in mind initially would not be relevant and your doctors would have thought about them.
So relax, I do not see anything you should be unduly worried about now.
Live a normal life, only take care to adopt good life style and avoid anything that may harm your liver.
Wish you a good day and good health.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Doctor,
I really appreciate your help.
Until this point, Metformin was not able to reduce my GGT.
CPR and ESR-normal
Yes, there are indeed diabetes cases on the family.
Finally, would you be able to indicate me blood exams that you think are the most important considering my case as presented to you?
From now on, what should I test from time to time
Thank you so much.
Have a nice day.
?
I really appreciate your help.
Until this point, Metformin was not able to reduce my GGT.
CPR and ESR-normal
Yes, there are indeed diabetes cases on the family.
Finally, would you be able to indicate me blood exams that you think are the most important considering my case as presented to you?
From now on, what should I test from time to time
Thank you so much.
Have a nice day.
?
Brief Answer:
Minimum tests if symptom free
Detailed Answer:
You are welcome.
Metformin helps you in other ways like reducing the Insulin Resistance and improving cardiovascular health.
As long as you are asymptomatic and your ESR and CRP are normal, there is not much cause for concern, I feel.
Have a healthy life style, eat wholesome food, exercise and practise stress relieving measures and you will do well.
I don't think you should be doing frequent tests and keep worrying about results that are not adequately explained.
Have faith- you will cross the bridge if/when you come to it.
I will be happy to interact with you, if you need me any time.
Wish you good health and a great day.
Dr Noble Zachariah
Minimum tests if symptom free
Detailed Answer:
You are welcome.
Metformin helps you in other ways like reducing the Insulin Resistance and improving cardiovascular health.
As long as you are asymptomatic and your ESR and CRP are normal, there is not much cause for concern, I feel.
Have a healthy life style, eat wholesome food, exercise and practise stress relieving measures and you will do well.
I don't think you should be doing frequent tests and keep worrying about results that are not adequately explained.
Have faith- you will cross the bridge if/when you come to it.
I will be happy to interact with you, if you need me any time.
Wish you good health and a great day.
Dr Noble Zachariah
Note: For further follow up on digestive issues share your reports here and Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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