Brief Answer:
??Hepatic adenoma: simple benign liver tumor; hormone dependent

Detailed Answer:
Hello ma'am and welcome.

Thank you for writing to us.

I have gone through your query with diligence and would like you to know that I am here to help. I completely understand how some doctors do not take the XXXXXXX to explain to their patients the diagnosis in detail and help them better understand their condition, leaving them doubtful and worried almost for their entire lives.

First, the other test you were talking about that was something like ALT is AST (aspartate aminotransferase). It is not an issue if you cannot remember the values for the liver enzymes.

In my opinion, if your doctors did not show any concern for the isodense spots seen on the MRI and flagged them as benign then the most likely diagnosis would have been a 'hepatic adenoma'.

Hepatic adenomas are benign liver tumors that develop due to hormonal influences. Some of the most common causes in women are:

+Birth control pills
+Some contraceptives
+Reproductive system relating conditions (e.g. ovarian cysts, etc.) which can influence hormone levels
+Type 1 glycogen storage disease

If at all the diagnosis was accurate (which was why your doctors did not worry about it), then there is nothing to worry about as hepatic adenomas are harmless and usually shrink and disappear once the cause is removed/discontinued.

I hope you find my response both helpful and informative. Please feel free to write back to me for any further clarifications, I would be more than happy to help.

Best wishes.

---

Brief Answer:
My sincere apologies, have tried to be as elaborate as possible

Detailed Answer:
Hello once again ma'am.

My sincere apologies if I summed up my response concentrating on the possible causes that you were not aware of, I thought it was important for you to know the cause. Either way, that is additional information for you and I shall now address your main concern.

Let me start with step by step explanation and providing you with information that should help you better understand your level, and possibly why the ER reacted the way they did.

1. The normal range of alkaline phosphatase (ALP) is 25-100 U/L in an adult female.

2. ALP can be raised in numerous conditions that are primarily related to abnormalities of the liver, bone and pregnancy. But on some cases can also be related to abnormalities in the kidney, lungs, heart, etc.

3. The level or range of the ALP is an important indicator is suspecting the cause for the rise or drop. Like in your case, your level is 210 and this is considered a rise that is approximately equal to 2 times the normal value (which is between 25-100).

There are conditions that cause the ALP levels to rise to 10 times the normal, and so on. As your ALP level is raised twice the normal value, there are particular conditions that should be suspected with this value. Let me list them out for you:

-Parenchymal liver disease (e.g. cirrhosis, hepatitis, etc.)
-Healing fractures
-Pregnancy
-Paget's disease
-Rickets
-Osteomalacia
-Pulmonary infarction
-Myocardial infarction
-Hodgkin's disease
-Chronic liver failure
-Ulcerative colitis
-Hyperparathyroidism
-Sarcoidosis
-Amyloidosis
-Hepatic tumors

Now that I have provided you with that information I shall address your queries. In my opinion, your levels are not something to be worried about if all the systems have been evaluated (like for example, with your ALP level there can be a cardiac cause as well, if the heart is found to be normal, and all the other conditions on the above mentioned list are ruled out), then the cause for your ALP level is the hepatic adenoma.

So if we find the hepatic adenoma to be the cause for your raised ALP level, then there is nothing to worry about as the raised level in itself cannot do you any harm. And as the cause is also benign (i.e. hepatic adenoma) then we need not worry at all. This is because the hepatic adenoma will settle on its own in a while (in a few years).

But I would like to emphasise here that we should only consider this to be free from worry if at all other conditions that can depict such a level are ruled out (just to be on the safer side). If your doctor is uncooperative, or if at all you need to know for yourself if everything else is fine, then just go in for a complete body health check, and send me the reports. I shall rule out all the causes for you. :)

I hope I have explained things in a manner best understood by you ma'am. Please do not hesitate to write back to me if at all there is anything unclear to you, I am always here to help you.

Best wishes.

---