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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Autoimmune Hepatitis

my daughter was diagnosed with Autoimmune Hepatitis in 2010. Her ALT was 714 and AST was 574. prior to this date I found records from 2004 where here liver enzymes were normal. ALT 19 and AST 18. My daughter was immediately put on prednisone and Azathioprine. Levels now range average of AST 47 and 34. I also found some insurance records where my husband was rated because of his elevated liver enzymes in 2009 ALT 85 and AST 195. I was also told by his mother that she has had a history of elevated levels. The doctors do not seem to be concerned about my husband s family history concerning my daughter. I don t understand how her levels could be normal then abnormal, unless there was some kind of external cause, such as medicinal or environmental. If hereditary wouldn t she have always had elevated levels? Lastly, she is asymptomatic. I would like to know possible causes of her elevated levels.
Tue, 24 Jan 2017
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General & Family Physician 's  Response
Hi,
Thanks for your question.
I do understand your pain and discomfort.
As per your history is concerned ,there are several pathological causes responsible for elevated enzyme level to rise so please follow my advise below-:
1)Do full blood count with differential & TSH
2)Do a [IgA TTG]to ruled out celiac disease
3)Do Renal function test & [Alpha-1 antitrypsin]
4)Do USG whole abdomen
5)Correct [Choline deficiency] in diet
6)for autoimmune hepatitis check liver enzyme in every 8 weeks and take prednisone 5mg/day tapper over 8 weeks with azathioprine-1mg/kg/day as maintance therapy
I hope I was able to address your query. If you have any further questions, please do not hesitate to write to me.
Wishing you all the best.
Kindly rate the answer if you are convinced.
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Suggest Treatment For Autoimmune Hepatitis

Hi, Thanks for your question. I do understand your pain and discomfort. As per your history is concerned ,there are several pathological causes responsible for elevated enzyme level to rise so please follow my advise below-: 1)Do full blood count with differential & TSH 2)Do a [IgA TTG]to ruled out celiac disease 3)Do Renal function test & [Alpha-1 antitrypsin] 4)Do USG whole abdomen 5)Correct [Choline deficiency] in diet 6)for autoimmune hepatitis check liver enzyme in every 8 weeks and take prednisone 5mg/day tapper over 8 weeks with azathioprine-1mg/kg/day as maintance therapy I hope I was able to address your query. If you have any further questions, please do not hesitate to write to me. Wishing you all the best. Kindly rate the answer if you are convinced.