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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Elevated Liver Enzymes While Suffering From Crohn's Disease?

My daughter has crohn's and is being treated with remicade. All of her blood test numbers have been normal until last month when her SGOT went to 54 and her SGPT to 74. There has been a slight increase in these numbers over the last three months and she has some muscle pain periodically. She is under doctor's care, but as her mother, may I ask what these numbers mean and why she would have muscle pain associated with them? Her specialists do not seem concerned.
Wed, 25 Apr 2018
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Ayurveda Specialist 's  Response
Hello,

1. Remicade [infliximab] is used to treat autoimmune disease like Rheumatoid Arthritis, ulcerative colitis, and Crohn's disease. [present]

Many studies in teenagers taking Remicade for Crohn's disease have seen the rare type of lymphoma [cancer] growing in them which specifically affects liver, spleen and bone marrow and can be fatal, so if your specialist is not concerned much take a second opinion and see a Pathologist/ Hematologist.

2. muscle/joint pains are documented side effects of the drug, so consult your attending physician as to how to alleviate the symptoms

3. Another cause of mild elevation of the liver enzyme is muscle injury due to exercise without causing any other symptom, kindly consult your physician or a Hepatologist.

4. I at most can let you know about the diet, lifestyle, and investigations which one has to follow:

i. blood examination: Hb%, TLC, DLC, ESR [ESR will be increased in presence of infection]
ii. Liver function test: Serum Bilirubin, SGOT/SGPT/Alkaline phosphatase.

PS. keep a note that although these tests are sensitive but very nonspecific and serve to detect liver disease rather than quantitative liver function so their high values don't signify a serious complication most of the time, it is the underlying pathophysiological process which needs to be diagnosed and managed.

iii. Take Antioxidants, probiotics, low carbohydrate diet, fish, beans, legumes, low-fat milk, yogurt, olive oil, coffee, raw garlic, spinach, taro root, soybean, broccoli, carrot, mango, papaya, pumpkin, cauliflower, tomato, mushroom, cheese.

Avoid: milk/dairy products, heavy food, oily/fried food, IRON, KAPHA food

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Munish Sood
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What Causes Elevated Liver Enzymes While Suffering From Crohn's Disease?

Hello, 1. Remicade [infliximab] is used to treat autoimmune disease like Rheumatoid Arthritis, ulcerative colitis, and Crohn s disease. [present] Many studies in teenagers taking Remicade for Crohn s disease have seen the rare type of lymphoma [cancer] growing in them which specifically affects liver, spleen and bone marrow and can be fatal, so if your specialist is not concerned much take a second opinion and see a Pathologist/ Hematologist. 2. muscle/joint pains are documented side effects of the drug, so consult your attending physician as to how to alleviate the symptoms 3. Another cause of mild elevation of the liver enzyme is muscle injury due to exercise without causing any other symptom, kindly consult your physician or a Hepatologist. 4. I at most can let you know about the diet, lifestyle, and investigations which one has to follow: i. blood examination: Hb%, TLC, DLC, ESR [ESR will be increased in presence of infection] ii. Liver function test: Serum Bilirubin, SGOT/SGPT/Alkaline phosphatase. PS. keep a note that although these tests are sensitive but very nonspecific and serve to detect liver disease rather than quantitative liver function so their high values don t signify a serious complication most of the time, it is the underlying pathophysiological process which needs to be diagnosed and managed. iii. Take Antioxidants, probiotics, low carbohydrate diet, fish, beans, legumes, low-fat milk, yogurt, olive oil, coffee, raw garlic, spinach, taro root, soybean, broccoli, carrot, mango, papaya, pumpkin, cauliflower, tomato, mushroom, cheese. Avoid: milk/dairy products, heavy food, oily/fried food, IRON, KAPHA food Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Munish Sood