New patient - non-viral hepatitis, can it flare up again?

I wish I had found this forum a couple of months ago!

Late last year, I started getting headaches and had them daily. I was taking ibuprofen, paracetamol, codeine or voltaren daily (not at the same time!). I rarely need to take medication for anything. Then about a week later when I was back at work, I was so exhausted I couldn't make it through the day. I had to nap at work and I have never done that before. I also woke up in the middle of the night later that night, shaking violently and uncontrollably. Fevers were shocking, hot and cold. Muscles were tired, my appetite was gone and I could eat nothing for days. Went to the doctor and had some blood tests which showed I have hepatitis. After more tests, it was determined that I had non-viral hepatitis. Ultrasound showed a liver lesion of unknown pathology, multiphase CT scan showed that it didn't appear cancerous, but they still aren't quite sure what it is and recommended another ultrasound in 3 months. The location is amongst the major veins/arteries that lead in to the liver, so impossible to biopsy without a GA. CT also showed my spleen was approaching the upper limit of the normal range.

It's a couple of months on and I had been doing much better. My last blood test results, the inflammation had decreased (not sure of the readings). But this week I have been feeling more tired than usual, my appetite has been a little bit off at times, my muscles are tired at times and today I've had a stitch like pain in my liver region. I don't feel as bad as i did a couple of months ago (I had 2.5 weeks off work and slept day and night for most of that - I couldn't even function). I've also been getting mouth ulcers on the inside of my cheeks.

Work has been pretty stressful lately, my workload has increased dramatically in the last couple of weeks. I am trying not to let stress get to me, because I don't think being stressed is going to help me in any way and I don't want to have a relapse in my recovery. I have no idea whether stress could contribute. No cause could be found in my case but the doctor suspects any number of viruses has started this.

Is it possible that non-viral hepatitis can just flare up again? My GP seems to think that the inflammation will just decrease until it eventually disappears. He hasn't referred me to a hepatologist as the last results showed a decrease in inflammation. If they had jumped up, he would have sent me straight to the specialist. I'm really not sure whether the symptoms I've been getting this week are related or if I'm just run down. There is no planned follow up with my GP, no further blood tests planned, just need to see him for the ultrasound referral next month, or make an appointment with him if I'm having problems.

The results at their worst were
ALT 188 U/L (normal range <30)
AST 609 U/L (normal range <30)
ALP 128 U/L (normal range 20-105)
GGT 79 U/L (normal range <30)
Albumin 34 g/l (normal 38-50)

These seem quite high compared to other results I've seen in this forum?

Bilirubin/Protein/Globulin all with normal range.

It has been a really scary time for me. I never get sick, I don't even drink alcohol so to have a liver problem is such a shock to me. There is very little information available about non-viral hepatitis.

I guess my questions after all that are:
Can non-viral hepatitis flare up? Can stress impact recovery?
Could my weird symptoms lately be part of the hepatitis or just stress related?
Seeing as though it's the weekend I'll just rest and see if I improve, and if not I'll go back to the doctor next week.

Thanks for your reply!

I'm not sure of the #s now, the dr's receptionist said 'he wasn't too concerned with the numbers' but if I wanted to find out what they were, I'd have to make an appt this isn't my usual dr's surgery, so I'm thinking I may go to my usual dr because they do tell you results over the phone without having to make an appt. getting time off work to go to hear some numbers is just pretty inconvenient, as much as I like the dr.

I don't drink alcohol. Previous to this my alcohol intake was 1-2 drinks a year, in my youth there was binge drinking involved but those days are far behind me. I just don't see the appeal in alcohol anymore. I'm 33 and female, forgot to add that in my original post.

It is frustrating not knowing the cause. Dr asked if I'd been in contact with pesticides or poisons. I wonder if possibly it's hair dye? I do have one energy drink every day, dr said that wouldn't be the cause. Also didn't think it was the painkillers I'd been taking for headaches as I was only taking 2 a day maximum. I did test positive for EBV but it's not a current infection (no idea when that happened!?).

Hi Loujay

As you are finding out lots of things seem able to send liver readings out of kilter. There are a number of autoimmune liver diseases where our own bodies attack the liver or bile ducts for example plus viruses, fatty liver, medication etc etc Diagnosing liver disease can be difficult.

There is no single test for autoimmune hepatitis. Some of your readings are similar to those commonly found in people with autoimmune hepatitis but others are not. Given that the high readings have been going on for some time I would recommend you ask your GP for a referral to a specialist. They can do a full work up and narrow down the possibilities. It may be at the end of the day everything settles down and they never find the cause - but if it is something like AIH then the earlier you start treatment the better.

loujay,
what kind of dr are you seeing??? unless your liver enzymes have come down close to normal, and your dr can easily explain your suspicious imaging results, i would demand immediate referral to a specialist..

dont know your laws about medical records, but in the US, you cant withold a patients records, tests, imAging etc...

Hi Loujay: Just ask for records, I have quite a file full. It some how helped my mental status to have them. I have also collected all my liver scans and MRI.
I also have a small tumor on my liver ,so they do a CT scan or MRI , blood work, ... every 6 months I have almost the exact symptoms as you . The same diagnosis Cryptogenic ESLD. Some of my problem is the encephalopathy due partially to the high ammonia levels in my blood. I did have hep A when I was about 6 years old.
Please excuse my mistakes.
I was listed for transplant for about 3years . Then I was told I no longer qualified because my meld score is usually below 10. But I have to continue going to the clinic 600miles away .
I was given 48hours - a possible 5years. That was 10 years ago. That's when I decided join my friends here at Healing Well in 2006. You may understand how I began my journey. Hope I can be some help. Just remember "The Greatest is Love" [ lavender ]
[ june17 ]

Post Edited (lavendar) : 3/23/2016 4:01:04 PM (GMT-6)

My guy's "lesion" became cancer. It would bear watching that lesion.

Sandia

Mike's started as a shadow and gradually to a lesion and so forth. Keep an eye on it because there are treatments if it doesn't get too far. It may be nothing. Monitoring it would be the best thing for now. Now just breath and don't think worse case scenario.

One step at a time!

Sandia

Wow that was nice of you to come back and let us know! Wish you luck! Stop back in once and a while!!