question about drug induced hepatitis

Hi,

I post on the MS board. I would really appreciate your input.  I had severe abdominal pain and nausea Wed. night and went to my primary on Thurs.  She thought I had pancreatitis and drew labs.  I have been on  Imuran for about 10 days due to my MS progression.  I also take Avonex but have been on it for 6 months without any liver problems.

 

Ok, the rest of the story...the doc called me and said it wasn't my pancreas but I had liver damage.  My ALT and AST were very elevated.  She is assuming it's from the Imuran.  She was concerned though because of the severe pain.  She said all that can be done is for me to stop all meds and recheck weekly.  If it is going down then we'll just watch it but if it is the same or worst she wants me to see a specialist.

 

Don't you think I need to at least have an ultrasound?  I am still having pain both on the right side and the left side, why?  Also nausea.  I am not jaundiced.  I am scared.  I never thought I would have this on top of all my other medical problems.

 

Thank you so much for an info.  My heart goes out to you who have liver disease.

Michelle,
I agree with Trish. Do you know how high your ALT and AST were. If not, try to find out. I have autoimmune hepatitis. When I started treatment my doctor had me on 20mg. of pred. and 50mg of imuran. The imuran made me very sick. I was either on the toilet or over it, sounds gross, but that's the way it was. I called my PCP and my GI. My PCP had me come in right away and did labs. My liver enzymes had tripled. I was immediately taken off the imuran. It was toxic to my body. I was put on a higher dose of prednisone and my LFT began to come down within a few days. My PCP wanted to watch me very closely, so she tested me every 2-3 days for a week or so. When put on the higher dosage of prednisone, and taken off the imuran, my LFT's became normal within two weeks. That was a wonderful sign that the prednisone was working. I am now weaning gradually off it. It will be replaced with a less dangerous medication.

I also agree with Trish that the only way you can detect liver damage is through a biopsy. It sounds to me if you have not had high LFT"s before that it is indeed the imuran. I would have my doctor get me into a GI ASAP and not fool around. I'm sure the symptoms will ease once the offending drug is out of your system. I remember how sick it made me. And I also remember that it took about a week or so before I got that way. So, it has to build up in the system. For so many it works, and for some, like us, it's toxic to our bodies. Make sure you keep a close eye on your liver enzymes. If you have a good doctor, he/she won't mind doing them often for you. Mine started coming down within a few days of going off the imuran.

Good luck and keep us posted.

Judy

Hi All,

Thank you so much for your reply's!  My AST was 352, my ALT was 388.  The docs words were "they are threw the roof". Also, my white count is 3000, which is low and down a little more than it was.

 

So you are saying even if my labs come down I still may have damage?  I have a GI doc who I can probably get myself into, do I really need a biopsy?  I do not drink at all.  I do hope to be able to go back on my Avonex which can give you liver problems, I pray it doesn't. 

 

My pain is less, I can tell it's still there and sometimes on the left, is that weird?  Nausea is still a problem but I have that alot anyway.

 

I appreciate your help.

Hi Trish,

I have an appt. with my GI doc at 8 in the morning.  My left side under my ribs (as well as the right) is really hurting today and the nausea is worst.  I can't wait to hear what she has to say.  Thank you all for your input and I'll let you know what I find out.

marg, ill drink a couple extra glasses of wine for you on New Years,,,as i toast a New,healthier year for everyone....i had to refrain from all alcohol during my acute bout with hep ,,,so 7 mths without any,,,and though i dont drink much at all,,,,it was harder being told i could NOT have it,,,,,take care

Hi all,

I went to my gi doc this morning and what she said was: draw liver panel today, if results are better, redraw in 2 weeks.  If worst, follow up with hep panel etc...  She does not think pain was from liver, she said it isn't possible unless it is very swollen and today it didn't feel swollen. (she couldn't give me an explanation for pain).  She said I can take my zofran and advil but until she gets levels back still no avonex or baclofen.  If i still have pain next week she'll probably order a ct.

 

I'll let you know when I get my lab results. If you know of anything else I need to ask please tell me.  Thanks!

Hi,
I have good news! My labs are getting better. I will have them drawn every 2 weeks for a while. I can go back on my usual meds (except for Imuran, which is fine w/me!) Thanks all of you for your kind words and help. I may need you all again! :)

That's great news Michelle. Glad the Forum served it's purpose and you were able to get some support from all of us here. As trish said visit when you like. you don;t have to wait for your liver to become disfunctional.
Take care.
Marg

Sorry to jump into this thread like this, but I have a question.

I noticed some of your ALT'S and AST's are extremely high.

My Dr. told me my levels were high also when I found out I had HCV.

AST - 26 (I think that's the normal one)

ALT - 65 (He said that was high for me)

Does that sound about right?

I have trouble reading this lab stuff out, but mine shows up this:

HEP C VIRAL AB                        REACTIVE  *

Now according to my paperwork, the * stands for (* Abn Alpha)

Any idea what that means?

Again, sorry to highjack the thread, but those ALT's and AST's rang a bell to me.

Thanks!