Looking for some expert advice.
UC Dx Oct 2010 (Pancolitis).
I have had my share of flareups and remissions. But the past year has been great. Just lialda and Humira.
My Alkaline Phosphatase levels have always been high ( i mean not really high, 125 - 185 depending on the lab used, but overall about
1.3-1.5 times the upper normal). All my other liver functions have been absolutely normal, ALT, AST, Bilurubin are always at the lower end of the recommended range. My GGT also has been always at the low end. A normal GGT with an elevated ALP is supposed to practically rule out liver disease. But there is always this lurking fear of PSC with an elevated ALP in someone with UC. I had elevated ALP even before my DX with UC.
So my previous GI did a ALP fraction just to see why it is consistently high, even though the GGT is always normal. That time the results were as below (recommended range in brackets)
ALP: 176 (35-125)
ALP-Liver Fraction: 67 (5-93)
ALP-Bone Fraction: 60 (5-58)
ALP-Intestinal: 49 (<15)
GGT: 24 (8-62)
ALT: 17 (7-52)
AST: 21 (13-39)
Of course, if you add the individual upper limits, they exceed the recommended limit on the ALP, but i guess that how labs work. Anyway he concluded that the liver fraction is normal, and on top of that GGT is normal.
Now that i have moved, my new GI insists that I have an MRCP. I refused outright. I mean I see no sense in having an MRCP when my GGT is normal and my ALP fraction clearly shows that the liver fraction is completely normal and I have absolutely no symptoms whatsoever.
He says, he does not trust ALP fractioning, he does not trust GGT. Gosh, I mean he has confused me a lot. On top of this, my old GI was a cleveland clinic trained guy and this guy is a completely local and even told me on my colonoscopy that pseudopolyps are an indication for colon cancer (which all my previous GI's completely rubbished). I have also has a CT scan and Ultra Sound previously which indicated that my liver was absolutely normal.
Quincy, any inputs??
Post Edited (Gayu) : 3/6/2014 1:54:40 PM (GMT-7)