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758338 tn?1235785002

Looking for a Brilliant Hepatologist

I'm looking for a whizz--bang hepatologist - Someone with the brilliance of a Dr. "House" (as in the TV series).

Last summer, I fell profoundly sick. Impossible fatigue, upper right quadrant bloating, bouts of generalised itching that would wax and wane, and the gratuitous pale stools, dark urine, and flatulence - but no noticeable jaundice. Time to see the Doc (and straight away), as I was certain I had one of the "heps".

Dr. appointment scheduled - and symptoms had gradually improved by then - (basically save for the itching and on and off feeling of "hepatomegally). So the hep screens came back neg (a, b, and c), and the labs looked ok save for ALT of about 150. Follow up scheduled. Next labs, looked ok again - save for high ALT (about 96 that time), so more tests ordered: I was tested for many esoteric diseases - autoimmune hep, hemachromatosis, wilson's, etc. - and my ceruloplasmin was 1 point low - so next came the 24hr pee test: it looked ok - and at that point, I scheduled a follow up appt to see what was happenning. ALT was still up, so next an ultrasound scheduled - and the results reviewed and looked ok, so no (apparent) sign of obstruction, primary biliary cirrhosis, or primary sclerosing cholangitis.  Next in my saga, a biopsy was ordered - and with a wilsons dry copper weight test. The biopsy came back showing no marked cirrhosis, it did show a bit of steatosis, and my copper was at appx 60ug per g (but for the last 4 months I had been popping about 400 mg of zinc daily to the point of nausea and avoiding chocolate, shellfish, nuts, and other high copper foods - so I *may* have skewed the result down).

SO, as of today, my energy has largely returned, I also have linked a mild but lingering pre-existing problem to all of this (which I never gave a lot of thought to when it all cropped up about 5 yrs ag) - where I would have bouts of what I thought "gastritis" or maybe gall stones - causing mild upper right quadrant bloat - but it would come and go last a week and be in hibernation for a couple of months, that, and I would occasionally notice a mild itch on my arms - and attributed it to an allergy - but now I think that "whatever I have" these were early warnings/manifestations.  Presently, theres still the lingering on and off itch, and the random "bloat" around my liver/spleen, and the occasional slightly darkened urine. I too have a bit of a gas problem (seems to be independent of what I eat). I have noticed sodium seems to make the itch more pronounced about 90 minutes after consumption. I also have noticed one newer symptom and thats a bit of random and transitory sharp pain from around my liver area (like maybe a stone moving?).

ANY brilliant docs out there that may have a clue? did my ultrasound miss something in my bile ducts??? might I have Hep C (which im told is sometimes hard to find) ? ANY thoughts? Your help would be greatly appreciated

Sincerley,

"Jack"
2 Responses
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Avatar universal
You may indeed have hepatic impairment of some sort but you may not have it due to a virus (hep A, B, C, etc)

You still seem to be in the diagnosis stage.  Off hand it appears that the Doc you have working for you is doing a decent job.  I wonder if there could be any environmental issues (such as work exposures to chemicals) or any drug interactions have been ruled out?  

It seems to me that persistent elevated ALT may show some signs of liver damage. (but not necessarily so)

Assuming that it is not HCV related this forum may not be the ideal place to get ideas.

If you keep after this in a methodical manner I think you'll get to the bottom of this.  In "House" I think the formula is to find arcane oddities and construct a plot line around them.  You may not need a brilliant addicted doctor to solve this mystery.  ; )

Often times things are not readily apparent but may progress.  You need to continue to monitor things and in time your issue may "self diagnose" as my friend and mechanic says.

best,
Willy
Helpful - 0
Avatar universal
the closest thing we have to Dr. House here is Dr. Dietrich in our expert forum but it will cost you a modest fee. I suggest however, that you be a bit more specific with your biopsy report, for example what "stage" did they give you? they did not have the actual report, that would be a good time to get your own copy. and no, hepatitis C is not "hard to find", it's actually quite easy to find, just hard to treat. All you need is an antibody test which you're ready have had. You can take it again if you think you have a false negative, or better yet, order a PCR viral load test.
http://www.medhelp.org/forums/show/272
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