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ALP etc in 3.5 yo

I’m wondering if someone could help me just brainstorm something. Blood tests can be elevated but what the untrained eye can’t see is that usually the elevation needs to be more than a few points.. so I need help.

3.5 yo boy got:

TP: 6.3 g/dL (6.5-8.3)
ALP: 584 IU/L (110-345)
(Billirubin at 0.3mg/dL where range is from 0.2)

LD: 270 IU/L (120-260)
Cholinesterase: 508 IU/L (235-494)

Iron and HDL cholesterol also a tiny bit low.

ALP caught my attention the most, is this elevation still normal in children? The doctor wanted to take more tests but my son needed to be sedated and we just didn’t get anywhere as he didn’t respond to the medicine and they didn’t seem to want to do proper sedation and I won’t push something doctors seem to feel OK with not happening.

This is a child who eats a very limited diet he completely controls.
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Avatar universal
The answer maybe as simple as his diet.  His protein level is slightly low. If the diet is very low in protein and high in fat, the liver can become fatty and congested putting stress on the intrahepatic biliary system.

You didn't list the ALT or AST, but these would also tend to be slightly elevated as well.  Doing followup blood tests would be the natural course of action.  If the diet could be improved, and changes reflected in follwup blood labs, then that might be an answer..

Ultrasound tests are pretty straight forward, but some children may not think so.
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Thank you for your reply. According to the nutritionist he is getting enough protein but I don’t agree with her fully as I feel she doesn’t listen as well as she should but I could just be an annoying mom, I do realize that, haha. He has selective eating disorder and the only protein he gets is peanut butter, one bottle of infant formula and if he happens to eat a pancake with eggs in it. He’s struggled with food since he was 6 months old and seems to be protecting himself from it.

He’s almost 6 now so these tests are old. He was very traumatized during the test so they weren’t able to run full panels on the little blood they got but the ALT and AST was within range at 10 for ALT (5-39) and 30 for AST (9-38). I’ve just always wondered if they could hold a clue to why he as a baby got those horrible diaper rashes from all the bowel movements and rather starved than ate what I gave him.

I brought him to my doctor last week who now has ordered a test for celiac for both of us so we will see. It would explain a lot but I’m not too hopeful that we will finally have an answer to a lot of question marks in both our daily life health. But who knows!
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