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Young daughter with elevated levels

My daughter (8yrs old) continues to have strong abdominal pains. Last May it was really bad and was also coupled with mono and fifths disease. At that time her levels were crazy high. AST = 1312, ALT = 1692. These levels freaked out the Weill Cornell doctors so we went back the next week, still high but much lower AST = 394, ALT = 807, GGT = 84. Also did sonogram at that point which was inconclusive. Went back two weeks later and not better AST = 532, ALT = 682, GGT = 71. No answers, no idea what was going on. The doctors seem to phone it in at that point. My daughter started feeling better so we didn't push it for a couple months and went back in and the levels seem close to normal AST = 57, ALT = 42, GGT = 12. We were given no comfort as to what caused it. My daughter does complain a couple times a week about her stomach hurting, but she isn't in the extreme pain she was in...that is until this week. She is back to waking up in pain, spending most of the school day in the nurses office. So now we are heading back to the hospital for more blood as we didn't get any answers from the first 37 vials of blood they have taken. Any clues what might be causing this?
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1530171 tn?1448129593
If the onset of mono had preceded the strong abdominal pains, it is possible that it caused hepatitis, leading to abdominal pains among the classic / hallmark mono symptoms.
Often mono diagnosis gets missed at the beginning, however it does cause inflammation of the liver in about 10% of the patients.
5th disease may also cause liver inflammation.
The liver is involved in a gazillion important functions
like blood cleansing, energy management, hormone regulation, production of numerous essential substances to facilitate various bodily functions and so on.
Some of these functions depend on the integrity of the liver and when the liver is inflamed, detoxification, metabolism,
digestion, immunity, etc. get compromised.
Has the possibility of a mono reactivation been explored?
The risk of infection and re-infection is greater when the liver is affected, naturally. If this is the case indeed, it is like a double edged sword.
How about her biliburin levels? Were they elevated?

There's a Diagnostic Algorithm that maps out the dx process in some logical manner.
If interested do a search under :
Pediatr Gastroenterol Hepatol Nutr. 2013 Dec; 16(4): 225–232. Then go to table 1 and open it by clicking on it.

Best wishes,
Niko



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