Concerns About My 9-Month-Old's Elevated Liver Enzymes
Age: 9 months Gender: Male Medical Conditions: mild hypercalcemia, cystinuria mutation Current Medications: none Hello everyone, I am deeply concerned about the health of my 9-month-old son. When he was around 4 months old, we took him to a renal specialist due to the presence of uric acid crystals in his urine. After a series of tests and genetic evaluations, we've discovered that he has mild hypercalcemia and a single mutation related to cystinuria. It’s worth noting that the uric acid crystals have since resolved, but this post isn’t focused on that issue. What troubles me greatly is that during his regular CMP (Comprehensive Metabolic Panel) checks, both his AST (aspartate aminotransferase) and ALT (alanine aminotransferase) levels have consistently appeared to be slightly elevated. I’ve also noticed that he has been unwell in the weeks leading up to each test, which adds to my anxiety. The information I find online, especially regarding conditions like muscular dystrophy, is quite alarming. Should these lab values raise red flags for any serious conditions? Here are his recent lab results: **Test Dates and Results:** - **March 19, 2025** - AST: 91 U/L (High) - ALT: Not specified - Albumin: 4.7 G/DL (Normal) - **December 19, 2024** - AST: 102 U/L (High) - ALT: Not specified - Albumin: 4.4 G/DL (Normal) - **November 6, 2024** - AST: 78 U/L (High) - ALT: Not specified - Albumin: 5.2 G/DL (High)
Answers (1)
3/26/2025, 8:50:44 PM
OpenHealth AI
Elevated liver enzymes in a 9-month-old can be concerning, but they often indicate a temporary issue rather than a serious underlying condition. It’s essential to understand the potential causes, and I’ll guide you on what steps to take next.
Explanation
AST and ALT Elevated Levels:
- AST (aspartate aminotransferase) and ALT (alanine aminotransferase) are enzymes found in the liver. Elevated levels can indicate liver distress or damage but can also be seen due to a range of other factors, including infections, medications, or even physiologic responses to other illnesses.
- Given your son's history of unwellness leading up to tests, these elevations might correlate with acute conditions like viral infections, which can temporarily affect liver enzyme levels.
Differential Diagnoses:
- Elevated liver enzymes in infants can be caused by various conditions, including:
- Viral hepatitis
- Metabolic disorders (possibly linked to his known hypercalcemia and cystinuria)
- Fatty liver disease (less common in infants)
- Muscle disorders (muscles also leak AST)
Your understandable concern about conditions like muscular dystrophy, given the elevated levels, is valid, but it’s vital to remember that not every elevation implies a severe problem, especially in the context of viral illnesses and minor metabolic aberrations.
Next Steps
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Continue Monitoring:
- Keep a close eye on your son’s overall health. Observe for any symptoms such as jaundice (yellowing of the skin or eyes), significant fatigue, or changes in feeding. This will help contextualize his lab values.
-
Ensure Follow-Up Testing:
- Schedule regular follow-up blood tests to monitor AST and ALT levels. Discuss with your pediatrician the idea of possibly including ALT in future tests for a more comprehensive picture.
-
Document Symptoms:
- Keep a diary of any symptoms he experiences, noting the timing relative to his lab tests. This information can be helpful in understanding patterns or triggers.
-
Consult a Pediatric Gastroenterologist:
- Given the persistent elevation and history of health concerns, consider consulting with a pediatric gastroenterologist for a thorough evaluation and additional testing if recommended by your pediatrician.
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Avoid Unnecessary Anxiety:
- While it's natural to worry, try to focus on tangible steps you can take. Educate yourself constructively about liver health, and avoid excessive comparison with extreme cases you may find online unless they align closely with his specific findings.
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Maintain Routine Health Checks:
- Ensure that all routine pediatric care, including vaccinations and well-child visits, continues. This ensures a comprehensive evaluation of your child’s growth and health.
Conclusion
Elevated liver enzymes can be a normal response to a variety of temporary conditions in infants. While it's crucial to stay vigilant, maintain communication with your healthcare provider, and seek specialty support as needed. You're doing the right thing by being proactive about your son’s health concerns, which is a key part of effective parenting and care.
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