Elevated liver enzymes
AnonymousMay 4, 2007 at 1:18 pm
Hi all. I’m wondering if any of you who receive IVIG have had elevated liver enzymes as a result. Mine are slightly elevated. I asked my neuro about it (since I get blood tests before every infusion) and she said that they were a little high but nothing to worry about. Of course, other Dr is concerned, so I’m scheduled for a liver ultrasound next week.:(
I ran across one reference on the internet indicating that IVIG could cause liver enzymes to be elevated, but most info on IVIG does not indicate that.
I’m interested to hear your experiences.
May 4, 2007 at 2:43 pm
Are you on any other medications? My father in-law takes Lyrica and neurotin and is tested often. Dawn
AnonymousMay 4, 2007 at 2:55 pm
No other drugs for the CIDP. I do take 2 blood pressure meds and Wellbutrin, but I’ve been on them a long time. Also clonazepam (mild seditive) at night as needed. Asprin for pain (ironically to spare the liver since tylenol and advil can cause damage).
Recently, my Dr tried to put me on the cholesterol lowering drug, Zetia, and I had an unconventional reaction: diplopia/blurred vision. I thought it was from the CIDP, but on a hunch I looked at the medication dates and the vision problems started within days of beginning the drug and ended pretty much right after discontinuing it. Go figure. They must not have tested that one on CIDP patients!
May 4, 2007 at 3:02 pm
Maybe just plain old high cholesterol is the culprit. My mom has elevated liver enzymes and she has high cholesterol. She takes lipitor, that gives her cramping in the legs and irritates her neuropathy (diabetic) Cure one thing, wreck another! At 41, I have finally figured out life is difficult and just a crap shoot! Sorry, didn’t mean to be so dismal!!!! Dawn 😮
AnonymousMay 4, 2007 at 3:31 pm
You’re not dismal, just a realist! I do have very high cholesterol, but to be honest, since I got sick I just really didn’t care — I was so miserable most of the time that food (and wine ;)) were all I had!! (Not really true, but you get the picture.) I’ve never been an optimist, but I’m finally getting used to being “better” and caring about myself again. Started watching what I eat again so I can lose the weight I gained from the inactivity caused by the disease. Hopefully that will lower my cholesterol and, if fat is the culprit, bring my enzymes down, too.
AnonymousMay 5, 2007 at 12:01 am
Tylenol can affect the liver. Are you premedicated with it before each infusion? Also I believe that a way to test for possible blood clots is through liver function tests. I’m not exactly sure on that though.
I don’t think that IVIG affects the liver. IVIG containing sucrose *may* cause kidney failure though.
I hope you get good results back from your ultrasound.
AnonymousMay 5, 2007 at 12:19 am
[B]IVIG with sucrose should never be given to a diabetic it will damage and shut down their kidneys in a rapid manner.This is the one thing that I learned about IVIG because we had to be careful with Frank because he was a diabetic, so no sucrose based IVIG for him. As far as kidney damage to someone without diabetes that is probably very rare.
Elavated liver enzymes can be from a variety of things and if I’m not mistaken one of the things can be from auto-immune hepatitis. High blood pressure meds are another “Big” culprit.[/B]
AnonymousMay 5, 2007 at 10:15 pm
into your system, the first filter for the body in dealing with the wastes of this is your liver…that’s why docs’ always do the CMP -metabolic panel to see if it’s affecting that all important liver. If you read the information about any IVIG brand you’ll find statements that indicate it can affect it. They just don’t say which numbers mite change. For most folks they don’t change much. If your numbers change a lot or suddenly, it could be a time to sit down and re-think with your neuro and other doctors what medications you’re on, even supplements and how the each affect one another.
I’ve had infusions for over 2 years and some of my #’s are up, others down…I’m on a lot of other meds for other things as well tho. My docs’ aren’t concerned, just curious now as numbers that should be hi aren’t and low aren’t what each would view as normal for each single condition and med. Soo I blame the combination of meds.. and, as long as nothing suddenly changes, I don’t worry! Don’t we all have enough to worry about?
Who knows, maybe we’re doing something right and don’t know it?
AnonymousMay 7, 2007 at 11:01 am
Hi all. Thanks for the info. My enzymes are only slightly elevated, which is why my neuro says it’s nothing to worry about. It’s the other doc who’s concerned. I’ll get the scan anyway to be sure. I get screened for hepatitis — all negative.
I didn’t know blood pressure meds could have an effect, but my enzymes were fine until IVIG and I’ve been on BP meds for a long time. The only tylenol I ever take is pre- and post-IVIG (to avoid/manage headache). I do take ibuprofin for bad pain, but primarily asprin, which probably also has it’s effects.
I get sucrose-free IVIG. I’m not diabetic but my neuro prefers it since sucrose alone can cause kidney damage. It also apparently has fewer side-effects.
Homeagain — I agree — life is too short to spend it worrying!
AnonymousMay 7, 2007 at 7:15 pm
VERY USEFUL to get these two docs to talk to each other about this concern – why? because they BOTH are looking after you but from very different perspectives…Therefore as your ‘other’ doc is concerned it’s because he is familiar of all the issues of IVIG. Print out the prescribing info of the brand you use and HILIGHT the ‘hepatic-function’ issues and also the side effects, common and rare…Point out to him that the neuro isn’t concerened and that you appreciate his being alert and concerned. The docs will talk to each other, get on similar if not same pages and YOU will benefit. What’s to lose? I see you getting great benefit from all this and your docs appreciating that you are well informed about all this complicating treatment can mean. Count your blessings for such good docs!
I’m interested about the brand of IVIG you are on, I was on a saline based one, [mostly Gammagard] and now I am on a sucrose based one [Gammunex] and for ME I’m finding far fewer side effects [headaches, diahrea etc.] That’s what makes each of us different. I am not diabetic or pre-diabetic that I know of, only prone to hypoglycemia on occasion…which causes similar s/e’s to diabetes but different.
It seems that: Not only is diagnosing our problems, in all it’s forms a demon, but, treating it as well. I think WE are INTERESTING! And, if Docs aren’t interested..then they are the dull ones! Good thoughts!
BTW, tho they don’t tell you, they DO screen for AIDS and Hepatitis right off-from the start…IF it were a positive in any way, they have to tell you. But, reassure yourself, get copies of all your tests…then not only do you know, but, you’ve got all the other good stuff as well to look at and, be confused about!
AnonymousMay 7, 2007 at 10:28 pm
I noticed that you mentioned wine. I had decided that wine was good for
you and had it every evening with dinner. Before I knew it my slightly raised
liver count was raised even more so. I quit drinking the wine, and there was a better report. My elevated liver count is from Imuran, and evidently the wine made it worse. Try laying off alcaholic beverages and see what happens.
AnonymousMay 8, 2007 at 8:51 am
Caryn – for three years my pcp has been chasing my “slightly elevated” liver enzymes. It was discovered in the lab work that was done at the time I was diagnosed with CIDP. I had been taking a low dose of lipitor for a couple years before this, with no indication of even “slightly elevated” numbers in regular, periodic lab work to follow my cholesterol counts. I started IVIG in August ’04 after several rounds of PP. I have gotten IVIg every 28 days since then, usually at 2G/k formula. Also take Cellcept. Also take meds for high blood pressure which developed during the 18 months I took prednisone.
My liver enzymes have remained “slightly elevated” all along, and since my local neuro, my teaching university neuro, my infusion center oncologist all said “…hmmm, slightly elevated liver enzymes – we’ll watch that….” nothing was ever done until my pcp decided it was a challenge. I had also been taken off tylenol – 2 extra strength at bedtime every night for 2 years.
Last fall the doctor took me off lipitor for 2 months and noticed a “slight improvement”, he then kept me off for another 4 months. Had a lipid profile in March and numbers were sky-high, but liver numbers were again “slightly improved”. I then went on crestor – another statin – and six weeks later my cholesterol was down 87 points and my liver function and numbers are NORMAL. Who knows why after all this time?
I really think that the amount and combination of drugs and treatments that CIDP (patients? victims?) folks have to deal with, changes so many chemical balances in our bodies that things get out of whack. And your liver is first to tell you. Even “slightly elevated” can’t be good for extended lengths of time.
I hope you and your doctor are able to find the source of your “slightly elevated” liver enzymes – everything is “slightly”, so give it some “slight persistance”! Bonney
AnonymousMay 8, 2007 at 11:00 am
Interesting you talk about getting the docs to talk to each other. I just started seeing a new internist specifically because my neuro knows and referred me to him, and my family doc wasn’t communicating with her (the neuro). I think the internist is just covering the bases — he’s trying to get me on cholesterol meds, too, but I just don’t tolerate them. I figured that there’s no harm in getting an ultrasound of the liver just to see if there’s any physical problem or if this is an artifact of the IVIG.
I’ve been on Flebogamma since I started IVIG in July. It is sucrose-free. I’m not sure when my enzymes became elevated; I plan to ask her when I see her later this month.
Thanks again for all the good info. I’m sure learning a lot by participating in this board.
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