Laurie

[Guest guest]

Laurie,

I just read your post with absolute shock. I don't understand your GI saying

that pancreas problems can't possibly cause elevated liver enzymes. I do

actually have two separate things going (well actually more than two) and it did

make diagnosing both challenging. However, every single acute attack I've had

causes my liver enzymes to elevate. I have autoimmune liver disease. This was

diagnosed in Jan 03 after my previous GI finally did a liver biopsy. I also

have chronic pancreatitis. This was diagnosed in Jun 03 when I switched to a

new GI doc. I was put on prednisone for my liver disease and within 3 weeks, my

liver enzymes were almost normal (after being as high as 770 - which is over 20

times the normal limit). However, every time I'd have an episode of the severe

RUQ pain, nausea, and vomiting that was bad enough to send me to the ER, my

liver enzymes would shoot back up. My amylase was normal so the doctors kept

blaming the pain and elevated liver enzymes on my liver disease. I went to a

hepatologist at Vanderbilt in Nashville, TN and he said that my liver disease

was fairly stable with the prednisone but he felt the episodes of pain and

'spikes' in my liver enzymes were being caused by my pancreas or a bile duct

blockage. Ends up that even though my amylase was normal, my lipase was

probably elevating during these episodes of pain. They never bothered checking

it at my local hospital because it had to be sent out. Once I put the pieces of

the puzzle together, I decided I'd go to the hospital in the next town (about 25

miles away) where they could check my lipase. That very night I had an attack

and sure enough I was right! My liver enzymes were up in the 700's, amylase was

dead center normal and lipase was 514. I was admitted with a diagnosis of acute

pancreatitis under the care of my internal med doc because he was my only doc in

that town. That was the best thing that could have ever happened. He had never

seen me during an attack as most of the time I was seen by my pcp in the town

where I live. I spent 4 days in the hospital, begged my internal med doc to let

me go home and ended up back 36 hours later. That time they kept me for 7 days.

A new GI was called in since my previous GI was 100 miles away. What a blessing

this was! The new GI specializes in liver/pancreas problems because he 'finds

the liver and pancreas absolutely fascinating'. The new GI said pretty much

what the hep at Vandy said. My liver disease was pretty much under control with

the prednisone. The pain, nausea, vomiting, and spikes in liver enzymes were

being caused by the pancreas. He diagnosed me with relapsing idiopathic chronic

pancreatitis. He put me on actigall to thin the bile because he thinks that's

part of the problem. He also put me on pancreas enzymes so my panc doesn't have

to work so hard. I still have problems and pain but I was able to go two months

without a hospitalization or ER visit due to an attack. That's the longest I've

gone since the acute panc attacks returned in Jul 02. The attacks first started

in Jan 00. I had a rough year and then went about 18 months without any major

problems.

Anyway, from what my GI tells me, it is very normal to have elevated liver

enzymes when having problems with the pancreas.

W