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Hello - I'm hoping someone can provide me with a bit of perspective and knowledge as I await an appointment with the liver specialist later this month. I learned over the past year that I had several potential medical conditions and am unclear if they are interconnected.

Quick background - I had a physical last January and was told my platelet levels and ALT levels were off. My ALT was elevated at 53 (normal 0-40) and my platelets levels were 119 (normal 150-450). I was told to repeat the lab in six weeks, and about four weeks in I was actually hospitalized with pneumonia and the flu. My ALT was 151 in the ER and later dropped back into the 50 range. My platelet count was lower, around 70 or so. It rose to the 90s or so in the couple of days I was there. One of the doctors examined my blood under the microscope and told me my platelets were clumping and it was reducing the platelet count.

Six weeks after my release, I had more bloodwork run. My ALT increased to 71 and my platelet count rose to 151. My doc ordered an ultrasound of my liver which he said indicated fatty liver. He also ran an antitrypsin level and the number came back 76 in one check and 70 in another. The phenotype check told me I had one Z allele and appeared to be an Alpha 1 carrier.

Six weeks later, my repeat labs came back normal. The ALT was 43.

In November, I requested repeat labs to make sure it wasn't a fluke, and was told my platelet level was 58, the ALT was 55, and they're referring me to a liver specialist, who I see in late January. I picked up a copy of my labs and it indicated there was significant clumping of my platelets and it appeared the levels were normal, but they could not tell.

Questions -

I know platelets can clump as a result of the tubes used, etc...but is it common for platelets to clump so frequently over a period of months?

Is there any relation between being an Alpha 1 carrier and a low platelet level, if in fact I have one?

What is likely to happen when I visit the specialist? What testing will he likely wish to perform to "get to the bottom of this?"

Thanks so much,

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