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Hi there.
I need some help! About 2 months ago I started having episodes of random unexplainable fevers that lasted less than 24 hours, but came on with severe body aches and no other symptoms. Then a month ago, I had these fevers followed by intense itching that sent me to the ER because I was scratching even when blood showed up. It was then they discovered my liver enzymes were highly elevated, and asked me to follow up with family dr. Family dr said I was positive for Hepatitis B.:
HBsAg - positive
HB Core Ab, IgM - Negative

My most recent numbers (and some have even gone down slightly):
AST: 132
ALT: 344
Alkaline Phosphatase Serum: 569
Alk Phos iosenzyme: Liver Fraction 82% Bone Fraction 18%
Bilirubin, total: wavers between .8 and 2.7
Protien: 8.1 (norm 6.3-8.2)
Albumin 3.7 (norm 3.7-5.1)

The specialist I was referred to said he thought it was a false positive or I was a carrier, but that those numbers weren't typical of Hep. B, especially the ALP. He put me on antibiotics 10 days ago and I have not had a fever/itching episode since. Since then he has done the following tests, all which came back normal:
Liver ultrasound, AMA, ANA, Iron, Ferritin, IGG, glucose, A1C
I am told this rules out diabetes, cirrhosis, auto immune Hep, PBC, PSC, and Hemochromatosis.
I have a limited time in which to solve this due to losing health insurance. I am wondering what the next steps might be, or what possible condition you think I could have since so many have already been eliminated? The dr mentioned I could have a blockage caused by a stone but I no longer have my gallbladder, and wouldn't that show up in ultrasound?
Thank you for your help.
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replied April 10th, 2011
Hello and thank you for posting your medical question on E health forum.

From the description provided it seems that you might be having primary biliary cirrhosis.

Primary biliary cirrhosis is irritation and swelling (inflammation) of the bile ducts of the liver, which blocks the flow of bile. This obstruction damages liver cells and leads to scarring called cirrhosis.

The clinical presentation of fatigue and intense itching and the presence of Albumin in the lower range of normal, elevated alk phosphatase (Liver) indicate this condition.

The next probable step , that might be helpful would be a liver biopsy to have a tissue diagnosis.

You might consult your gastroenterologist for further advice and clarification.

I hope this helps.


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