instruction: hi doctor I am 23 years old it has been more than a year my liver function test result remains high I have been tested for hepatitis a c and autoimmune hepatitis but the result all came out negative my doctor told to take blood test regularly but it has been almost a year now the result still remains high the lowest result so far I get is ast 90 but my latest liver function test result shows my ast alp and get all 200 may I get any advice on this I did not take any medication consume any alcohol but the result still came out high I am so worried about that please help
output: hello I can imagine that you must be very concerned about your persistent elevation of the liver enzymes as you already have viral etiologies excluded this is time to look for other things which could lead to persistent elevation of the liver enzymes notably the wilson alpha antitrypsin deficiency hemochromatosis autoimmune hepatitis type I i want you to upload all your previous investigations ultrasound reports if done and any other testing that you have been performed in the past two years I also suggest you to get following blood tests which would help us excluding the above possibilities it is possible that you have some testing already and I do not want that you should repeat it but do upload the reports as I can see those secondly despite you had a viral screening that showed nothing abnormal but there are certain other tests like he core total which can tell occult or latent infection and cause of your raised enzyme levels since the investigation may cause you significant cost it is possible alternative that you can discuss with me in detail as we can shrink some of those testing by closely inquiring about those causes in history before getting tested I am sure we would reach a conclusive diagnosis by relevant information you provide and after investigations wilson hemochromatosis autoimmune hepatitis type I alpha antitrypsin deficiency chronic viral hepatitis complete blood count liver function test fresh and all previous as I can see the trend he core total hbsab hbsag serum ceruloplasmin serum copper ferritin and transferring saturation anti lam antibody serum alpha antitrypsin level autoimmune or other metabolic diseases follow up after investigations and all previous reports or earlier if want to discuss before getting tested