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Gastroenterology (Expert Forum)
Liver Biopsy and blood work with high carbon dioxide readings
Answered by
Kevin Pho, MD - Internal Medicine
Kevin, M.D.
Boston - MA
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
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Liver Biopsy and blood work with high carbon dioxide readings
by sandybliv, May 07, 2004 12:00AM
I wrote to you about a month ago, concerned with elevated AST & ALT levels. You recommended a liver biopsy, which I had done. The test read as follows: Core biopsy of liver, the speciem consists of three cylinders of tan-white tissue each 1.2 cm in length, filtered. The results were: Liver biopsy negative for metastitic carcinoma. Note: the biopsy shows no increase in stainable iron but the trichrome stain shows portal fibrosis without periportal fibrosis or other more severe fibrosis. Fatty change is present as is individual cell drop out, patchy portal inflamation and mild sinusodial dilatation. The diagnostic features of steatohepatitis are not seen. Bile ducts are intact. A drug effect is favored. end.
My ocologist is statisfied that liver inflamaiton is from med's I was taking. MY GI is not, she sent out specimem to another specalist. Why?
Since I am no longer taking tomoxefin for my breast cancer I had blood work done to see if I was menopausal. My tumor was estrogen positive. I am 52, had breast cancer, chemo and radiation in 2000. When I had bloodwork done last week, my carbon dioxide level was very high, 40 H, my potassium was low, 3.5 and my estrogen level shows that I am not completely menopausal. I am concerened about the carbon dixiode reading, which has never been high in all my monthly blood tests. I workout nightly in my basement on a treadmill, where I really push myself. Is it possible to be inhaling carbon dioxide from the furnace located there?? Can this be corrected?
I would like your oppinion on the biopsy, the bloodwork and any recommendations.
The only medication I was taking is Tomxifin and nexium. Which I stopped tomoxifin 2 months ago.
Oh by the way, my AST returned to normal- AST is 40 and ALT IS 75 (ALMOST NORMAL) and it had been in the triple digits last month.
thank you very much.
Sandy
My ocologist is statisfied that liver inflamaiton is from med's I was taking. MY GI is not, she sent out specimem to another specalist. Why?
Since I am no longer taking tomoxefin for my breast cancer I had blood work done to see if I was menopausal. My tumor was estrogen positive. I am 52, had breast cancer, chemo and radiation in 2000. When I had bloodwork done last week, my carbon dioxide level was very high, 40 H, my potassium was low, 3.5 and my estrogen level shows that I am not completely menopausal. I am concerened about the carbon dixiode reading, which has never been high in all my monthly blood tests. I workout nightly in my basement on a treadmill, where I really push myself. Is it possible to be inhaling carbon dioxide from the furnace located there?? Can this be corrected?
I would like your oppinion on the biopsy, the bloodwork and any recommendations.
The only medication I was taking is Tomxifin and nexium. Which I stopped tomoxifin 2 months ago.
Oh by the way, my AST returned to normal- AST is 40 and ALT IS 75 (ALMOST NORMAL) and it had been in the triple digits last month.
thank you very much.
Sandy
Doctor's Answer
by Kevin Pho, MD, May 10, 2004 12:00AM
, May 10, 2004 12:00AM
The biopsy results state that it doesn't suggest metastatic disease. Like everything else, the results are based on pathologist's interpretation, so it is likely that the biopsy is being sent out for another pathology opinion - just to be on the safe side.
Regarding the elevated carbon dioxide - there are many reasons for this. This includes causes of volume depletion, chronic vomiting, or elevated corticohormone levels to name a few. Inhaling carbon dioxide is also possible - if this is suspected (i.e. the furnace), this should be investigated. The next step would be to obtain a urine chloride to further evaluate the cause. A nephrology consult can be obtained for another opinion.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
Medical Weblog:
kevinmd_b
Regarding the elevated carbon dioxide - there are many reasons for this. This includes causes of volume depletion, chronic vomiting, or elevated corticohormone levels to name a few. Inhaling carbon dioxide is also possible - if this is suspected (i.e. the furnace), this should be investigated. The next step would be to obtain a urine chloride to further evaluate the cause. A nephrology consult can be obtained for another opinion.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
Medical Weblog:
kevinmd_b
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