Elevated LFT and Abnormal Platelets

Patient

Q: Hello

A year ago during a physical I had a liver function test which showed elevated ALT levels. They ranged from 43 to71 mg dl over a two month period, with 0 to 40 mg dl being the normal range. Most frequently in the mid 50s. An ultrasound of my liver showed a fatty liver - they said the spleen looked okay - and an alpha 1 antitrypsin check showed levels of between 70 to 76 mg dl, with the phenotype test showing 1 z-allele, a presumed carrier.

At the same time, my platelet count came back at 112k, with 130 to 450 being the normal range. I was hospitalized with flu and pneumonia and my levels were reported to be in the 70 to 90k range. The hematologist at the time looked under the microscope and said my platelets were clumping and the true number appeared higher.

With a platelet count of 151k and an ALT level of 43 mg dl, my doctor declared victory. Six months later, I insisted on having my levels checked again. Platelets were 58k, ALT was 55, MPV was 12.1 (high end of the normal range was 11.9), albumin was 5.0 (normal high range 4.9) and the lab work said all over it that there was "massive clumping" and that the numbers appeared normal but it should be rechecked. Hence the referral to the hematologist.

My doctor tends to err on the side of not telling me anything unless I specifically ask as not to heighten my anxiety, which usually doesn't work, so here I am. I understand platelet clumping occurs because of an issue with the collection tube, but I've had multiple clump readings over the past year. Could the fatty liver or any other liver condition cause my platelets to clump and also explain the high ALT levels? I'd appreciate any insight or suggestions as to what all of these various readings could mean.

Nervous Bob

Doctor

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