Indicators
From ShortGut - Wiki
What numbers do you pay close attention to in those weekly lab results, and what do they portend?
caprofile.net provides some standard info on these measures. See also labtestsonline.org.
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bilirubin
Direct and total bilirubin are probably universally tracked, although it is apparently well known that these are not always a very good indicator of underlying liver function. It also seems that they don't necessarily correlate all that well with skin and eye color, once they get above a certain value. Share your values here:
MaxMunakata -- direct bili has been fairly steady at around 9 for many months, with some jumps up to 14 or so during infection. When he was biopsied (twice) he has cholestasis with some amount of fibrosis but not bridging fibrosis.
AustinRath -- Austin follows a rather unusual pattern. His bili is actually on the low side of normal at .3. However, his AST and ALT (see below), another indicator of liver function, are 3 to 4 times the normal range.
liver enzymes (AST/ALT)
Another indirect measure of liver function; often strongly affected by infection.
MaxMunakata -- was steady at around 300 or so AST but then went up to 8-900 with a staph epi infection and rifampin treatment.
Platelet count
Low platelet counts (e.g. <100K) can indicate liver damage and portal hypertension, which is caused by inflammation of the spleen and consequent poor blood flow through the portal vein. These are often highly variable/noisy values, and can also be affected by how quickly the test is run after the blood sample is collected -- if it sits around a long time the platelet's can clot and thus decrease the count.
MaxMunakata -- steadily decreasing platelet counts over a period of months down to around the 50K range, but with high levels of variability (still gets 100K values occasionally).
H&H (hematocrit & hemoglobin)
See Anemia.
CRP
This is a general measure of inflammation, and is apparently affected by many things including persistent liver damage. Should be < 1.
MaxMunakata -- baseline CRP around 2 or so, with increases to 5 or more during infection.
Eosinophil
A type of white blood cell (Wikipedia entry -- obtained in the "differentials" on a CBC) -- apparently can be a good indicator of infection specifically in the intestine.
BUN
blood urea nitrogen levels -- apparently a good indicator of dehydration if values are too high (above 19 or so), which indicates a higher concentration -- but this can also be affected by other factors like protein levels.
IgG
Hypogammaglobinemia (low IgG) in short gut kids is the result of a poorly functioning/absorbing gut that causes the IgG/immune function to be low. IVIG (IV immunoglobulin) may be used to treat hypogammaglobinemia, which can help in treating bacterial overgrowth.
