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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Do These Liver Enzyme Results For Joints Pain And Swelling In Hand Indicate?

Our 22 yr. old daughter awoke yesterday with joint pain and some swelling in one hand- pain was in extremities. She also had a sore throat. went to immediate care. liver panel done came back elevated AST (495) and ALT (918). Any idea what is going on? Their only recommendation was take ibruprofen and check back in a couple of weeks or if she gets worse see dr.
posted on Fri, 4 Dec 2015
Twitter Thu, 28 Jan 2016 Answered on
Twitter Fri, 29 Jan 2016 Last reviewed on
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Pathologist and Microbiologist,  's  Response
Hello and welcome to HCM,
A sore throat followed by swelling and pain in joints may be due to streptococcus infection.
Streptococcus bacteria is known to illicit an autoimmune reaction in body due immuno-mimicry.
This implies that the antigens of streptococcus bear a close resemblance to certain human tissue.
The resemblance is so close that human body starts developing antibodies against its own tissue and the process may continue for long even after the primary infection with streptococcus is over.
The joint pain and swelling could be due to inflammation caused by the auto-antibodies.
However, this is one of the possibility.
The joint pain and swelling could be due to other cause also like rheumatoid arthritis etc.
Please continue with the treatment for sore throat.
Once the sore throat is treated, the joint status needs to re-evaluated and the cause for the pain and swelling needs to be found out with clinical assessment and relevant investigations.
In the meanwhile, the joint pain can be controlled with pain killers and hot fomentation.
The elevated AST and ALT also need to be re-evaluated after treatment of sore throat.

Thanks and take care
Dr Shailja Puri
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What Do These Liver Enzyme Results For Joints Pain And Swelling In Hand Indicate?

Hello and welcome to HCM, A sore throat followed by swelling and pain in joints may be due to streptococcus infection. Streptococcus bacteria is known to illicit an autoimmune reaction in body due immuno-mimicry. This implies that the antigens of streptococcus bear a close resemblance to certain human tissue. The resemblance is so close that human body starts developing antibodies against its own tissue and the process may continue for long even after the primary infection with streptococcus is over. The joint pain and swelling could be due to inflammation caused by the auto-antibodies. However, this is one of the possibility. The joint pain and swelling could be due to other cause also like rheumatoid arthritis etc. Please continue with the treatment for sore throat. Once the sore throat is treated, the joint status needs to re-evaluated and the cause for the pain and swelling needs to be found out with clinical assessment and relevant investigations. In the meanwhile, the joint pain can be controlled with pain killers and hot fomentation. The elevated AST and ALT also need to be re-evaluated after treatment of sore throat. Thanks and take care Dr Shailja Puri