Variations in S.G.P.T,Serum Creatinine and HB readings

Dear Friends,

The year 2010 started with a tough note for me.As i and my husband were down with viral fever our daughter Samyuktha's (In short Samyu) transfusion got delayed by 2 months.We usually transfuse her once every 5 weeks when her HB is around 8.5 gms/dl.

When we checked her HB pre transfusion 3 weeks back,i was shaken to find it very low at 4.5 gms/d .We transfused her with 220 ml Packed red blood cells(20ml/kg).Her weight is 11.5 Kg.The Doctor said she may need a transfusion again in 1 week since her HB will increase only up to 4 points maximum from 4.5 to 8.5 Gms/dl .When i checked her HB post transfusion i was more surprised when i got the value as 9.9 Gms/dl.

After 2 weeks we checked her HB to see how much it has dropped.But we were astonished to find her Hb at 10 gms/d .This happened last wednesday.Her HB had increased 0.1  decimal which had never happened before.
But we found her Serum Creatinine at 1.15 mgs/dl which was quite high and S.G.P.T at 37.0 U/L.

Her Asunra intake was upgraded from 200mg to 300 mg 2 months back.When i informed her Doctor about the high values of Serum Creatinine and S.G.P.T,she asked me to stop Asunra for 1 week and redo the Creatinine test.

After 1 week sans Asunra  we repeated her Serum creatinine which dropped to 0.80mgs/dl and her S.G.P.T increased to 76.0 U/L  :'(.
Moreover i was totally depressed to find her HB at 8.5 gms/dl.From last week value of 10 gms/dl to 8.5 gms/dl.Why such a droop?

What is happening with her Andy?

First her HB increased 0.1 decimal in a week and now it has dropped 1.5 points which has never happened before.And why did the S.G.P.T jumped from normal value of 37 to 76.0 U/L that too when she was with out Asunra intake  ?

I am so confused Guys...

She is playing and doing her routine work as usual.But i am quite worried with the above readings.

Viji,

I think once Samyu is back on a regular transfusion schedule, that you will see the Hb get back to its normal pattern. The fluctuations in Hb don't make much sense and could be lab error or even influenced by hydration level at each test. The SGPT is not high enough to be of any concern and is common with Exjade. The serum creatinine is the test of more concern and the drop is good. It sometimes takes some starting and stopping and starting again with Exjade to get the body used to the drug, but this does have to be watched closely. A patient will be taken off Exjade quickly if the creatinine gets much out of range, but won't stop Exjade as quickly with changes in SGPT, which fluctuates quite a bit during the day, with morning tests often yielding lower results.

I think you'll see her Hb act more predictably after the next transfusion or two. Try having the SGPT test done in the morning and see if you get a lower value. It's not very elevated with the last test, and not in a range where Exjade would be stopped.

Hi Viji,

Andy is right,try the test in the morning,it made a big difference in my daughter's case,hope everything will be back to normal soon.

Zaini.

You were right Andy.

I did see some variation in her SGPT .Wee ,she had her transfusion  on 30th Jan.

I need to check her HB post transfusion and creatinine tomorrow.
Hopefully all the readings should be satisfactory.
Her Haematologist has reduced her dosage of Asunra from 300mg to 200 Mg.

What is IP6? By what name should i ask for it in the Pharmacy and what should be her dosage?

Samyu weighs 12 Kg, She is 3 years old.

Thank you Zaini for your kind words.I was too worried over her fluctuating readings.Now i feel better.

Thank you friends.

IP6 is phytic acid (Inositol Hexaphosphate). It is a supplement derived from the bran of grains like rice. It is completely safe to take.

You can see a list of sellers at http://www.google.com/products?q=ip6&oe=utf-8&rls=org.mozilla:en-US:official&client=firefox-a&um=1&ie=UTF-8&ei=wvxmS_vuJMKZ8AaE4_2RAw&sa=X&oi=product_result_group&ct=title&resnum=4&ved=0CDEQrQQwAw

A young child can take one 500 mg capsule per day. This can be mixed with water or juice by opening the capsule. Do not mix it with milk or any other protein containing substances, as it can cause some nausea when taken with protein. Don't worry about the dose. IP6 is extremely safe and a known toxic level has not been observed.