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Early Symptoms

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Beware the Flu Bug
Any of these early warning signs may signal his presence. This guide may help you to identify a possible oncoming infection and afford you the opportunity to seek out the appropriate treatment.

Adult Symptoms

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Childhood Symptoms

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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Note:  Symptoms listed are from a collection of postings that pertained to their experiences with Adults  and Children and submitted by the Alpha-Liver Mailing Support Group List.  Readers should always consult their physicians before taking any action (or inaction) which may affect their health or involve decision making.

Alpha Liver Doc’s Corner: If you would like to read, or print out, Dr. Teckman’s technical papers go to the following site:    http://pubmed.gov. At the top, in the box that says for, type in: teckman j  (no punctuation, e.g., smith ja). Then click on: Go. His articles will pop up.
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Early Alpha Liver Symptoms Highlights

Liver disease is not the only cause of some symptoms. Consult your physician.

  • Ankles swelling
  • Anxiety
  • Ascites
  • Asthma
  • Bad breath
  • Body odor
  • Bloating
  • Bowel movement, increased frequency
  • Bronchitis (chronic)
  • Cirrhosis
  • Cramps
  • Diarrhea
  • Edema
  • Fatigue
  • Fluid retention
  • Flu
  • Jaundice
  • Joints, aching
  • Liver, tenderness
  • Liver enzymes, elevated
  • Liver function tests, elevated
  • Mental lapses
  • Mononucleosis
  • Muscle tightness
  • Night sweats
  • Pain in right side
  • Sinus infection (chronic)
  • Stomach upsets, frequent or severe
  • Stool, black, grayish
  • Stool, unusually hard, unusually soft
  • Urine, dark

Adult Symptoms

The following are summaries of individual experiences regarding early symptoms of liver disease. Readers should always consult their physicians before taking any action (or inaction) which may affect their health.

  1. Cirrhosis found after ten years’ failure to confirm hepatitis. Cause of cirrhosis undiagnosed; platelet count fell to 90, biopsy confirmed alpha.
  2. Long-term elevation of liver enzymes. Biopsy found alpha, five years later bloating, fluid retention.
  3. Slightly elevated liver enzymes for a year, then bloating and right side pain, and dramatically abnormal liver enzymes. Biopsy at time of gall bladder surgery found alpha.
  4. Asthma began at age 26, with recurring moderate influenza, sinus infection, pleurisy, fatigue. COPD diagnosed at age 46. First liver involvement age 65.
  5. After years of treatment for asthma, liver function tests led to diagnosis of alpha (lung and liver affected). Biopsy showed cirrhosis. Hepatitis C found later.
  6. Fatigue, cramps, muscular tightness, and out of shape; mental lapses; increase in stomach aches and susceptibility to influenza.
  7. Fatigue, mental confusion, right side pain, bloating, black stool. Two years of high liver enzymes. Tenderness of liver, severe fatigue. Diagnosed alpha.
  8. Jaundice and diarrhea at age 17; presumed chemical exposure. Exceptional fatigue during and after pregnancy. Bloating 1989, right side pain, inconclusive ultrasound. 1990, bad response to Provera. 1992, bronchitis and onset of chronic sinus infection. 14. Increased liver function tests, influenza, rise in blood pressure. l998. Severe fatigue, aching joints.
  9. Platelet count decreased two years before alpha diagnosis, and five years before symptoms. Marked fatigue. Digestive problems (stool noticeably hard or soft, bad breath and body odor), night sweats. Symptoms worsen over six months or more.
  10. First noticed increased frequency of bowel movements. Elevated liver enzymes, biopsy confirmed alpha.
  11. Constant bloating and fullness, some tenderness around liver. Cirrhosis. Diagnosed alpha age 23.
  12. Elevated liver functions for 14 years; marked decrease in energy; rapid decline ending in transplant after bilirubin reached 3.3.
  13. Ten years of slightly elevated liver function tests; stomach pains led to inconclusive ultrasound, then to endoscopy which revealed esophageal varices, and a presumptive diagnosis of cirrhosis. Blood test for alpha revealed ZZ. Fifteen months later biopsy confirmed alpha and cirrhosis.
  14. Elevated liver enzymes while hospitalized for throat infection. Bad response to medication due to liver. Previous mononucleosis and migranes, and unexplained elevation in liver enzymes.
  15. Asymptomatic until episode of esophageal bleeding.
  16. Fluid retention in stomach, ankles, and feet. Fatigue and weight loss. Fresh blood in stool.
  17. Chronic nose bleeds, and shortness of breath. Fluid in legs and lungs, infections in kidneys and testicles, latter with pronounced swelling.

Childhood Symptoms Summary

  1. I’ve given a lot of thought to the symptoms that XXXX had and then someone wrote about breastfeeding So I looked back at the beginning. Normal birth, no jaundice, weight normal but breastfeeding didn’t go as well as my other three children; also her stools were very foul smelling and very loose. At 18 months I thought she had to have milk allergies (also large tummy), so we went to the Gastroenterologist. After they ruled out everything from cancer to Wilson’s, they finally did the open liver biopsy (so far 3 needle 1 open); A1AD MZ diagnosis. That was six years ago and at least every test known to mankind. She’s had other things from:

         • small liver
         • cirrhosis
         • asicitis
         • large spleen
         • portal hypertension
         • Varice of the esophagus (which bled this summer three time’s)
         • kidney pancrese (last summer)

    But all and all, she is doing tons better and is back in school. She has some learning disabilities. XXX had a REX shunt and we are hoping that this will be in place of a transplant. This is a new shunt, only five kids have had it done in the XXX, but only XXXX was able to use her coronary vein not her jugular.
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  2. XXXX, I didn’t have any of the problems you mentioned during my pregnancies. I did, however, have morning (and afternoon and evening) sickness all nine months!
  3. After reading the responses from other parents, I must say “thank you” for making things clearer for me. My daughter, XXXX, had an unrelated intestinal surgery when she was born, and I had attributed many of her problems to that. Also, some of your responses jogged my memory. I think this was a good idea.

    Before diagnosis (2-1/2 weeks old):

         • Slow to gain weight
         •
    Pale stools - almost white
         • Cholestasis (a radio isotope scan determined no bile was leaving the liver)
         • Liver inflammation (biopsy performed at 3 weeks old)

    After diagnosis (4 weeks old):

         • Jaundice - skin and eyes became quite yellow
         •
    REFLUX - frequent spit ups, but not projectile
         • Lack of appetite and very slow at eating - content with a small amount of formula, then would doze
           off. Sometimes she would cry painfully during and just after eating. Otherwise she was very content,
           so it was not cholic.
         • More sleepy than the average newborn Unable to tolerate most formulas-had to use Alimentum
           (she couldn’t even tolerate Pregestimil) XXXX required a gastrostomy (feeding tube) until she was
           eight months old. At some point, I plan to visit XXXX Children’s and read XXXX chart again to
           find out what was done and when.

    After almost a year and a half, it’s hard to remember if her bilirubin was high before or after diagnosis. I am not even sure at what point they ordered the test for Alpha1.

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  4. A question for the Moms—did you have a normal pregnancy? I ask because mine was normal until I had a rash during the last month. XXXX’s contribution of itchiness as a symptom for XXXX made me think of this, because I itched severely with no relief. My OB tested my liver enzymes and found they were slightly elevated. Was this just a coincidence?

    XXXX’s symptoms were as follows:

         • failure to thrive—born at 10lbs. 4oz and at six wks he was 10lbs!
         •
    normal and healthy at birth and then at three weeks he developed jaundice—all over.
         •
    a very yellow baby.

    That is it!! Besides his liver being enlarged. He was a very happy baby and nursed very well. Thought his reason for not gaining weight was because of nursing, but soon found out that wasn’t it. After he was diagnosed at six weeks, he was on phenobarbital, ADEK vitamins and actigall and we haven’t had any other symptoms.

  5. XXXX’s pre-transplant symptoms were:

         • low birth weight
         •
    very spitty/projectile
         •
    A1AT level was 32, with a normal range of 83—199. Of course, he was also put on Pregestimil
          
    after just two weeks of breast feeding
         • had really bad broken down skin on his bottom (those of you with liver-disease kids in diapers
           should know what I mean)

  6. XXXX was diagnosed around 1 ½ months, liver biopsy just prior to two months, evaluated for transplant at 2 ½ months, and listed just prior to three months. I know a major factor is the liver biopsy. Obviously, XXXX’s was bad enough to list him. . . . . He had a lot of fibrosis, and portal to portal track, bridging fibrosis. During his tranplant (age eight months), when we were called in the waiting room, after they took out his liver, I asked the nurse what his liver looked like and she said it was bad. The subsequent pathology report also showed bridging fibrosis as well as cirrhosis.

  7. The symptoms that XXX showed were:

         • low birth weight
         •
    projectile vomiting
         •
    falling asleep while eating
         •
    not able to eat a lot at one time
         •
    crying a lot
         •
    always wanting to eat
         •
    jaundice
         •
    unsuccessful at nursing

  8. Some of them started right away, with building up to jaundice. The slow eating of small amounts and projectile took many months to out grow (p.s., the only symptoms of the above that XXXX had was unsuccessful nursing, (may not be alpha related), seeming hungry a lot, strong crying after meals.

  9. I had projectile vomiting as an infant and needed an operation for pylorus-stenosis, a narrowing of the sphincter connecting stomach to bowel. A doctor once told me this was not uncommon with A1AD but I’ve not seen it mentioned anywhere.

  10. I also had projectile vomiting as an infant, but nothing was ever done about it.

  11. Haven’t posted in a while, but have been lurking. XXXX is doing very well. 17 months old now, going on terrible two. It makes me feel good when she is acting like a normal toddler. Her early symptoms were:

         • failure to thrive
         • projectile vomiting
         •
    slight jaundice detectable only in the whites of the eyes
         •
    very frequent loose stools.

  12. My daughter XXXXX was jaundiced at seven weeks old. That was her ONLY symptom. Thanks to a very persistent pediatrician, she went through many different tests. Finally, they discovered Alpha 1. She’s SZ. She currently sees a specialist at XXXX Hospital of XXXX County who has had other cases of Alpha 1. So far, XXXX has had no other symptoms or problems although her levels are still up.

  13. I think symptoms in children vary. With our son, he was:

         • lethargic as a newborn
         •
    very jaundice (not yellow but turning brown) due to the biliruben increase
         •
    sluggish digestive system—determined with further testing before diagnosis, but I could tell having
          
    had children before him (but a new parent may not)
         •
    also had a lot of mucus with spit up after feeding.

  14. As I’m sure you have heard, most newborns or infants with such symptoms are diagnosed improperly at first—such as biliary atresea (not sure of spelling, but means born without bile ducts). It is sad to think that a heel test after birth, such as is done for PKU children, could relieve a lot of parent’s stress such as we went through to determine what was wrong with our baby.

  15. Even after diagnosis in a child, there are a lot of things to watch for depending on where a child falls in the Alpha1 progression of this disease.

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Updated May 16, 2005

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