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Can I pick your momma medical brain?


Dianne-TX
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DS16 went in for pre-op visit and routine lab work showed elevated bilirubin of 2.6.  We were called back in the do repeated lab work and a complete abdominal ultrasound.  Second lab showed bilirubin of 2.5 (1-2 weeks in between labs).  Dr. sent message through our online chart and said U/S didn't showed kidney abnormalities, but an abnormality in the kidney.  I think I get what she means, but that's still confusing.  She has referred us to gastro.  Just wanting to see what you may know about this type of medical issue.  My own research turned up Gilbert's Syndrome because he has no other obvious symptoms and has had a slight yellowing to the whites of his eyes before, but not often.  But, now that the U/S showed something with his kidneys, I don't know.  I have to wait until Monday to talk to dr. because of holiday.  Happy Thanksgiving!

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DS23 has Gilbert's.  His shows up the most when he is stressed.  The whites of his eyes yellow and he gets a specific body odor that apparently only I can smell ( I am guessing a wife will be able to smell it).   He doesn't even notice that his eyes are yellow when he looks ina mirror, lol.  He just pushes the fluid, tries to get some sun shine on his torso and if possible, reduces stress.  (He volunteers, works full time and is a full time student). It goes away in a day or so. He was diagnosed as a teen.

 

The only time I was concerned was when he traveled out of the country.  I was worried that the stress of traveling would make his eyes yellow and people could be concerned that it was something more sinister than it really is.  I made sure he carried documentation of his illness when traveling. 

 

 

I don't know if it is related or not, but ds had jaundice/ high bilirubin as an infant.  He bilirubin was a 22 but we brought it down with sun and fluids then too. 

Edited by Tap
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The right kidney measures 12.6 and left kidney 12.3 cm in length. A 2.1 cm isoechoic structure within the mid to upper pole of the left kidney demonstrates indeterminate characteristics and requires further investigation. The kidneys otherwise 

demonstrate a normal sonographic appearance.  

 

Here's the exact wording on the U/S report regarding his kidney.  Any thoughts?  He's completely asymptomatic.  Even the slight yellowing of his eyes was years ago, probably 4-5 years ago.  That's it.

 

 

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So, the liver was normal but a kidney has a mass? Further investigation means an mri maybe, or a nephrologist consult, possibly a biopsy? And lots of things show up on studies which turn out to be nothing.

 

What is the surgery for? Did they do specialty labs to check for genetic or other causes of elevated bilirubin (unlikely if you’re referred to gastro as they’ll order their own things).

 

Elevated bili can be due to high breakdown of blood cells, poor metabolism by the liver, or high load/inability for the kidneys/stool/skin to help eliminate and metabolize. Bilirubin is a complex molecular product. Some people have chronic elevated bili, and it can be a wide range of things from no big deal to others.

 

My guess is the pediatrician will start ordering more tests or send you to a nephrologist.

 

I recommend seeing pediatric specialists if possible, all at your closest children’s hospital. Some cities may only have one ped nephrologist, so you may not have options.

 

(Hugs) while you’re waiting. The unknown can be worrisome.

 

Btw, most people with jaundice (yellowing of skin/eyes), need their bili levels at a certain level before it’s visible.

Edited by displace
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Thank you.  He is having cornea transplant surgery after an eye injury this summer.  They ordered a pre-op visit and lab work before surgery and all this came up from that visit.  He's asymptomatic with nothing to be concerned about to date.  It's surprising and confusing that all this has come about.  I'm hoping and praying that it's nothing.  We are near Houston, so the dr. is sending his records to Texas Children's to review and let us know if they want to see us or not.  Thanks again for your response and details.

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I hope you heard some follow up today or yesterday. Houston is big enough there should be enough specialists. Hopefully he only has some “minor anomaly†that just causes an elevated bili with no consequences.

 

Other questions the GI will ask is color of urine (which will be tested for bili too, probably), and stool color, which can be white if bili isn’t excreted properly. The kidney is a conundrum and hopefully just another anomaly.

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