We really don't have any answers yet, and did not expect too this soon, but we have a theory or two.
In February Sam started receiving Iron Dextran Infusions once a week to help with his severe Anemia. In March Sam started a different medication for his reflux.
Since that time his Anemia has improved as has his reflux. Unfortunately we can not rule out either one of these as the cause for the huge spike in his liver enzyme levels.
The plan is to stop the Iron Dextran infusions for the next month. If he shows improvement in his next round of labs then we will know the culprit was the Iron. If he shows no improvement or is worse then we will stop the Protonix and wait another month. So in a nutshell we could be waiting at least a month or two before we have an answer. If there is no improvement in two months then we are back to square one and will start with other theories which we discuss in more detail with the team in Boston during our visit on May 14th.