Gem,
An ALT of 64 is not extremely elevated. Were the rest of your liver enzymes okay?
ALT (SGPT) can mean there is a problem with your liver-possibly autoimmune since the other test was positive (ANA). But, ALT can be elevated for quite a few reasons since it is found in muscle tissue, pancreas and kidneys (but mainly liver). For example, if you over exerted your muscles your ALT would be elevated. It would probably need to be checked again to see if there is a trend.
Now for the drug aspect-your antibiotic Cefuroxime or Zyrtec actually could cause your liver enzyme to be elevated. This is not common but would be possibility.
Also, Norvasc,Zyrtec, Estrasorb, Cefuroxime all have a small chance (like a vast number of drugs) of causing hepatitis.
A rheumatologist will probably be able to shed some light on the problem. Have you tried calling to see if they would call you if they have a cancellation?
I know that is nothing definitive, but hope it helps-
Pharmercoon
(registered pharmacist)
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