12 y/o/m Wt 37kg Vital WNL Appetite Normal Desire Sweets Icterus +++ve HCV- Negative HbsAg- Negative Vaccination not done Brought by his grandmother...she complains that child sleeps with cooling air overnight in every winter season without fan he can't sleep, severe itching all over the body, some pustules present on b/l palm... She told, when he was 8 months old he had severe diarrhea and after that he had to bear 1 unit blood transfusion and also told 7yrs of age he had severe jaundice S.Bili level 8.3 % continue 2 years infected by jaundice...and now again increasing S.bilirubin level... 5 days back S.Bili - 3.8 SGOT- 51 SGPT- 63 And Today S.Bili - 8.35 SGOT-53 SGPT-65 Continue on Rx Tab Augmentin 625 1BD Tab Hepamerz 1BD Cap Nupenta D 1BD Tab Cetgel 1HS Syp Livosyp DS 2TSP TDS Inj Keplin Stat Plz suggest further investigation and management thanks...
definitely icterus is here no doubt . hepatitis a should b ruled out first by doing IgM HAV . plus prothrombin time n inr . if there long history plus pruritis . obstructive causes of jaundice should b considered do usg whole abdomen first . other good d/ds are autoimmune hepatitis / wilson disease . liver biopsy should b kept as last resort for diagnostic .
*jaundice with icterus **Hepatitis ( obstructive ) Needs further investigation and evaluation to conclude particularly USG Abdo IgM HAV .... Till reports complied. Continue treatment as you given. Diet control advise.
Thank you for sharing the case, Child seems to have abnormal facies as well. Get a detailed history about other associated symptoms as well. A thorough physical examination..... Get fractionation of the bilirubin into its components .... Rule out causes of direct or indirect hyperbilirubinemia , such as enzyme deficiencies , ineffective erythropoiesis , hemolytic anaemia ....Treat accordingly.
12 YEARS MAKE CHILD HISTORY OF SEVERE JAUNDICE AT 7BYEARS OF AGE AND AT 8 MONTHS HAD SEVERE DIARRHEA RECEIVED BLOOD TEANSFUSION CAN ONLY SLEEP WITHOUT FAN EVEN IN WINTER HAS PASTURES ON BOTH PALMS IMPRESSION BOY HAS DIFFERENT B M R NEEDS ULTRASOUND ABDOMEN FOR ANY ORGANOMEGALY REGULAR MONITERING OF SERUM BILIRUBIN L F T CONSULTATION OF PAEDIATRICIAN
Find out cause Let me know congugated bilirubin Usg liver Elastography of liver Hepatitis Cirrhosis of liver Obstructive jaundice
12 YEARS OLD CHILD HAS PAST HO SEVERE DIARHEA RECEIVED ONE PINT OF BLOID RECURENT JAUNDICE SHOULD BE INVESTEGATED FOR LIVER PATHOLOGY ONE COULD DO LIVER BIOPSY ULTRASIUND ABDOMEN
SUGGESTIVE. OF PERSISTENT JAUNDICE.. NEEDS LIVER. FUNCTIONS ANALYSIS AND C T. SCAN
Jaundice with. Itching. Usg study abdomen. Hepatitis viral study. Fibro test. Hpe study.
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