19 yr old male ,driver , complaints of yellowish discoloration of sclera , palms ,soles for 2 mnths .no H/o abdominal pain , loss of appetite ,wt loss ,discolourationof urine &stool , diarrhoea,offers no other complaints O/E .Abdomen non tender, Hepatomegaly (+), splenomegaly (+) .I have attached d investigation report .Give Ur valuable suggestions .

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Jaundiceis there so investigate for CBC LFT hbsag and HCV

Do HIV..heptosplenomegaly..Serum ceruloplasmin levels low..Do 24 hour urine copper excretion..Do hcv RNA..Other blood reports...

Obstructive jaundice.

Is there hemetemesis or melena???if + do upper gi endoscopy H/o alchoholism or not?? Do usg abdo pelvis with portal venous Doppler.

Doesn't consume alcohol .No such complaints sir
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Obstructive jaundice

Check HBSAG

Was found to be non reactive
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Adv cbc ldh PBS anti hcv anti HEV anti HAV if all negative anti sma anti lkm antibodies...cholestasis due to cholelithiasis is also possibility but detail finding of gall Stone is not available

May be a case of obstructive jaundice,do LFT & USG whole Abdomen

LFT reports are attached.usg revealed Hepatomegaly
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Hepatosplenomegaly with cholelithiasis. Consider hemolytic anemia. What about cbc and peripheral smear?

CBC yet to be done , PS showed normochromic normocytic picture
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What's SGPT,SGOT ,S. Bilurubin level, Australia Antigen tests report ,only then can be disscussed

All those test report av been posted
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