55/male /labor worker,chronic alchoholic c/o Distention of abdomen Vomiting Nasuea Fever Yallow colour urine Total bilirubin 10.8 Sgpt127 CBC as shown in report. Platelets r too low. What to do? Refuse for admission.

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This is a case of chronic alcoholic hepatitis . Ask him to stop alcohol immediately otherwise he may land in complications and die. Do other viral markers to rule out Hepatitis B and C Order for USG abdomen to rule out CLD, ASH ( Alcoholic steato hepatis) ,ascites, Cirrhosis ,and Hepatocellular carcinoma. Rule out acute cholelithiasis. Rule out acute pancreatitis. Rule out hepaticencephalopathy. Coming to the treatment Advice admission . Advice absolute bed rest. Advice soft bland vegetarian diet with low fats. Advice plenty of fruits. Symptomatic treatment Periodical monitoring of platelets.and bleeding time, clotting time When platelet count is less than 10000 advice platelet transfusion.

It is alcoholic hepatitis. He has fever with thrombocytopenia. Pl exclude dengue fever by ns1 antigen test.pl advise usg abdomen and pelvis. U can prescribe him ta doxy.100mg.1 bid.tab paracetamol. Pan D tab udilv 300mg 1bid.pl follow with daily CBC PT / inr.pl convince for admission. He may bleed severely at any time

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Alcoholic hepatitis , with underlying cirrhosis with portal hypertension ( this will explain hyperbiliribinemia, raised enzymes and thrombocytopenia. ) Need to check PT ,if it is high ,chances of vertical bleeds are high . Hepatic viral profile and Dengue profile needed Needs institutional care .

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Alcoholic Liver Disease with Thrombocytopenia. Hospitalisation is essential to completely work up with the case to reach at final diagnosis & treatment plan.

Chronic Alcoholic hepatitis ask for HbSAg HIV Hepatitis B and c ,USG of whole ABDOMEN may be Chirroshis of liver

Alcoholic Hepatitis

Refer to s Gastroentrrologist

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