65 yrs m presenting icterus++++, hbsag +ve,renal cyst,no dm,no htn MANAGEMENT plz


Looks like acute hepatitis b. Ask for past jaundice and family history of liver disease. Needs further tests like prothrombin time. HBe antigen. Anti HBe antibody. Igm anti HBc. Endoscopy to look for varices. Agree with dr. Manu. Patient probably needs antiviral tenofovir or entecavir. Lamivudine is rarely used now because of high resistance

Sir when do you treat acute cases? Coagulpopathy or even in patient with >10 bilirubin

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I would really question this radiology report. This person has acute hepatitis. How long has he had jaundice for? Usually in most patient the body will fight against the infection and control it. Management is symptomatic. Control nausea, vomiting, fluid intake. Only indication to give treatment is when patient is when patient has acute liver failure( jaundice + altered mental status+ INR>1.5)

Jaundice since 1 month

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There are two system involved.Acute Hepatitis B and multicystic kidney disease Both may turn chronic. Hepatitis follow up. For renal further investigation ie CBCESR, KFT. Ht monitor. Treatment accordingly.

This is surprising that au antigen is +ve with high serum bilirubin and still liver is normal on usg anyway this is a c/o of hepatitisB hence strat antiviral like heptavir or lamuvir 300mg twice daily with support of iv fluids and other supportive treatment you can add VIMLIV tab or syp for better and faster results check viral load qualitativeand quantitative.so that you can give antiviral for long period

pl look up the dose of lamivudine. it is given 100mg OD for chr hep B, 300mg OD for HIV. if there is latest recommendation, pl let me know.

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No active treatment for renal cyst right now However urine analysis and plain Ct abdomen required. Gastroenterologist opinion for acute hepatitis

I believe your patient present acute failure liver, the cyst in kidney can offer diagnosis different at actual problem. may be need to begin research about other viral hepatitis, HIV, cytomegalovirus, Epstein Barr, autoimmune hepatitis, pharmacological reaction with liver failure, leptospirosis, fasciola... I'm think necessary other basical laboratory studies for better orientation.

Hbsag quantitative tests.if he than lactulose rifagut supplement potassium if low.if active hbsag carrier than antiviral can be started.if anaemic r/o variceal bleed.if ascites present than think of tapping if respiratory embarassment present.pleural effusion can also be there.if deranged coagulogram than correct it.by FFP.family counselling for liver transplantation.

Do hbeag if positive start antiviral do fibroscan looks infective hepatitis with hepatitis b udiliv 300 bd

Tab Heptral bd Tab udiliv 300 od Cap Raciper-D od syrup Betonin 2 tsp bd High carbohydrates diet

Repeat LFT after 5 days from some other reliable lab

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