Anemia with deranged LFTs - Part 1

Upon seeing his CBC, which he had done at first visit, as MCV and RDW was high, I had made a diagnosis of Vit B12/Folic acid deficiency anemia and infused one ampoule of Optineuron daily, until Iron studies, Vit B12, Stool for R/E, LFT was awaited Chief Complaints A 21 year old male presented to OPD with complaints of weakness, loose motions few days back History On the follow up visit, he told that he had similar episodes of loose motions and his HB has been low since 2016, then 2019 and now in 2021 too Investigations For the sake, as images might not be clear, I am writing all values below - Hb - 7.9 HCT - 23.9 RBC count - 2.04 MCV - 117.2 RDW - 15.1 VIT B12 >2000 Iron studies - S. Iron, TSAT, TIBC - Normal VIT D3 - 45 SGOT - 101 SGPT - 87 S. BILIRUBIN - 2.03 D - 0.41 I - 1.62 Stool for R/E - Normal Asked him to investigate further and get done - USG W/A HBsAg Anti HCV HIV Diagnosis ?Folate deficiency anemia ?Sickle cell anemia ?Hep B ?Hep C Management In the management part, I have started him on - Tab Usibon 150 BD, Syp Sorbilin 2tbsf TDS PPI + Prokinetic Folvite 5mg OD Inj Hepamerz 1 ampoule IV in 1 DNS @80ml/hr per day for 3 days Tab Zinconia 50 OD Please give your valuable advice on this case

(Edited)

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Most likely viral hepatitis D/d ulcerative colitis Hrishprung's disease

Thanx dr Ajeet Pal Singh
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? HEMOLYTIC ANEMIA WITH .. HYPERBILLIRUBINEMIA .. NEED'S CLINICOPATHOLOGICAL EVALUATION WITH EXPERTS.. OPINION..

Tnx &wc Dr Ajeet Pal Singh
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Its haemolytic anaemia which cause deranged LFT'S. Need further evaluation to find out cause

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Celiac disease should be considered in the differentials as well along with all expert suggestions. Hb electrophoresis may be advised.

Haemolytic Anemia Further evaluation is required for diagnosis and treatment

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Hemolytic B12 deficiency

Sir, I already mentioned B12 is more than 2000 @Pk Jain Hrh sir
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Low hemoglobin sickle cell Anemia need clinicopathologic evaluation with experts doctor

Thanks doctor
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Auto immune disorder

NICELY DISCUSSED. IN DETAILS... THANKS. .DR

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