2022-02-18 06:21:45
Case study :
A 26 -year-old man. He had jaundiced. The laboratory results as the following :
●GOT: 720 U/L ( up to 40)
●GPT: 980 U/L ( up to 40)
●T- bilirubin: 21.5 mg/dl ( up to 1.0 ).
●D.bilirubin: 15.9 mg/dl ( up to 0.2).
●ALP: 590 U/L ( 60 - 170)
1. Comments on these results?
Comment:
• ALT > 10 X ULN ( > 400 U/L).
• ALP >3 X ULN ( > 510 U/L)
•Total bilirubin very high
2. What the possible causes?
1. Mxd hepatitis( acute hepatitis with Biliary obstruction ).
2. Acute hepatitis with Vitamin D deficiency
3. Acute hepatitis with Bone disease
4. Acute hepatitis with renal failure
4. What the test required for differentiate diagnosis?
●GGT: 50 ( 5–35U/L)
4. Comment on this result?
Comment:
High increased ALT by > 10-fold (> 400 U/L) and ALP by
ALP >3-fold ( > 510 U/L) with mild increased of GGT exclude the cause of mxd hepatitis.
5. What the possible causes?
1. Acute hepatitis with Vitamin D deficiency
2. Acute hepatitis with Bone disease
3. Acute hepatitis with renal failure
6. What the tests required for differentiate diagnosis?
●Creatinine 1.2 ( 1.3 mg/dl
●Urea 30. ( 20 - 50 mg/dl)
7. Comments on these results?
Normal of Creatinine and Urea exclude the renal failure as the cause and suggested the causes of Vitamin D deficiency or bone disease.
What the other tests are required?
●Ca+ 0.8 mmolL (2.20 – 2.60).
●P- 0.60. mmol/L ( 0.8–1.4).
●Vitamin D 3 12 ng/mL (20 - 57 ng/mL).
4. Comment on these results?
Comment:
•Low of phosphate, calcium and vitamin D confirm osteomalacia caused by Vitamin D deficiency (Dietary osteomalacia) and exclude bone diseases.
5. What the diagnosis?
Acute hepatitis with osteomalacia caused by Vitamin D deficiency (Dietary osteomalacia).
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280 viewsD.Haidar Al-Mamari, 03:21