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    Old 06-24-2001, 12:28 PM   #1
    zizo2000
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    Join Date: Jun 2001
    Location: egypt
    Posts: 1
    zizo2000 HB User
    wanna information

    Name: Sherif adel Age : 17.5

    HISTORY:
    AT 24/12/2000 there was an attack of fever 39.5 c , malaise, shevering , nausea ,and abdomenal discomfort
    2 days after he noticed dark urine and malaise {total bilirubin 3.56 -(N.up to 1mg/100 ml)}

    26/12/2000:
    S.G.O.T 189 {N.up to 40 Iu/ml}
    S.G.P.T 182 {N.up to 45 Iu/ml}

    Urine
    1.Dark
    2.Bile pig. ++
    3.Bile salts ++
    4.Urobilinogen ++
    then fever subsides , yellowish skin & itching appears
    Pt. was under complete rest , diet was jelly , sweet juice, honey , jam

    30/12/2000:
    total bilirubin 6.25
    direct bilirubin 4.32
    total anti HAV +ve
    anti HAV - IGM +ve
    HBs AG -ve
    then PT. was severly ill and deep jaundice & increase itching

    6/1/2001 :
    Total Bilirubin 12.9
    Direct bilirubin 6.7
    Alk.Phospatase 31.8 (N. 3-13 K.& K.U./100 ml)
    S.G.P.T. 268 (N. up to 45 I.U./ml)
    abd. ultrasonography -----> within normal

    then the PT. was under the treatment
    1.Silymarine 70 mg t.d.s
    2.Ursodeoxycholic acid 250 mg bid.]
    3.Reducdyne (1. N. acetyl . D.L. homocysteine thiolactone 0.05 gm)tds
    4.vit B. complex t.d.s.
    20/1/2001:
    total bilirubin 3.13
    direct bilirubin 2.06
    S.G.O.T 58
    S.G.P.T 55

    1/2/2001:
    total bilirubin 2.53
    direct bilirubin 1.3
    S.G.O.T 38
    S.G.P.T 42

    15 /2/2001
    total bilirubin 1.4
    direct bilirubin 0.9
    S.G.O.T 35
    S.G.P.T 37
    PT.'s condition was good , itching decreased , diet was allowed but no fat
    29/3/2001
    total bilirubin 1.4
    Alk. phosphatase 9.2
    S.G.O.T 36
    S.G.P.T 38
    effort was allowed and no restriction on any diet , treatment was stopped
    20/5/2001
    total bilirubin 1.4
    Direct bilirubin 0.28
    Alk. PH. 13.8
    S.G.O.T. 36
    S.G.P.T 35
    PT.'s concentration decreased as he was unable to concentrae well and malaise
    then PT. was under the treatment of ursodexoycholic 250 mg cap bid. again
    at 6/6/2001
    PT. felt malaise and tendency to sleep
    at 7/6/2001
    there is fever ,malaise (the same picture as the 1st time 6 monthes ago but to a lesser extend )
    total bilirubin 2.1
    direct bilirubin 0.59
    alk. ph. 12.7
    S.G.O.T 38
    S.G.P.T 43
    10/6/2001
    the PT.was hospitalized in a fever hospital & under the treatment of
    glucose 5% 500 ml , 1 lit./day
    normal saline. 0.9 % , 500ml/day
    reducdyne tab tds
    cefomandal 1gm I.V. /12hours
    adenoplex forte amp. every other day .
    diet ------->fat free diet
    10/6/2001
    there is slight tinge of jaundice
    liver ------> Palpable 2 fingers below the RT. costal margin
    skin ------> yellowish
    sonar ------> mild hepato megalye diffuse ecopattern , no focal lesion no , no intrahepatic biliary delatation with normal common bile duct
    urine -------> clear yellow
    viral markers :
    HAV -VE
    HCV Ab -VE
    HBs Ag -VE
    10/6/2001
    total bilirubin 2.9 mg/100ml
    S.G.P.T 14 (N up to 30)
    S.G.O.T 10 (N up to 30)
    S. alk.ph. 55 (N.UP TO 190)
    S.creatinin 1.1
    Bl. urea 25
    Bl. picture
    RBC's 4.5
    HB's 14.8 g
    WBC's 4.200
    platletes 240.000
    13/6/2001
    total bilirubin 3 mg/100ml
    S.G.P.T 18
    S.G.O.T 12
    S. ALK.PH. 44
    all treatment was stopped on 14/6/2001 after discharge from fever hospital
    -the Pt. then took silymarin 140 mg bid.
    16/6/2001
    total bilirubin 1.7
    direct bilirubin 0.65
    alk.ph. 9.5 N up to 13
    S.G.O.T. 33 N up to 40
    S.G.P.T. 35 N up to 45

    FINALLY I WANT TO KNOW THE REASON OF RISING THE PERCENTAGE OF BILIRUBIN AFTER TREATMENT FROM THE VIRAL HEPATITIS "A"
    AND WHAT IS THE MANGMENT IF POSSIBLE IN SUCH CASE.

    N.B. :
    Before the second attack the pt. adminstrate SUPAVIT CAP.(VIT A, D,B COMPLEX, AND MINERALS) AND ARCALION 200 (200mg. sulbutiamine.)

     
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    Old 06-24-2001, 01:06 PM   #2
    thanbey
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    Join Date: Nov 2000
    Posts: 693
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    Re: wanna information

    Hi there,

    Sounds like you have had a very rough time.

    Glad to see that things are improving for you.

    Given that your results have no reference ranges and that you are in Egypt, I cannot help you with the reason there was a slight elevation after treatment.

    The best I can offer is a guess based on seeing that your results went down again. Most lab tests vary and it is in the trend (in your case downward, even with a little spike) of the results that one may find clues and decide that more intervention may be warranted.

    My impression is that the HepA has reolved and that the liver is normalizing in the aftermath of the infectiuon and the treatment.

    If you are still feeling poorly, do go back to your physician and let him/her know that you are still having difficulty.

    Please be retested for HCV in about six months time as the rates for HCV in Egypt are the highest in the world. Just as a precaution.

    I hope this helps,

    thanbey



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