Please Help - Critical Liver Condition 
Author Message
 Please Help - Critical Liver Condition

Dear Madams/Sirs,

I have a cousin that is in ICU in critical condition. If anyone can
shed any light, or provide a link to other ways to obtain information,
we will be very grateful. Here follows the doctor's report:

This is a 44 yo patient with a history of jaundice since childhood. He
is being followed at the University of Sao Paulo Liver and Transplant
Unit since 04/99. One year from now jaundice increased progressively
and developed ascites and leg edema. On 06/14 was admitted at the ICU
with hepatic encephalopaty secondary to SBP, renal failure,
dehydration and constipation. Treatment with lactulose, ampicilin,
cefotaxime and hydration with colloids was initiated with improvement
of the conscious level in 36 hs. Renal function did not improve and he
developed uremic encephalopaty and pulmonary edema, hemodyalisis was
started on 06/17. On the same day he became hypotensive and a
Swan-Ganz catheter was inserted, an orotracheal canula was placed and
mechanical ventilation started, and sedation with fentanyl and
midazolam was started. Dopamine was initiated and was switched to
Norepi and Dobutamine because of septic shock (CI 5.8, iSVR 586,
Pwedge 16, MAP 65). Antibiotic regimen was changed to Imipenem, Vanco
and Anfo B, because of fever, leucocytosis and deterioration of the
clinical status. The patient did not improve and Liver function,
Pulmonary function, Renal function, Coagulation and Hemodynamics
deteriorated.

List of exams:
--------------

Hepatitis A, B and C sorology - negative
CMV IgM and IgG negative
Anti mitochondia, smooth muscle, parietal cell and LKM negative
[alfa]1 antitripsin and ceruloplasmin being processed

      ---------------------------------------------------------
      | 04/30 | 06/07 | 06/14 | 06/16 | 06/18 | 06/19 | 06/20 |
---------------------------------------------------------------
AST   |   456 |       | ------|   181 |   141 |   173 |   216 |
---------------------------------------------------------------
ALT   |   202 | ------| ------|   132 |    96 |   112 |   113 |
---------------------------------------------------------------
BbT   |  13.8 | ------| ------|  39.7 |  36.9 |    47 |  41.2 |
---------------------------------------------------------------
BbD   |   9.2 | ------| ------|  36.9 |  35.5 |  40.5 |  37.6 |
---------------------------------------------------------------
LDH   | ------| ------| ------|   241 | ------|   166 | ------|
---------------------------------------------------------------
AF    |    92 | ------| ------|   646 |   332 |   394 |   463 |
---------------------------------------------------------------
GGT   | ------| ------| ------|    79 |    50 |    67 |    61 |
---------------------------------------------------------------
INR   |   1.7 |   2.2 |   2.5 |   3.0 |   3.5 |   3.8 |   7.2 |
---------------------------------------------------------------
UREA  |    36 | ------|   215 |   221 |   145 |   123 |   149 |
---------------------------------------------------------------
CREAT |   0.8 | ------|   4.6 |   7.0 |   5.7 |   5.4 |   7.1 |
---------------------------------------------------------------
LEUCO |  4,870| 10,700| 23,500| 11,300| 11,100| 13,800| 19,700|
---------------------------------------------------------------
PLAT  |   175 |   212 |   171 |   111 |    74 |    52 |    44 |
---------------------------------------------------------------
LACTA | ------| ------| ------| ------| ------|    58 |    68 |
---------------------------------------------------------------

Biopsy: hepatic B[alfa] - disease in acute phase: Sederose IV

Biopsia:
B[alfa] hepatica: doenca hepatobiliar em fase aguda - Sederose IV



Sat, 08 Dec 2001 03:00:00 GMT
 Please Help - Critical Liver Condition
take some herbs. arti{*filter*}juice and milk thistle.

Sent via Deja.com http://www.***.com/
Share what you know. Learn what you don't.



Sat, 08 Dec 2001 03:00:00 GMT
 Please Help - Critical Liver Condition
Just a thought from newbie.
Ask them to check out Wandering Spleen / Liver
and / or porphyria or damage due to immunizations / anesthesia
<http://anesthesiology.miningco.com/library/weekly/aa030998.htm?rf=ma&...>

diseases mistaken for schizophrenia / encephaphy
<http://www.schizophrenia.com/family/misdiag.html>
<http://neuro-www.mgh.harvard.edu/forum/PorphyriaMenu.html>
<http://neuro-www.mgh.harvard.edu/forum/PorphyriaF/1.9.9911.16AMTestin...>

What is status of pancreas and spleen?
Also consider Chemical Poisoning (carbon monoxide, methane, mercaptans,
benzene, varnishes, pesticides/herbicides)...what is patient's work and
home environment?

Mayo Clinic???/?

Best wishes

J

Quote:

> Dear Madams/Sirs,

> I have a cousin that is in ICU in critical condition. If anyone can
> shed any light, or provide a link to other ways to obtain information,
> we will be very grateful. Here follows the doctor's report:

> This is a 44 yo patient with a history of jaundice since childhood. He
> is being followed at the University of Sao Paulo Liver and Transplant
> Unit since 04/99. One year from now jaundice increased progressively
> and developed ascites and leg edema. On 06/14 was admitted at the ICU
> with hepatic encephalopaty secondary to SBP, renal failure,
> dehydration and constipation. Treatment with lactulose, ampicilin,
> cefotaxime and hydration with colloids was initiated with improvement
> of the conscious level in 36 hs. Renal function did not improve and he
> developed uremic encephalopaty and pulmonary edema, hemodyalisis was
> started on 06/17. On the same day he became hypotensive and a
> Swan-Ganz catheter was inserted, an orotracheal canula was placed and
> mechanical ventilation started, and sedation with fentanyl and
> midazolam was started. Dopamine was initiated and was switched to
> Norepi and Dobutamine because of septic shock (CI 5.8, iSVR 586,
> Pwedge 16, MAP 65). Antibiotic regimen was changed to Imipenem, Vanco
> and Anfo B, because of fever, leucocytosis and deterioration of the
> clinical status. The patient did not improve and Liver function,
> Pulmonary function, Renal function, Coagulation and Hemodynamics
> deteriorated.

> List of exams:
> --------------

> Hepatitis A, B and C sorology - negative
> CMV IgM and IgG negative
> Anti mitochondia, smooth muscle, parietal cell and LKM negative
> [alfa]1 antitripsin and ceruloplasmin being processed

>       ---------------------------------------------------------
>       | 04/30 | 06/07 | 06/14 | 06/16 | 06/18 | 06/19 | 06/20 |
> ---------------------------------------------------------------
> AST   |   456 |       | ------|   181 |   141 |   173 |   216 |
> ---------------------------------------------------------------
> ALT   |   202 | ------| ------|   132 |    96 |   112 |   113 |
> ---------------------------------------------------------------
> BbT   |  13.8 | ------| ------|  39.7 |  36.9 |    47 |  41.2 |
> ---------------------------------------------------------------
> BbD   |   9.2 | ------| ------|  36.9 |  35.5 |  40.5 |  37.6 |
> ---------------------------------------------------------------
> LDH   | ------| ------| ------|   241 | ------|   166 | ------|
> ---------------------------------------------------------------
> AF    |    92 | ------| ------|   646 |   332 |   394 |   463 |
> ---------------------------------------------------------------
> GGT   | ------| ------| ------|    79 |    50 |    67 |    61 |
> ---------------------------------------------------------------
> INR   |   1.7 |   2.2 |   2.5 |   3.0 |   3.5 |   3.8 |   7.2 |
> ---------------------------------------------------------------
> UREA  |    36 | ------|   215 |   221 |   145 |   123 |   149 |
> ---------------------------------------------------------------
> CREAT |   0.8 | ------|   4.6 |   7.0 |   5.7 |   5.4 |   7.1 |
> ---------------------------------------------------------------
> LEUCO |  4,870| 10,700| 23,500| 11,300| 11,100| 13,800| 19,700|
> ---------------------------------------------------------------
> PLAT  |   175 |   212 |   171 |   111 |    74 |    52 |    44 |
> ---------------------------------------------------------------
> LACTA | ------| ------| ------| ------| ------|    58 |    68 |
> ---------------------------------------------------------------

> Biopsy: hepatic B[alfa] - disease in acute phase: Sederose IV

> Biopsia:
> B[alfa] hepatica: doenca hepatobiliar em fase aguda - Sederose IV

--
"The man that hath no music in himself,
  Nor is not mov'd with concord of sweet sounds,
  Is fit for treasons, stratagems, and spoils;
  The motions of his spirit are dull as night,
  And his affections dark as Erebus:
  Let no such man be trusted. Mark the music."

  - William Shakespeare, The Merchant of Venice (Act V, Scene i)



Mon, 10 Dec 2001 03:00:00 GMT
 Please Help - Critical Liver Condition

Quote:
> Dear Madams/Sirs,

> I have a cousin that is in ICU in critical condition. If anyone can
> shed any light, or provide a link to other ways to obtain information,
> we will be very grateful. Here follows the doctor's report:

Thanks to all, but Antonio Eduardo died last Tuesday. There is no need
to comment anymore.

Alberto Gomide



Mon, 10 Dec 2001 03:00:00 GMT
 
 [ 4 post ] 

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