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    A 28-year-old pregnant woman at 8 months gestation presented with fever, jaundice, and altered sensorium for 3 days. On examination, she was found to have pallor, jaundice, and drowsiness. Her lab investigations showed features of acute liver failure like low hemoglobin and platelets, elevated bilirubin and prothrombin time. She tested positive for IgM antibodies to hepatitis A and E viruses, suggesting acute viral hepatitis as the cause of her liver failure.

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    Case Presentation

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    aqsa_munir
    26 views13 pages
    A 28-year-old pregnant woman at 8 months gestation presented with fever, jaundice, and altered sensorium for 3 days. On examination, she was found to have pallor, jaundice, and drowsiness. Her lab investigations showed features of acute liver failure like low hemoglobin and platelets, elevated bilirubin and prothrombin time. She tested positive for IgM antibodies to hepatitis A and E viruses, suggesting acute viral hepatitis as the cause of her liver failure.

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    A 28-year-old pregnant woman at 8 months gestation presented with fever, jaundice, and altered sensorium for 3 days. On examination, she was found to have pallor, jaundice, and drowsiness. Her lab investigations showed features of acute liver failure like low hemoglobin and platelets, elevated bilirubin and prothrombin time. She tested positive for IgM antibodies to hepatitis A and E viruses, suggesting acute viral hepatitis as the cause of her liver failure.

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    26 views13 pages

    Case Presentation

    Uploaded by

    aqsa_munir
    A 28-year-old pregnant woman at 8 months gestation presented with fever, jaundice, and altered sensorium for 3 days. On examination, she was found to have pallor, jaundice, and drowsiness. Her lab investigations showed features of acute liver failure like low hemoglobin and platelets, elevated bilirubin and prothrombin time. She tested positive for IgM antibodies to hepatitis A and E viruses, suggesting acute viral hepatitis as the cause of her liver failure.

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    of 13

    CASE PRESENTATION

    DR UZMA RANA
    PGR G1

    CASE SUMMARY
    UB , 28yr, PG at 8 months of
    Gestation al Amenorrhea(received
    IUD) , with Acute Fulminant Hepatic
    Failure in DIC.

    HISTORY
    BIODATA:
    UB, 28YR, UNEDUCATED, HOUSEWIFE
    RESIDENT OF SHAH PUR.
    PRESENTING COMPLAINTS:
    FEVER & JAUNDICE ------ 3DAYS
    ALTERED SENSORIUM----- 1DAY

    HISTORY
    PT WAS IN USUAL STATE OF HEALTH 3DAYS
    AGO , WHEN SHE DEVELOPED FEVER WITH
    YELLOW DISCOLORATION OF BODY,
    FOLLOWED BY TREATMENT FROM LOCAL
    DOCTOR , FOLLOWED BY ALTERATION IN
    SENSORIUM FOR 1DAY. PT WAS BROUGHT
    TO L/R-1 JHL ON 7-07-2014 AT 1AM .
    NO H/O HTN, DM, HEPATITUS
    NO H/O ANY SURGERY
    NO PREVIOU HOSPITALIZATION

    HISTORY
    NO H/O ANTENATAL VISITS TO ANY
    HOSPITAL/CLINIC
    NO H/O JAUNDICE IN OTHER FAMILY
    MEMBERS
    POOR SOCIO-ECONOMIC STATUS

    EXAMINATION
    GPE:

    YOUNG LADY OF AVERAGE BUILT AND


    HEIGHT LYING DROWSY IN BED
    GCS 15/15
    PALLOR +
    JAUNDICE +++
    CYANOSIS VE
    PEDAL OEDEMA +

    EXAMINATION
    GPE:
    A YOUNG LADY OF
    AVERAGE BUILT
    &HEIGHT,DROWSY
    LYING IN BED
    PULSE104/M
    BP110/70MM/HG
    R/R20/M
    TEMP98.6F

    PALLOR +
    JAUNDICE +++
    CYANOSIS VE
    OEDEMA VE
    GOITRE VE
    JVP NOT RAISED

    EXAMINATION

    P/A EXAM :
    SOFT
    SFH--TERM
    L/C
    LIQOUR ADEQUATE
    FHS ABSENT
    EFW2.8KG
    P/P4/5PALPABLE

    P/V EXAM:
    OS CLOSED
    CX FULL LENGTH
    FIRM, POSTERIOR
    VX HIGH
    PELVIS ADEQUATE

    EXAMINATION
    SYSTEMIC REVIEW:
    S1+S2+0
    NORMAL VESICULAR BREATHING,
    BILATERAL AIR ENTRY NORMAL
    ALTERED SENSORIUM
    OTHER SYSTEM SEEMED TO BE
    UNREMARKABLE.

    INVESTIGATIONS

    07-07-2014(1:00AM) 07-07-2014(4:00PM)
    HB 9GM/DL
    8GM/DL
    TLC 12,000
    PLATELETS 41,000
    1,51,000
    BSR 32MG/DL 82MG/DL
    ANTI-HAV IGM +VE
    ANTI-HEV IGM
    +VE
    ANTI-HCV AB
    --VE
    HBsAG
    --VE
    PT
    >1MIN >1MIN(AFTER TRANSFUSIONS OF 4
    FFPS)
    APTT
    >1MIN >1MIN

    INVESTIGATIONS
    07-07-2014 AT
    1:00AM

    07-07-2014 AT
    4:00PM

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