Diagnose This #21

Hey guys, and welcome back to Diagnose This! Hope your week was a fruitful and thoroughly enjoyable one 🙂

Differentials for this guy are pretty much the Hepatitis viruses, as his travel overseas, lack of immunisation, and potentially unsafe sexual encounters are all major risk factors. Any others that you may think of? We had quite a number sent in, from hepatocellular carcinoma to TB to NASH. But yeah, fingers crossed you got that hepatitis picture.

The investigations that should’ve been ordered include an FBE, U & E, PT/INR, LFTs, and a hepatitis viral panel. Other bonus tests include a urinalysis, liver ultrasound, and various markers for inflammation.

The FBE shows a microcytic anaemia with thrombocytopaenia. The LFTs show elevated ALT/AST. The PT/INR is normal. Significant viral panel results shown below:

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Now, the final part of the puzzle: What do you make of these results? What sort of management plan would you recommend for this gentleman? How can this type of infection be prevented for future patients of yours?

Find out next week on Diagnose This!

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