Case 22
Perhaps
the most awesome thing in her problem was that the results of the pooled
investigations revealed no identifiable cause for her bothersome
jaundice which persisted for moths without remission.
She is 55 year-old, was very well
before this event, when she attended us her delight was great because we
have proved that her problem is post-hepatitis (A) cholestasis,
seemingly that this diagnosis was not in their minds because of its
simplicity, the cornerstone of her management was the assurance that
everything will be well, and actually within a short time she totally
improved either clinically and laboratory.
She has continued in a good general
condition up to 2 months when she developed right facial palsy for which
she took some medications and have already improved.
Two weeks ago she started to suffer
from fatigue, fever, dyspepsia, followed by jaundice which have
escalated rapidly, total bilirubin 35 mg/dl, direct 24 mg/dl, indirect
11 mg/dl, also there are increased transaminases>500 U/L.
What is the management?
