Case 3
A 50 years old farmer (exposure and treatment of biharzisis), on
treatment of hepatic decompensation that occurred as a complication of
operative intervention (subtotal thyroidectomy) as he was informed by
his treating personnel, so he was on :
Silymarin 140 mg 1x2
spironolactone 100 mg 1x2
Bumetanide 1mg 1x1
He came complaining of asthenia, early fatigue, generalized heaviness
especially in his lower limbs, muscle cramps, and increased abdominal
size.
-Summary of examination:
- B.P 130/80
- pulse 70 b/m
- Pallor, bilateral lower limbs edema and hepato-splenomegaly.
-Investigations:
- disturbed liver functions tests (↑ transaminases )
- (+ ve) hepatitis C virus markers, (+ve) bilharzial antibodies
- megaloblastic anemia
-U/S: hepatomegaly, periportal fibrosis, splenomegaly and ascites.
What is the problem? and how can you deal with ?
Answer
