Case study # 2 The following laboratory results are obtained from a 19 year old
ID: 270709 • Letter: C
Question
Case study # 2 The following laboratory results are obtained from a 19 year old college student who consulted the Student Health Service because of fatigue and lack of appetite. She adds that recently she has noticed that her sclera appears somewhat yellowish and that her urine has become dark. Serum bilirubin normal Urine bilirubin elevated ALT elevated AST elevated anti-HAV IgM anti-HAV IgG HBsAg positive negative negative negative negative antiHBs anti-HCV Questions 1. What is the likely diagnosis? 2. What additional factors in the patient's history should be sought? 3. What is the prognosis?Explanation / Answer
Answer 1. The patient is suffering from liver disease due to recent Hepatitis A infection. This can be deduced by observing that anti-HAV IgM antibody test is posiive and urine bilirubin, ALT an AST are elevated.
Answer 2. As HAV infection is easily spread in crowded areas and being a college student she lives in crowded environment and has interactions with several people, so following points should be noted and the patient should be asked if she has
Answer 3. Hepatitis A infection usually goes away on its own within six months. Although it is advisable to take bed rest, drink lots of fluids, eat a healthy diet and avoid alcohol. Medicines are not usually given in HAV infection. Although Itchy skin caused by HAV can be treated with non-prescription anti-itch medicine.