Case Report
Grave’s Disease with Severe Hepatic Dysfunction: A Diagnostic and Therapeutic Challenge
Table 3
Investigations of the patient at readmission.
| TSH (mIU/L) | <0.001 | Urine R/E | 2–6 pus cells/HPF, RBC-present | FT4 (ng/dL) (0.89–1.7) | 10.2 ng/dL | Urine culture | No growth on two occasions | T3 (nmol/L) (1.25–2.74) | >9.24 nmol/L | Blood culture | No growth | TC (total count) (per cm) | 16250 | X-ray chest PA view | Normal | DLC (differential leucocytic count) | Neutrophilia | 2D echo | Normal | Erythrocyte sedimentation rate (ESR) | 106 mm after the end of 1st hour | USG abdomen | Mild hepatomegaly, no evidence of chronic hepatitis, no evidence of cholangitis | C reactive protein (CRP) (0–10 mg/dL) | 58 | S. bilirubin (Total) (mg/dL) | 30.2 | Conjugated (mg/dL) | 26.3 | Malaria parasite | Negative | Unconjugated (mg/dL) | 4.23 | Widal test | Negative | AST (U/L) | 96 | PBS study | No abnormal or immature cells seen | ALT (U/L) | 61 | HBS Ag, anti-HCV Hepatitis A Hepatitis E-IGM | Negative | Serum alkaline phosphatase (U/L) | 151 | ANA | 42 IU (weakly positive) | S. albumin (g/dL) | 2.3 | S. ammonia | Normal | Prothrombin time (sec) | 15.3 | | | S. Na+ (mmol/L) | 138 | | | S. K+ (mmol/L) | 3.1 | | |
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