A young man with acute generalised jaundice and intermittent epigastric pain

Deutsche medizinische Wochenschrift
B Walz, B Riecken

Abstract

A 24-year-old Iraqi was admitted to our hospital with acute generalised jaundice and intermittent epigastric pain. His family doctor suspected a viral hepatitis. Two days prior admission the patient had consumed large quantities of alcohol and had subsequently taken analgetic dosages of paracetamol and acetylsalicylic acid. Besides an otherwise inconspicuous physical examination the laboratory results revealed a distinct hemolysis with macrocytic, hyperchromic anaemia and negative Coombs-test. Indirect bilirubin was initially 25.2 mg/dl, LDH 2367 U/l and reticulocytes 4.4 %; haptoglobin and transferrine levels were correspondingly low. A hemoglobinopathies was excluded by hemoglobin-electrophoresis and a blood-smear. DIAGNOSIS, TREATMENT AND FURTHER COURSE: A glucose-6-phosphate dehydrogenase deficiency (G6PDD) was suspected and subsequently confirmed within three days. Acetylsalicylic acid, the most probable trigger, and other possible triggers like ciprofloxacin, metamizole, and cotrimoxazole were avoided; the jaundice faded rapidly, and the laboratory-parameters almost normalized. In patients with acute jaundice, abdominal pain, and signs of hemolysis collection of accurate anamnestic information is essential. In case of a y...Continue Reading

Citations

Jul 31, 2009·Annals of Clinical Microbiology and Antimicrobials·Günther SlesakPaul N Newton
Aug 13, 2010·Drug Safety : an International Journal of Medical Toxicology and Drug Experience·Ilan YoungsterMatitiahu Berkovitch
Apr 2, 2014·European Journal of Haematology·Simon PhillpottsSambit Sen

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