Resolved question:
Hi there,
I am writing to you to get your expert opinion in regards to my recent lab results, symptoms, and Hx.
Patient details:
Age 24y 10m (9/12/1989)
Caucasian (Australian)
Male
Height: 186cm (6ft).
Weight: 105kg
Build: Muscular/Overweight with fat in abdominal and thigh region.
Blood type: B Negative
Occupation: Paramedic
Family Hx: Father (65yo) Hx of Lupus SLE, which manifests mainly as dermatitis; and, Deep Vein Thrombosis. Mother: (60yo) Hx Obese Osteoporosis, Lymphedema. Uncle (Mother's Twin) Hx Obese, Coronary Heart Disease requiring Triple Bypass surgery.
Patient PMHx: 5 years old patientfeeling of fatigue, low/absent libido, and mood disorder (2012 Dx Depression/Anxiety); ?Gynecomastia (however, normal testosterone levels); ?Gout (2 years), pain in right Hallux which comes and goes, however, Uric acid levels normal; Anal Fissure 1 year ago, progressed to internal haemorrhoids (unconfirmed) with occasional pain in bowel.
3 years old patientago a Live Function Test result came back elevated, although, I cannot remember which test.
Current complaint: Right Upper Quadrant pain described as 'dull', not constant, comes and goes every couple of days. Sometimes I get pain in different quadrants (LUP & LLQ).
Recent test results came back: Moderate positive for Cytoplasmic Antibodies ("Anti-Smooth Muscle and Anti-Mitochondrial, if clinical indicated"). ****Please see test results attached****
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My main query is:
- Do my symptoms and lab results suggest a Dx of Primary Biliary Cirrhosis?
- What is your provisional Differential Diagnosis?
- If yes, how urgently should I seek medical help? (I am currently working on a remote mine site in the desert of Western Australia). Am I able to wait for 10 days before I see my general practitioner (GP) again?
- When I see my GP, what tests should I have done? (i.e. LFT, CBC, Hormones, Liver Biopsy etc..)
- is there any other advise you can give me?
Sincerely yours,
John Trewin
Submitted:
4 Days
Category:
Hepatologist
Hi John Trevin,
Thanks for posting your query at DoctorSpring.com
I am Dr.R.K and I am pleased to assist you.
I went through your lab results.
Now coming to your questions -
1. Your symptoms and lab results are not suggestive of primary biliary cirrhosis
2. You are having only vague nonspecific symptoms. Some of the causes of pain in the right upper quadrant are cholecystitis, hepatitis, peptic ulcer and pancreatitis.
3. You can wait for 10 days before you can consult your GP again.
4. You can get the following tests done - Ultrasound scan of the abdomen, liver function test and Upper GI endoscopy.
I hope that answers your question.
Let me know if I can assist you further.
Regards,
Dr.R.K.