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easy bruising and recurrent admissions for upper gastrointestinal bleeds


easy bruising and recurrent admissions for upper gastrointestinal bleeds


حالة سريرية

الوصف الكامل Background
A 40 year old man presented to his local hospital with a long history of easy bruising and recurrent admissions for upper gastrointestinal bleeds. On this admission, he had had a further GI bleed.
الفحص السريري Clinical Exam
On examination, it was noted that he had an enlarged tongue. He had easy bruising. In addition he had marked hepatosplenomegaly with ascites
الاستقصاءات Investigations
. A number of investigations were performed. Full blood count: Hb 9.0, WCC 14.0, Platelets 400. Clotting (PT and PTTK) normal. Gastroscopy performed: this showed evidence of altered blood, no evidence of ulceration. A biopsy was performed at gastroscopy- histology of the biopsy was positive on Congo Red stain.
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Question 1
Based on these findings, what is the diagnosis?
Dr.Syrian's picture
by
طبيب مقيم


amyloidosis

Dr_Ayyad
بعد التخرج

Regardless of the biopsy.....we can role out Cirhosis due to a normal pt and ptt ?1 is that right ?......
sopy's picture
sopy
طالب دراسات عليا


no sopy u cant
u can have cirrhocis with normal PT and PTT
in fact coagulation abnormalities are considered ominous as they point out to an advanced disease

Dr_Ayyad
بعد التخرج


Cirrhosis is a histologic diagnosis.
PT ,albumin and bilirubin are funtional heotaic tests that are commonly altered in advanced chronic liver disease.

ABIM's picture
ABIM
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