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 BOF 120

 

   

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BOF: 120

A 20 year old male presents with a history of abdominal discomfort and feeling generally unwell. He also complains of passing dark urine .He says there have been similar episodes in the past. He has no significant past medical illness and is not on any medication. He tells you that one of his cousins has a condition affecting the nerves and that the cousin has something like Parkinsonís disease. He is an university student and does admit to alcoholic binges.

On examination you note that he looks unwell is jaundiced. There are no signs of chronic hepatocellular failure or portal hypertension. His liver is enlarged 3 fingerbreadths and is tender

Investigations:

Hb 9.6 g/dL

MCV 104

WBC 6.3 x109 /L

Platelets 200 x109/L

ALT 450 U/L

Alkaline phosphatase 250 U/L

Bilirubin 95 Ķmol/L

In this patient which one of the following is the most likely diagnosis?

a)   Wilsonís  disease

b)   Alcoholic hepatitis

c)    Zieveís syndrome

d)   Paroxysmal nocturnal haemoglobinuria

e)   Acute hepatitis C

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