Diagnostic Dilemma

Acute liver injury with cardiac involvement

A 5 years old boy presented with generalized edema, 2 episodes of vomiting and respiratory distress. He required ventilatory care and ionotropes in view of ejection fraction of 57 percent. He was detected to have elevated liver enzymes {SGOT = 6210 IU, L, SGPT of 5480 IU, L} with normal bilirubin and ammonia of 186 mg, dl. Initially PT, INR were deranged which gradually normalised. He had history of jaundice a year ago. He also had acidosis and low serum ceruloplasmin. His dengue, leptospira IgM were negative, HIV, HBsAg, Anti Hepatitis C were negative. Urine aminoacidogram, 24 hrs urine copper and ophthalmological examination were normal and USG abdomen showed coarse echotexture of liver.

What is the likely cause of his hepatitis_?
Expert Opinion :
This child has acidosis, hepatitis, Cardiac dysfunction, increased ammonia and previous jaundice. Suspicion of metabolic liver disease. Urine aminoacidogram normal. Serum Carnitine was found to be low. He is suspected to have fatty acid oxidation defect
Answer Discussion :
Tahir Ahmad
Urea cycle defect
8 years ago
rahiul Islam
drugs induced
8 years ago

View More Comments

Disclaimer: The information given by www.pediatriconcall.com is provided by medical and paramedical & Health providers voluntarily for display & is meant only for informational purpose. The site does not guarantee the accuracy or authenticity of the information. Use of any information is solely at the user's own risk. The appearance of advertisement or product information in the various section in the website does not constitute an endorsement or approval by Pediatric Oncall of the quality or value of the said product or of claims made by its manufacturer.
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0