asympt 55yo DM2 +LFT ?

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asympt 55yo DM2 +LFT ?

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peter90036
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03/24/08 - 12:00 PM

asymptomatic 55yo M with 4 year DM2
AST 80 ALT 90
hepatitis tests are negative
high serum iron >200
high ferritin >1000
normal TIBC
no other symptoms, signs.

What's your diagnosis?
1. Hepatitis
2. Alcoholic
3. Wilsons disease
4. Hemochromatosis
5. Alpha-antitrypsin deficit

Edited by peter90036 on 03/24/08 - 12:06 PM

ganesha123
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03/24/08 - 12:19 PM

hemachromatosis

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dr.wad
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03/24/08 - 12:43 PM

4- hemochromatosis. ..(.bronzed diabetes)

c/p : skin pigmentation, DM,hepatomegaly then cirrhosis, testicular atrophy,arthralgia, cardiomyopathy.

tx : phlebotomy or deferoxamine if pt is anemic.

Edited by dr.wad on 03/24/08 - 01:32 PM

peter90036
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03/24/08 - 12:49 PM

ok. so i guess alcoholism would have needed to be pretty severe on the LFTs to also cause a chronic pancreatitis-DM and sideroblastic anemia with increased iron etc :P ... is that too much thinking for the boards?
heh that also sounds too complicated when i write it down grin

dr.wad
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03/24/08 - 01:31 PM

sorrrrrrrrrry gys low ceruloplasmin is seen in wilson disease....i will edit my post ..

shahnaz.r
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03/24/08 - 06:53 PM

Ivonne
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03/24/08 - 07:26 PM

4. Hemochromatosis

Peter the classic transaminases pattern for alcohol is AST/ALT----------> 2/1

That ferritin level is screaming for hemochromatosis...

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peter90036
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03/24/08 - 07:47 PM

thanks

Eagle_303
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03/26/08 - 07:09 PM

Ivonne wrote:
4. Hemochromatosis

Peter the classic transaminases pattern for alcohol is AST/ALT----------> 2/1

That ferritin level is screaming for hemochromatosis...

Hemochromatosis with normal TIBC ??

peter90036
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03/26/08 - 08:44 PM

#10

ok you got me curious (i remmbr it can be NRML)

_______Norm______HMCRTS_______ETOH

iron:__ _9-27_______32-54_________often incr

TIBC __45-66_______36-54_________45-66

ferritin _10-200_____900-6000_______10-500

[harrison's]

so yup, that ferritin is screaming hemochromatosis grin

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