اليرقان

[LOLA]

مريض 23 سنة راجع بحالة يرقان خفيف مستمر


) mild)


تركيز البيلروبين المصلي دائما أكثر من 5 مغ/دل و بشكل رئيسي على حساب الغير مقترن


يتحرض بالصيام ,الجراحة , الحمى ,العدوى ,تناول الكحول


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مريضة 17 سنة راجعت بحالة يرقان معتدل


)moderate)


على حساب البيلروبين المقترن


تطور اليرقان لديها خلال الحمل


لديها ضخامة كبدية معتدلة و خزعة الكبد أظهرت تصبغات سوداء في الخلايا الكبدية


ما هو التشخيص الأكثر احتمالا مع كل حالة :

a. Dubin-Johnson syndrome
b. Rotor syndrome
c. Crigler-Najjar type 1 syndrome
d. Crigler-Najjar type 2 syndrome
e. Gilbert syndrome
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مشان الامانة انا ما عرفت شو الحلول !!!!!!!!!!!!!!أي حدا عندو تعليق ممكن يساعدنا نكون من الشاكرين

[NMWH]

معلومات عمو ستيدمان بالتأكيد مفيدة.... جاري القراءة


"حالات حلوة... شكراً"

Dubin-Johnson syndrome

autosomal recessive, inherited defect in hepatic excretory function characterized by levels of serum bilirubin up to about 6 mg/dL, over half of which is conjugated, and excretion of abnormal proportions of coproporphyrin I in urine. There is also retention of a dark pigment in the hepatocytes that is derived either from melanin or catecholamines, but otherwise liver histology is normal. Oral cholecystogram fails to visualize the gall bladder, and excretion of bromosulfothalein by the liver is abnormal. The basic defect is apparently in canalicular transport. No therapy is necessary.
Rotor's syndrome

jaundice appearing in childhood due to impaired biliary excretion; most of the plasma bilirubin is conjugated, liver fraction tests are usually normal, and there is no hepatic pigmentation.
Crigler-Najjar syndrome

a rare defect in ability to form bilirubin glucuronide due to deficiency of bilirubin-glucuronide glucuronosyltransferase; characterized by familial nonhemolytic jaundice and, in its severe form, by irreversible brain damage in infancy that resembles kernicterus and may be fatal; autosomal recessive inheritance. There is also an autosomal dominant form that may be identical with Gilbert's syndrome
familial nonhemolytic jaundice

mild jaundice due to increased amounts of unconjugated bilirubin in the plasma without evidence of liver damage, biliary obstruction, or hemolysis; thought to be due to an inborn error of metabolism in which the excretion of bilirubin by the liver is defective, ascribed to decreased conjugation of bilirubin as a glucuronide or impaired uptake of hepatic bilirubin. Syn: benign familial icterus, constitutional hepatic dysfunction, Gilbert's disease, Gilbert's syndrome

[NMWH]

بعد قراءة التعاريف تبين لي ودون أدنى شك أن:
الحالة الأولى=> e. Gilbert syndrome


الحالة الثانية=> a. Dubin-Johnson syndrome
شكرا جزيلا .. لولا هالحالات ماكنت تعرفت على هالشخصيات... عفوا المتلازمات!