werner@aecom.UUCP (Craig Werner) (02/02/86)
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Another patient comes into the hospital heavily jaundiced. (And, the
whites of BOTH eyes are deeply orange.) He had been seen in clinic for
another (and for this puzzle, unimportant) illness two weeks earlier and had
been prescribed tetracycline based on a history of Penicillin allergy.
Other than that, he had been previously healthy.
To confirm the initially obvious diagnosis, a liver biopsy is done,
and much to the suprise of the residents, it does not reveal membrane bound
fat accumulation typical of idiosyncratic Tetracycline toxicity, but rather
large quantities of iron in almost all the liver cells.
The blood count is normal, as is the hematacrit, so there is no
sign of hemolytic anemia, or increased Red Blood Cell destruction.
1. What was overlooked, and what needs to be done to remedy the
situation?
2. What is your best guess as to the cause of the liver failure?
--
Craig Werner
!philabs!aecom!werner
"Illness strips away superficiality to reveal reality in etched detail."