Background
Case presentation
WBC | 11,000/mm3 | Hbs Ag (ELISA) | Positive |
RBC | 327 × 104/mm3 | HBe Ag | Positive |
Platelet count | 327,000 | HBc Ab | Positive |
HGB | 10.5 g/dl | HBc Ab IgM | Positive > 15 IU/ml |
ESR | 77 → 32 mm | HBe Ab | Negative |
C-reactive protein | 10 mg/dl | HDV Ab | Negative |
Urea | 52 mg/dl | HCV Ab | Negative |
Creatinine | 1.2 mg/dl | HIV Ab | Negative |
Fe | 85 mg/dl | HBs Ab | Negative |
TIBC | 282 | HEV | Negative |
Calcium | 8.5 mg/dl | HAV Ab | Negative |
Phosphorus | 3.3 mg/dl | HBV viral load | 3,319,701,150 Copies/ml
570,395,386 IU/mL
|
Prothrombin time (PT) | 12.5 seconds | ||
Ferritin | 960 ng/ml → 357 ng/ml | ||
Potassium | 3.6 mEq/l | Rheumatoid factor | Negative |
Blood culture | Negative | ANA | Negative |
Wright | Negative | p-ANCA | Negative |
Coombs Wright | Negative | c-ANCA | Negative |
Troponin | Negative | Anti-ds-DNA | Negative |
Venereal disease research laboratory (VDRL) | Negative | Antimitochondrial Ab | Negative |
Thyroxine (T4) | 13 μg% | Anti-smooth muscle Ab | Negative |
Triiodothyronine (T3) | 1.5 ng/ml | Tissue transglutaminase Ab | Negative |
Thyroid-stimulating hormone (TSH) | 3.4 mlU/ml | Anti-gliadin Ig G | Negative |
Copper in a normal range | In blood and urine | Anti-gliadin IgA | Negative |
Total protein | 6.3 mg/dl | LKM-1 | Negative |
Albumin | 3.4 mg/dl | Anti-endomysial Ab | Negative |
Urinalysis | Normal | Aldolase | 40 IU/l |
Chest x-ray | Normal | Ceruloplasmin | 31 mg/dl, normal |
Neuron site | Nerve | Muscle | Result |
---|---|---|---|
Sensory NCS | L sural—Lat malleolus | L calf | Not obtainable |
R sural—Lat malleolus | R calf | Not obtainable | |
L superficial peroneal—foot | L Lat leg | Not obtainable | |
Motor NCS | Tibial malleolus—abductor hallucis brevis | Wrist | Not obtainable |
Elbow | Not obtainable | ||
L common peroneal—extensor digitorum brevis (EDB) | Ankle | Not obtainable | |
Fibular head | Not obtainable | ||
R common peroneal—EDB | Ankle | Not obtainable | |
Fibular hand | Not obtainable | ||
H-Reflex | L tibial—soleus | Knee | Not obtainable |
R tibial—soleus | Knee | Not obtainable | |
EMG | L TIB Ant | Mildly decreased | |
L gastrocnemius—Lat | Mildly decreased | ||
L vastus lateralis | Early recruitment | ||
R vastus lateralis | Early recruitment | ||
R biceps | Early recruitment | ||
R deltoid | Early recruitment |
At first visit | 3 days later | 7 days later | 10 days later | 14 days later | |
---|---|---|---|---|---|
CK, IU/l | 11,200 | 4605 | 3359 | 830 | 207 |
LDH, IU/l | 1250 | 882 | 842 | 636 | 823 |
SGOT, IU/l | 1161 | 763 | 529 | 225 | 371 |
SGPT, IU/l | 970 | 785 | 603 | 335 | 334 |
Billi T, mg/dl | 3.7 | 4.4 | 2.6 | 3.7 | 3.4 |
Billi D, mg/dl | 3.5 | 2.9 | 2.3 | 1.3 | 1.3 |
ALK P, IU/l | 1172 | 1033 | 842 | 878 | 877 |
Na, mg/dl | 121 | 118 | 116 | 131 | 137 |