Case Study #4Julia Burton and Maria Chiaffarano

PATIENT HISTORY• 42 year old male• No major health issue to date• Notable increase in weight over past month – gain of 17 pounds• Recent lethargy • Patient is on a new eating regimen – every meal is from a ‘fast food’

restaurant

PHYSICAL EXAMINATION• Enlarged liver• Muscle weakness

LABORATORY RESULTS • Negative for hepatitis • Excessive glycogen granules in liver• High levels of fat in liver – abnormal fat metabolism • Low testosterone levels • Abnormal cell calcium balance

DIAGNOSIS The organelle that is malfunctioning is the Smooth ER

RATIONALE FOR DIAGNOSISFatigue/Abnormal cell calcium balance• Calcium pumps are not operating properly• The storage/balance of calcium is not working correctly (maintaining

concentration process) • Calcium pumps maintain low levels for cell signaling• This could be the reason why muscle contraction is causing fatigue.

RATIONALE FOR DIAGNOSIS (CONT.)

Possible reasons for the enlarged liver: • Cancer• Heart diseases• Liver disease• Cirrhosis

RATIONALE FOR DIAGNOSIS (CONT.)

Increase in weight• The current “fast-food” diet is a factor of the weight gain. Fast food has a lot of fat

that is bad for the body in it. The excessive intake of fast food increases body weight.

• Weight gain can also be caused by nutritional imbalances (increase in fat and sugar)

RATIONALE FOR DIAGNOSIS (CONT.)

Low Testosterone levels• Testosterone is made up of steroids which are fats• The smooth ER is involved in lipid synthesis (making of fat) and therefore

would affect levels of testosterone if there is a smooth ER problem

RATIONALE FOR DIAGNOSIS (CONT.) Excessive glycogen granules in the liver/Enlarged liver • Glycogenoses are resulted from abnormal metabolism of glycogen or the lack

of a particular lysosomal enzyme to degrade glycogen or catabolism of glucose• Results in excess glycogen

• The liver and heart can also be affected

GENERAL DIAGNOSISThe patient’s symptoms cannot be classified as a single disease. The smooth ER is causing multiple problems, especially with his liver and fats because the smooth ER is responsible for lipids and detoxifications and calcium storage.