Safrin Hemophilia

8/3/2019 Safrin Hemophilia

http://slidepdf.com/reader/full/safrin-hemophilia 1/18

Click to edit Master subtitle style

4/22/12



4/22/12

NAME:Gopinath

AGE:13 years

SEX:Male

CHIEF COMPLIANTS:

C/O Hematuria for the past 2 days.

C/O Left loin pain for the past 2 days.

HISTORY OF PRESENT ILLNESS:

H/O Hematuria associated with loinpain.

No H/O frequency of micturition.



4/22/12

No H/O intake of any anticoagulants.

No H/O edema.

No H/O trauma.No H/O fever.

No H/O bleeding from other sites of the body.

PAST HISTORY:

H/O similar episode-1yr back-3days-spontaneously resolved.

No H/O TB.

No other relevant past history.

FAMILY HISTORY:



4/22/12

PERSONAL HISTORY:

Consumes a mixed diet.

Normal bladder and bowel habits.

GENERAL EXAMINATION:

Conscious,oriented,afebrile.Not anaemic,not icteric.

No cyanosis,no clubbing, no pedal edema.

No generalised lymphadenopathy.VITALS:

RR: 14/min,

PR: 82/min,



4/22/12

OTHER SYSTEMS:

CVS: S1,S2 Heard,No Murmurs.

RS: NVBS Heard,No added sounds.P/A:Soft,Not tender,No organomagaly.

CNS: Clinically Normal.

INVESTIGATIONS:

BLOOD:

Hb:11.2gm%,RBC:3.8million/cu.mm,

TC:8800cells/cu.mm,

DC:P-57%,L-40%,E-3%,



4/22/12

URINE ROUTINE:

Albumin:3+,sugar-Nil,Deposits:Field full of RBC’S.

24 hrs urine protein-516mg/day.X-RAY ABDOMEN: Normal.

USG ABDOMEN: Normal Study.

Patient was treated conservatively.On Day 2:

Urine Albumin:3+,sugar-Nil, Deposits-Field full of RBC’S.

NEPHROLOGIST OPINION:



4/22/12

On Day 5:

Since there was no improvement,he wasreferred to Higher Institute,Madras Medical

College,Chennai.

At MMC:

INVESTIGATIONS:

Blood:

Hb:12.8gm%

TC:7200cells/cu.mm,

DC:P-44%,L-55%,E-1%

ESR:7mm/hr,

Platelet count:3.3lakhs,

Urea:28mg,



4/22/12

For further evaluation,In Nephrology Department MMC,

RENAL BIOPSY was planned.

Before that routine COAGULATION PROFILE was done.From this Investigations

aPTT found to be prolonged indicating thepresence of COAGULATION DISORDER

aPTT-Test:55 sec.,control:28 sec

-



4/22/12

DIAGNOSIS:

HEMOPHILIA A



4/22/12

Hence Renal Biopsy was deffered,

thus a MAJOR CATASTROPHY wasPREVENTED.

Once the Diagnosis was made,we persuethe case retrospectively and revealed the presence of family history.

Presence of similar illness in his younger brotherwhich was not

revealed during routine history taking at the time of admission.



4/22/12



4/22/12

CASE DISCUSSION:

CAUSES OF HEMATURIA

MEDICAL CAUSE SURGICALCAUSE

Kidney

General cause Ureter

Disease of Renal Parenchyma Bladder



4/22/12

MEDICAL CAUSES:

GENERAL CAUSES:

Bleeding disorders

Anticoagulant Drugs

Sub Acute Bacterial



4/22/12

DISEASE OF RENAL PARENCHYMA:

Glomerulonephritis

Malignant Hypertension

Polycystic kidney

Renal Vein Thrombosis

Polyarteritis



4/22/12

SURGICAL CAUSES:

KIDNEY:

Wilms Tumor

Hypernephroma

Papilloma of Renal Pelvis

Hemorrhage into:hydronephrotic

kidney,renal cyst injury

URETER:

Stone

BLADDER



4/22/12

BLADDER:

Acute cystitis

Stone

Papilloma

Carcinoma

Trauma PROSTATE:

Tubercular prostatitis

Bleeding prostatic venous plexus URETHRA:

Trauma

Angioma



4/22/12

TAKE HOME MESSAGE:

This case illustrates the IMPORTANCE

OFROUTINE SCREENING of the individual before

any Invasive Diagnostic Procedure to preventserious complications.

A major part of DIAGNOSIS also relieson the HISTORY GIVEN BY THE PATIENT,so we

should try our level best to GET COMPLETEHISTORY from the atients.



4/22/12 THANK

YOU

Documents

Safrin Hemophilia