i suffer from severe dizziness, fatigue, headache, somnolence, breathlessness, nausea, lack of appetite and also depression.i am 14 years old.my menstrual cycle history is normal.i dont have fever.my bilirubin count is still the same,that is 2.7mg/ml.my ESR rate is 12 mm at 1h

Question (Posted on :  30 Aug 2008 )


i suffer from severe dizziness, fatigue, headache, somnolence, breathlessness, nausea, lack of appetite and also depression.i am 14 years old.my menstrual cycle history is normal.i dont have fever.my bilirubin count is still the same,that is 2.7mg/ml.my ESR rate is 12 mm at 1hr.i have been vaccinated against hepatitis B.medications did not help me.here the doctors are suspecting that my bilirubin count is high either due to congenital enzymatic disorder or i have blood cancer or thallasemia.i recently underwent a blood test and i did not have blood cancer or thallasemia.the doctors cannot make out the disease which has affected me.please help me.

Doctor's Response (Posted on : 30 Aug 2008 )


Many of your symptoms appear to be due probably to a type of anaemia called 'haemolytic anaemia' which leads to excessive destruction of red blood cells (may be due to congenital or acquired causes including drugs). You say thalassaemia had been ruled out (I hope they have done a haemoglobin electrophoresis). Other possibilities are hereditary spherocytosis, G6PD and PK deficiency which are diagnosed by appropriate screening tests.#13;#10; #13;#10;In case your anaemia is in fact due to excess haemolysis, the urine examination would reveal increasing amounts of urobilinogen (normal value is around 1.0 mg/dL). If this be so, please rule out chronic (resistant) malaria, frequent use of pain-killers (including aspirin, ibuprofen, nimesulide etc.,); in general, it is wise to avoid analgesics (pain-killers) unless prescribed by your doctor. Sometimes, viral hepatitis (say Hepatitis B jaundice) may last for about one year (called chronic persistent hepatitis) during which period the serum bilirubin would remain elevated and you would continue to suffer from the symptoms you have complained of. This would require a detailed virological studies including blood for HBsAg, HBeAg, Anti HBc Antibodies, serum electrophoretic pattern etc.,#13;#10; #13;#10;I would suggest a consultation with a haematologist / gastroenterolgist of your area who would definitely be able to help you. Other condions such as congenial hyperbilirubinemia (Gilbert's syndrome, Dubin-Johnson syndrome), chronic intrahepatic chlestasis etc., may have to be condsidered and your haematologist would be able to detect this. In the meanwhile, I would strongly urge you to avoid pain-killers belonging to 'NSAID' class of drugs.#13;#10;#13;#10;If you want us to recommend a doctor please let us know your city. Regards Clinical Team @ Clinnovo



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