25M It hc pain 3 days, jaundice 3 years back recovered, spastic quadriparesis birth, Telangana PaJR

26-10-2023

THIS IS AN ONLINE E LOG BOOK TO DISCUSS OUR PATIENT'S DE-IDENTIFIED HEALTH DATA SHARED AFTER TAKING HIS SIGNED INFORMED CONSENT. HERE WE DISCUSS OUR PATIENT'S PROBLEMS THROUGHSERIES OF INPUTS FROM AVAILABLE GLOBAL ONLINE COMMUNITY EXPERTS WITH AN AIM TO SOLVE THOSE PATIENT'S CLINICAL PROBLEMS WITH COLLECTIVE CURRENT BEST EVIDENCE BASED INPUTS.

A 20 years old male came to opd with chief complaints of yellowish discoloration of eyes since 1 year.. The patient was apparently asymptomatic 1 year back then developed yellowish discoloration of eyes Positive history: loss of appetite, irregular bowel and bladder movements, dehydration

Negative history: N/K/C/O asthma, TB, epilepsy, thyroid.

[12.15 pm, 26/12/2025] PPM 1: Reviewing this patient now after 2 years in OPD

[12:19 pm, 26/12/2025] PPM 1: CNS prominent upper motor neuron signs of hypertonia, hyperreflexia, absent jaw jerk and motor power deficits of 4/5 with spastic contractures and even hypertonia and hyperreflexia left more than right [12:22 pm, 26/12/2025] PPM 3: He has spastic quadriparesis since birth? [12:32 pm, 26/12/2025] PPM 1: Yes [12:32 pm, 26/12/2025] PPM 1: Noticed during infancy after milestones were delayed [12:49 pm, 26/12/2025] PPM 4: Jaundice 3 years🤔 [12:52 pm, 26/12/2025] PPM 1: 3 years back once, recovered

                                       

[8:56 pm, 26/12/2025] PPM 1: Likely Gilbert's

[9:20 pm, 26/12/2025] PPM 4: That is why I asked

[9:21 pm, 26/12/2025] PPM 4: Another thing at back end may be history prescription drug like Valproate

[10:23 am, 27/12/2025] PPM 3: A very common phenomenon in gastro/Hepatology opds is to get patients referred for unconjugated hyperbil (which almost always turn out to be Gilbert or any of hemolytic anemias)

[10:24 am, 27/12/2025] PPM 3: But if the patient is from northern WB, would be a good idea to get a Hb electrophoresis done, high incidence of hemoglobinopathies there which also exhibit persistent mild unconjugated hyperbil

[10:36 am, 27/12/2025] PPM 1: He's from Telangana

[12:33 pm, 27/12/2025] PPM 3: Regarding ethnicity, as you had previously shared, I am getting macro thrombocytopenia in a lot of Bengali patients visiting Hyderabad. Very interesting finding!