Case Study

Folate deficiency anaemia, liver cirrhosis

Case introduction

• Sex: Male• Age: 45

Complaints

• Fatigue • Lightheadedness• Shortness of breath• Decreased appetite• Headache • Nausea• Mild pain under the right part of the ribcage • Зүрх дэлсэх/Heart palpitations?• Abdominal bloating

Physical examination

• Breaths PM 16, Beats PM 72, AP R: 140/100;L: 150/100, t° 36,4° C

• Dry, pale skin• Decreased muscle tone• Slight enlargement of liver by percussion• Fluid level by percussion and palpation

Lab findings

• RBC – 3,9 *1012 • ESR – 27 mm/hour• WBC - 3,8*109• MCV – 76 fl• MCH – 26 pg

Biochemical findings

• AST 48• ALT 35• ALP 310 U/L• TBIL 22,1 mmol/L

Ultrasonography

• Slight enlargement of liver and spleen• Fluid level in the abdominal cavity

ECG

• Sinus rhythm• BPM 74• Left axis deviation