Von Hippelundau Disease

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HP1 PE

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Imaging

Gross Pathology Micro Pathology

Treatment Discussion

A 49-year-old male who is a known chronic alcoholic is brought to the emergency room with dehydration, jaundice, and fever; blood is drawn for routine tests, and he is infused with 5% dextrose, after which he becomes stuporous.

He had been admitted to the ER several times before for alcoholic gastritis and acute intoxication.

Patient confused and stuporous; normal fundus; nystagmus; skin and mucosal icterus; spider nevi on neck and upper chest; pitting pedal edema; abdominal distention with shifting dullness (= ASCITES); hepatosplenomegaly.

Increased serum bilirubin, predominantly direct; low serum albumin; increased serum AST and ALT (AST > ALT); markedly elevated gamma-glutamyl transferase (GGT); mildly elevated alkaline phosphatase; slightly prolonged PT; normal serum electrolytes and blood sugar; transudate revealed on ascitic fluid exam.

US/CT-Abdomen: hepatomegaly and splenomegaly with evidence of free fluid in peritoneal cavity.

Micronodular cirrhosis and fatty change of the liver.

Neutrophilic infiltrate; "Mallory hyaline bodies"; piecemeal necrosis and fibrosis surrounding central vein of portal triad on liver biopsy.

IV thiamine; complete abstinence from alcohol.

Caused by thiamine deficiency (most common cause is alcoholism). Alcoholics should receive thiamine before glucose to prevent this. p.235

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Beat The Battle With The Bottle

Beat The Battle With The Bottle

Alcoholism is something that can't be formed in easy terms. Alcoholism as a whole refers to the circumstance whereby there's an obsession in man to keep ingesting beverages with alcohol content which is injurious to health. The circumstance of alcoholism doesn't let the person addicted have any command over ingestion despite being cognizant of the damaging consequences ensuing from it.

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