1. Case Study #4
Julia Burton and Maria Chiaffarano

2. PATIENT HISTORY
• 42 year old male
• No major health issue to date
• Notable increase in weight over past month – gain of 17 pounds
• Recent lethargy
• Patient is on a new eating regimen – every meal is from a ‘fast food’
restaurant

3. PHYSICAL EXAMINATION
• Enlarged liver
• Muscle weakness

4. LABORATORY RESULTS
• Negative for hepatitis
• Excessive glycogen granules in liver
• High levels of fat in liver – abnormal fat metabolism
• Low testosterone levels
• Abnormal cell calcium balance

5. DIAGNOSIS
The organelle that is malfunctioning is the
Smooth ER

6. RATIONALE FOR DIAGNOSIS
Fatigue/Abnormal cell calcium balance
• Calcium pumps are not operating properly
• The storage/balance of calcium is not working correctly (maintaining
concentration process)
• Calcium pumps maintain low levels for cell signaling
• This could be the reason why muscle contraction is causing fatigue.

7. RATIONALE FOR DIAGNOSIS
(CONT.)
Possible reasons for the enlarged liver:
• Cancer
• Heart diseases
• Liver disease
• Cirrhosis

8. RATIONALE FOR DIAGNOSIS
(CONT.)
Increase in weight
• The current “fast-food” diet is a factor of the weight gain. Fast food
has a lot of fat that is bad for the body in it. The excessive intake of
fast food increases body weight.
• Weight gain can also be caused by nutritional imbalances (increase in
fat and sugar)

9. RATIONALE FOR DIAGNOSIS
(CONT.)
Low Testosterone levels
• Testosterone is made up of steroids which are fats
• The smooth ER is involved in lipid synthesis (making of fat) and
therefore would affect levels of testosterone if there is a smooth ER
problem

10. RATIONALE FOR DIAGNOSIS
(CONT.)
Excessive glycogen granules in the liver/Enlarged liver
• Glycogenoses are resulted from abnormal metabolism of glycogen
or the lack of a particular lysosomal enzyme to degrade glycogen or
catabolism of glucose
• Results in excess glycogen
• The liver and heart can also be affected

11. GENERAL DIAGNOSIS
The patient’s symptoms cannot be classified as a single
disease. The smooth ER is causing multiple problems,
especially with his liver and fats because the smooth ER
is responsible for lipids and detoxifications and calcium
storage.