SlideShare une entreprise Scribd logo
1  sur  34
INTERESTING CASE OF HEPATOMEGALY PROF S.SUNDAR’S UNIT Dr.A.NILAVAN PG
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
INVESTIGATION Hb 13.5g/dl TC 6300 cells per cu. Mm DC P 62 L34M4 ESR 30 mm/hr PLATLET COUNT 240000 cell per cu.mm HAEMATOCRIT 36 UREA 17mg/dl CREATININE 0.7mg/dl SODIUM 134 meq/l POTTASIUM 5.6meq/ l CHLORIDE 104 meq/l CALCIUM 8.8mg/dl PHOSPHORUS 4.1mg/dl RBS(mg/dl) 356
CONT… 12/12/10 15/12/10 18/12/10 22/12/10 FBS (mg/dl) 440 301 192 148 PPBS( mg/dl) 546 361 355 172
Total bilirubin 0.77mg/dl Direct bilirubin 0.32mg/dl AST 441u/l ALT 348u/l SAP 230u/l GGT 235u/l PT 17sec INR 1.7
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
PROVISIONAL DIAGNOSIS ,[object Object],[object Object],[object Object],[object Object]
FURTHER INVESTIGATIONS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
FINAL DIAGNOSIS ,[object Object]
TREATMENT ,[object Object],[object Object],[object Object],[object Object],[object Object]
Polyglandular autoimmune syndrome type II (PGA-II) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Adulthood, usually around the third and fourth decade. Middle-aged women  Associated with HLA-DR3 and/or HLA-DR4 haplotypes,  Pattern of inheritance is autosomal dominant with variable  penatrance.
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
DIFFERENTIAL DIAGNOSIS ,[object Object],[object Object],[object Object],[object Object],[object Object]
Laboratory Studies ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Medical Care ,[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object]
Polyglandular autoimmune syndrome type I (PGA-I) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object]

Contenu connexe

Tendances

Basic approach on short stature in children
Basic approach on short stature in childrenBasic approach on short stature in children
Basic approach on short stature in childrenAzad Haleem
 
Auto immune poly glandular syndrome
Auto immune poly glandular syndromeAuto immune poly glandular syndrome
Auto immune poly glandular syndromehodmedicine
 
Complications of Thalassemia major
Complications of Thalassemia majorComplications of Thalassemia major
Complications of Thalassemia majorGirish Bhatt
 
Short stature in children 2021
Short stature in children 2021Short stature in children 2021
Short stature in children 2021Imran Iqbal
 
Diagnosis and Management of malaria in children
Diagnosis and Management of malaria in children Diagnosis and Management of malaria in children
Diagnosis and Management of malaria in children Nagadatta Nayak
 
Autoimmune hepatitis
Autoimmune hepatitisAutoimmune hepatitis
Autoimmune hepatitisRintu Sharma
 
Pediatric Acute Liver Failure
Pediatric Acute Liver FailurePediatric Acute Liver Failure
Pediatric Acute Liver FailureAniruddha Ghosh
 
Approach to childhood rickets
Approach to childhood ricketsApproach to childhood rickets
Approach to childhood ricketsSingaram_Paed
 
Congenital Adrenal Hyperplasia (CAH)
Congenital Adrenal Hyperplasia (CAH)Congenital Adrenal Hyperplasia (CAH)
Congenital Adrenal Hyperplasia (CAH)Usama Ragab
 
Approach to a child with Rickets
Approach to a child with Rickets Approach to a child with Rickets
Approach to a child with Rickets Nassr ALBarhi
 
Pseudohypo pth.iyad.jaber
Pseudohypo pth.iyad.jaberPseudohypo pth.iyad.jaber
Pseudohypo pth.iyad.jaberiyad07
 
Henoch Schonlein Purpura (2)
Henoch Schonlein Purpura (2)Henoch Schonlein Purpura (2)
Henoch Schonlein Purpura (2)Dang Thanh Tuan
 

Tendances (20)

Basic approach on short stature in children
Basic approach on short stature in childrenBasic approach on short stature in children
Basic approach on short stature in children
 
Pseudohypoparathyroidism
PseudohypoparathyroidismPseudohypoparathyroidism
Pseudohypoparathyroidism
 
Auto immune poly glandular syndrome
Auto immune poly glandular syndromeAuto immune poly glandular syndrome
Auto immune poly glandular syndrome
 
Complications of Thalassemia major
Complications of Thalassemia majorComplications of Thalassemia major
Complications of Thalassemia major
 
Short stature in children 2021
Short stature in children 2021Short stature in children 2021
Short stature in children 2021
 
secondary hypertension
secondary hypertensionsecondary hypertension
secondary hypertension
 
Diagnosis and Management of malaria in children
Diagnosis and Management of malaria in children Diagnosis and Management of malaria in children
Diagnosis and Management of malaria in children
 
Anemia of chronic disease
Anemia of chronic diseaseAnemia of chronic disease
Anemia of chronic disease
 
Autoimmune hepatitis
Autoimmune hepatitisAutoimmune hepatitis
Autoimmune hepatitis
 
Pediatric Acute Liver Failure
Pediatric Acute Liver FailurePediatric Acute Liver Failure
Pediatric Acute Liver Failure
 
Henoch scholein purpura
Henoch scholein purpuraHenoch scholein purpura
Henoch scholein purpura
 
Approach to childhood rickets
Approach to childhood ricketsApproach to childhood rickets
Approach to childhood rickets
 
Short stature
Short statureShort stature
Short stature
 
SHORT STATURE
SHORT STATURESHORT STATURE
SHORT STATURE
 
Congenital Adrenal Hyperplasia (CAH)
Congenital Adrenal Hyperplasia (CAH)Congenital Adrenal Hyperplasia (CAH)
Congenital Adrenal Hyperplasia (CAH)
 
Approach to a child with Rickets
Approach to a child with Rickets Approach to a child with Rickets
Approach to a child with Rickets
 
Pseudohypo pth.iyad.jaber
Pseudohypo pth.iyad.jaberPseudohypo pth.iyad.jaber
Pseudohypo pth.iyad.jaber
 
Henoch Schonlein Purpura (2)
Henoch Schonlein Purpura (2)Henoch Schonlein Purpura (2)
Henoch Schonlein Purpura (2)
 
Approach to anemia
Approach to anemiaApproach to anemia
Approach to anemia
 
A Case of Hodgkin's Disease
A Case of Hodgkin's DiseaseA Case of Hodgkin's Disease
A Case of Hodgkin's Disease
 

En vedette (7)

Autoimmune Polyendocrinopathy-Candidiasis-Ectodermal Dysplasia
Autoimmune Polyendocrinopathy-Candidiasis-Ectodermal DysplasiaAutoimmune Polyendocrinopathy-Candidiasis-Ectodermal Dysplasia
Autoimmune Polyendocrinopathy-Candidiasis-Ectodermal Dysplasia
 
Type i polyglandular autoimmune syndrome
Type i polyglandular autoimmune syndromeType i polyglandular autoimmune syndrome
Type i polyglandular autoimmune syndrome
 
Case presentation 2 : Duane's Syndrome
Case presentation 2 : Duane's Syndrome Case presentation 2 : Duane's Syndrome
Case presentation 2 : Duane's Syndrome
 
Sindrome poliglandular
Sindrome poliglandularSindrome poliglandular
Sindrome poliglandular
 
A Case of Schmidt Syndrome
A Case of Schmidt Syndrome A Case of Schmidt Syndrome
A Case of Schmidt Syndrome
 
ECG: Atrial Dissociation
ECG: Atrial DissociationECG: Atrial Dissociation
ECG: Atrial Dissociation
 
Addison disease
Addison diseaseAddison disease
Addison disease
 

Similaire à A Case of Polyglandular Autoimmune Syndrome - Type II

Diabetic foot case presentation
Diabetic foot   case presentation Diabetic foot   case presentation
Diabetic foot case presentation Gowri Shankar
 
Diabetes Mellitus management in OPD
Diabetes Mellitus management in OPDDiabetes Mellitus management in OPD
Diabetes Mellitus management in OPDnium
 
Diabetes Mellitus.pptx
Diabetes Mellitus.pptxDiabetes Mellitus.pptx
Diabetes Mellitus.pptxAjitPal26
 
DIABETES MELLITUS & PERIOPERATIVE ANAESTHETIC MANAGEMENT
DIABETES  MELLITUS & PERIOPERATIVE ANAESTHETIC MANAGEMENTDIABETES  MELLITUS & PERIOPERATIVE ANAESTHETIC MANAGEMENT
DIABETES MELLITUS & PERIOPERATIVE ANAESTHETIC MANAGEMENTTuhin Mistry
 
Adrenal Crisis.pptx
Adrenal Crisis.pptxAdrenal Crisis.pptx
Adrenal Crisis.pptxnawan_junior
 
adrenalcrisis-220627010816-f7d5cddb.pdf
adrenalcrisis-220627010816-f7d5cddb.pdfadrenalcrisis-220627010816-f7d5cddb.pdf
adrenalcrisis-220627010816-f7d5cddb.pdfDrYaqoobBahar
 
Diabetes Diagnosis and Classification
Diabetes Diagnosis and ClassificationDiabetes Diagnosis and Classification
Diabetes Diagnosis and ClassificationDR. VIVEK ARYA
 
chronic diarrhea in young lady
chronic diarrhea in young ladychronic diarrhea in young lady
chronic diarrhea in young ladydrvijay_ayer
 
Approach to endocrine disorders
Approach to endocrine disordersApproach to endocrine disorders
Approach to endocrine disorderscoon n coon
 
TCELL - Case Presentation-2 - Copy.pptx
TCELL - Case Presentation-2 - Copy.pptxTCELL - Case Presentation-2 - Copy.pptx
TCELL - Case Presentation-2 - Copy.pptxDrAijazTalani
 

Similaire à A Case of Polyglandular Autoimmune Syndrome - Type II (20)

Dr Rajkumar
Dr Rajkumar Dr Rajkumar
Dr Rajkumar
 
Hypoadrenalism
HypoadrenalismHypoadrenalism
Hypoadrenalism
 
Diabetes Mellitus
Diabetes MellitusDiabetes Mellitus
Diabetes Mellitus
 
carbo case reports.pptx
carbo case reports.pptxcarbo case reports.pptx
carbo case reports.pptx
 
Diabetic foot case presentation
Diabetic foot   case presentation Diabetic foot   case presentation
Diabetic foot case presentation
 
Diabetes Mellitus management in OPD
Diabetes Mellitus management in OPDDiabetes Mellitus management in OPD
Diabetes Mellitus management in OPD
 
celiac disease
celiac diseaseceliac disease
celiac disease
 
CME: Chronic Renal failure
CME: Chronic Renal failureCME: Chronic Renal failure
CME: Chronic Renal failure
 
Renal failure
Renal failureRenal failure
Renal failure
 
Diabetes Mellitus.pptx
Diabetes Mellitus.pptxDiabetes Mellitus.pptx
Diabetes Mellitus.pptx
 
DIABETES MELLITUS & PERIOPERATIVE ANAESTHETIC MANAGEMENT
DIABETES  MELLITUS & PERIOPERATIVE ANAESTHETIC MANAGEMENTDIABETES  MELLITUS & PERIOPERATIVE ANAESTHETIC MANAGEMENT
DIABETES MELLITUS & PERIOPERATIVE ANAESTHETIC MANAGEMENT
 
Metabolic syndrome
Metabolic syndromeMetabolic syndrome
Metabolic syndrome
 
Dm 1 1
Dm 1 1Dm 1 1
Dm 1 1
 
Adrenal Crisis.pptx
Adrenal Crisis.pptxAdrenal Crisis.pptx
Adrenal Crisis.pptx
 
adrenalcrisis-220627010816-f7d5cddb.pdf
adrenalcrisis-220627010816-f7d5cddb.pdfadrenalcrisis-220627010816-f7d5cddb.pdf
adrenalcrisis-220627010816-f7d5cddb.pdf
 
Diabetes Diagnosis and Classification
Diabetes Diagnosis and ClassificationDiabetes Diagnosis and Classification
Diabetes Diagnosis and Classification
 
chronic diarrhea in young lady
chronic diarrhea in young ladychronic diarrhea in young lady
chronic diarrhea in young lady
 
Approach to endocrine disorders
Approach to endocrine disordersApproach to endocrine disorders
Approach to endocrine disorders
 
Acute Liver Failure
Acute Liver Failure Acute Liver Failure
Acute Liver Failure
 
TCELL - Case Presentation-2 - Copy.pptx
TCELL - Case Presentation-2 - Copy.pptxTCELL - Case Presentation-2 - Copy.pptx
TCELL - Case Presentation-2 - Copy.pptx
 

Plus de Stanley Medical College, Department of Medicine

Plus de Stanley Medical College, Department of Medicine (20)

Interpretation of Liver Function Tests
Interpretation of Liver Function TestsInterpretation of Liver Function Tests
Interpretation of Liver Function Tests
 
A Case of Sheehan's Syndrome
A Case of Sheehan's SyndromeA Case of Sheehan's Syndrome
A Case of Sheehan's Syndrome
 
Imaging: Cortical Vein Thrombosis
Imaging: Cortical Vein ThrombosisImaging: Cortical Vein Thrombosis
Imaging: Cortical Vein Thrombosis
 
ECG: Findings in CNS disorders
ECG: Findings in CNS disordersECG: Findings in CNS disorders
ECG: Findings in CNS disorders
 
A Case of Arrhythmogenic Right Ventricular Dysplasia - ARVD
A Case of Arrhythmogenic Right Ventricular Dysplasia - ARVDA Case of Arrhythmogenic Right Ventricular Dysplasia - ARVD
A Case of Arrhythmogenic Right Ventricular Dysplasia - ARVD
 
A Case of NASH with HYPOTHYROIDISM
A Case of NASH with HYPOTHYROIDISMA Case of NASH with HYPOTHYROIDISM
A Case of NASH with HYPOTHYROIDISM
 
IMAGING: NEUROCYSTICERCOSIS
IMAGING: NEUROCYSTICERCOSISIMAGING: NEUROCYSTICERCOSIS
IMAGING: NEUROCYSTICERCOSIS
 
ECG: Digitalis Effect / MAT / AF
ECG: Digitalis Effect / MAT / AFECG: Digitalis Effect / MAT / AF
ECG: Digitalis Effect / MAT / AF
 
Imaging: BOOP
Imaging: BOOPImaging: BOOP
Imaging: BOOP
 
ECG: Hypokalemia
ECG: HypokalemiaECG: Hypokalemia
ECG: Hypokalemia
 
A Case of Idiopathic Pulmonary Hypertension
A Case of Idiopathic Pulmonary HypertensionA Case of Idiopathic Pulmonary Hypertension
A Case of Idiopathic Pulmonary Hypertension
 
A Case of Rodenticide Poisoning
A Case of Rodenticide PoisoningA Case of Rodenticide Poisoning
A Case of Rodenticide Poisoning
 
A Case of Emphysematous Pylonephritis
A Case of Emphysematous Pylonephritis A Case of Emphysematous Pylonephritis
A Case of Emphysematous Pylonephritis
 
Imaging: Multiple Pulmonary Cavitary Lesions
Imaging: Multiple Pulmonary Cavitary LesionsImaging: Multiple Pulmonary Cavitary Lesions
Imaging: Multiple Pulmonary Cavitary Lesions
 
A Case of Hepato-Pulmonary Syndrome
A Case of Hepato-Pulmonary SyndromeA Case of Hepato-Pulmonary Syndrome
A Case of Hepato-Pulmonary Syndrome
 
A Case of Thalassemia
A Case of ThalassemiaA Case of Thalassemia
A Case of Thalassemia
 
A Case of Renal Amyloidosis
A Case of Renal AmyloidosisA Case of Renal Amyloidosis
A Case of Renal Amyloidosis
 
CXR: Silico-Tuberculosis
CXR: Silico-TuberculosisCXR: Silico-Tuberculosis
CXR: Silico-Tuberculosis
 
ECG: A Case of Flutter-Fibrillation
ECG: A Case of Flutter-FibrillationECG: A Case of Flutter-Fibrillation
ECG: A Case of Flutter-Fibrillation
 
A Case of Madras Motor Neurone Disease
A Case of Madras Motor Neurone Disease  A Case of Madras Motor Neurone Disease
A Case of Madras Motor Neurone Disease
 

Dernier

College Call Girls in Haridwar 9667172968 Short 4000 Night 10000 Best call gi...
College Call Girls in Haridwar 9667172968 Short 4000 Night 10000 Best call gi...College Call Girls in Haridwar 9667172968 Short 4000 Night 10000 Best call gi...
College Call Girls in Haridwar 9667172968 Short 4000 Night 10000 Best call gi...perfect solution
 
Call Girls Ludhiana Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Ludhiana Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Ludhiana Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Ludhiana Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Call Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...
Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...
Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...aartirawatdelhi
 
Call Girls Guntur Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Guntur  Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Guntur  Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Guntur Just Call 8250077686 Top Class Call Girl Service AvailableDipal Arora
 
Call Girls Agra Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Agra Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Agra Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Agra Just Call 8250077686 Top Class Call Girl Service AvailableDipal Arora
 
Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...
Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...
Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...parulsinha
 
Call Girls Service Jaipur {9521753030} ❤️VVIP RIDDHI Call Girl in Jaipur Raja...
Call Girls Service Jaipur {9521753030} ❤️VVIP RIDDHI Call Girl in Jaipur Raja...Call Girls Service Jaipur {9521753030} ❤️VVIP RIDDHI Call Girl in Jaipur Raja...
Call Girls Service Jaipur {9521753030} ❤️VVIP RIDDHI Call Girl in Jaipur Raja...Sheetaleventcompany
 
Call Girls Nagpur Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Nagpur Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Nagpur Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Nagpur Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
O898O367676 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad
O898O367676 Call Girls In Ahmedabad Escort Service Available 24×7 In AhmedabadO898O367676 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad
O898O367676 Call Girls In Ahmedabad Escort Service Available 24×7 In AhmedabadGENUINE ESCORT AGENCY
 
Call Girls Bangalore Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Bangalore Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Bangalore Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Bangalore Just Call 8250077686 Top Class Call Girl Service AvailableDipal Arora
 
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...hotbabesbook
 
Best Rate (Hyderabad) Call Girls Jahanuma ⟟ 8250192130 ⟟ High Class Call Girl...
Best Rate (Hyderabad) Call Girls Jahanuma ⟟ 8250192130 ⟟ High Class Call Girl...Best Rate (Hyderabad) Call Girls Jahanuma ⟟ 8250192130 ⟟ High Class Call Girl...
Best Rate (Hyderabad) Call Girls Jahanuma ⟟ 8250192130 ⟟ High Class Call Girl...astropune
 
Call Girls Cuttack Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Cuttack Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Cuttack Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Cuttack Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...
Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...
Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...Ishani Gupta
 
Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426
Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426
Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426jennyeacort
 
Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...
Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...
Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...tanya dube
 
Book Paid Powai Call Girls Mumbai 𖠋 9930245274 𖠋Low Budget Full Independent H...
Book Paid Powai Call Girls Mumbai 𖠋 9930245274 𖠋Low Budget Full Independent H...Book Paid Powai Call Girls Mumbai 𖠋 9930245274 𖠋Low Budget Full Independent H...
Book Paid Powai Call Girls Mumbai 𖠋 9930245274 𖠋Low Budget Full Independent H...Call Girls in Nagpur High Profile
 
Call Girls Faridabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Faridabad Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Faridabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Faridabad Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Call Girls Dehradun Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Dehradun Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Dehradun Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Dehradun Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 

Dernier (20)

College Call Girls in Haridwar 9667172968 Short 4000 Night 10000 Best call gi...
College Call Girls in Haridwar 9667172968 Short 4000 Night 10000 Best call gi...College Call Girls in Haridwar 9667172968 Short 4000 Night 10000 Best call gi...
College Call Girls in Haridwar 9667172968 Short 4000 Night 10000 Best call gi...
 
Call Girls Ludhiana Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Ludhiana Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Ludhiana Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Ludhiana Just Call 9907093804 Top Class Call Girl Service Available
 
Call Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service Available
 
Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...
Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...
Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...
 
Call Girls Guntur Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Guntur  Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Guntur  Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Guntur Just Call 8250077686 Top Class Call Girl Service Available
 
Call Girls Agra Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Agra Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Agra Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Agra Just Call 8250077686 Top Class Call Girl Service Available
 
Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...
Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...
Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...
 
Call Girls Service Jaipur {9521753030} ❤️VVIP RIDDHI Call Girl in Jaipur Raja...
Call Girls Service Jaipur {9521753030} ❤️VVIP RIDDHI Call Girl in Jaipur Raja...Call Girls Service Jaipur {9521753030} ❤️VVIP RIDDHI Call Girl in Jaipur Raja...
Call Girls Service Jaipur {9521753030} ❤️VVIP RIDDHI Call Girl in Jaipur Raja...
 
Call Girls Nagpur Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Nagpur Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Nagpur Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Nagpur Just Call 9907093804 Top Class Call Girl Service Available
 
O898O367676 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad
O898O367676 Call Girls In Ahmedabad Escort Service Available 24×7 In AhmedabadO898O367676 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad
O898O367676 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad
 
Call Girls Bangalore Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Bangalore Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Bangalore Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Bangalore Just Call 8250077686 Top Class Call Girl Service Available
 
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...
 
Best Rate (Hyderabad) Call Girls Jahanuma ⟟ 8250192130 ⟟ High Class Call Girl...
Best Rate (Hyderabad) Call Girls Jahanuma ⟟ 8250192130 ⟟ High Class Call Girl...Best Rate (Hyderabad) Call Girls Jahanuma ⟟ 8250192130 ⟟ High Class Call Girl...
Best Rate (Hyderabad) Call Girls Jahanuma ⟟ 8250192130 ⟟ High Class Call Girl...
 
Call Girls Cuttack Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Cuttack Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Cuttack Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Cuttack Just Call 9907093804 Top Class Call Girl Service Available
 
Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...
Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...
Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...
 
Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426
Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426
Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426
 
Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...
Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...
Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...
 
Book Paid Powai Call Girls Mumbai 𖠋 9930245274 𖠋Low Budget Full Independent H...
Book Paid Powai Call Girls Mumbai 𖠋 9930245274 𖠋Low Budget Full Independent H...Book Paid Powai Call Girls Mumbai 𖠋 9930245274 𖠋Low Budget Full Independent H...
Book Paid Powai Call Girls Mumbai 𖠋 9930245274 𖠋Low Budget Full Independent H...
 
Call Girls Faridabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Faridabad Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Faridabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Faridabad Just Call 9907093804 Top Class Call Girl Service Available
 
Call Girls Dehradun Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Dehradun Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Dehradun Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Dehradun Just Call 9907093804 Top Class Call Girl Service Available
 

A Case of Polyglandular Autoimmune Syndrome - Type II

  • 1. INTERESTING CASE OF HEPATOMEGALY PROF S.SUNDAR’S UNIT Dr.A.NILAVAN PG
  • 2.
  • 3.
  • 4.
  • 5.
  • 6.
  • 7. INVESTIGATION Hb 13.5g/dl TC 6300 cells per cu. Mm DC P 62 L34M4 ESR 30 mm/hr PLATLET COUNT 240000 cell per cu.mm HAEMATOCRIT 36 UREA 17mg/dl CREATININE 0.7mg/dl SODIUM 134 meq/l POTTASIUM 5.6meq/ l CHLORIDE 104 meq/l CALCIUM 8.8mg/dl PHOSPHORUS 4.1mg/dl RBS(mg/dl) 356
  • 8. CONT… 12/12/10 15/12/10 18/12/10 22/12/10 FBS (mg/dl) 440 301 192 148 PPBS( mg/dl) 546 361 355 172
  • 9. Total bilirubin 0.77mg/dl Direct bilirubin 0.32mg/dl AST 441u/l ALT 348u/l SAP 230u/l GGT 235u/l PT 17sec INR 1.7
  • 10.
  • 11.
  • 12.
  • 13.
  • 14.
  • 15.
  • 16.
  • 17.
  • 18.
  • 19. Adulthood, usually around the third and fourth decade. Middle-aged women Associated with HLA-DR3 and/or HLA-DR4 haplotypes, Pattern of inheritance is autosomal dominant with variable penatrance.
  • 20.
  • 21.
  • 22.
  • 23.
  • 24.
  • 25.
  • 26.
  • 27.
  • 28.
  • 29.
  • 30.
  • 31.
  • 32.
  • 33.
  • 34.