A child presents with complaints of oliguria, abdominal distension and diarrhoea. On examination there is deep jaundice. Hepatomegaly was present measuring 4 cm below the costal margin. Conjugated bilirubin in blood was 38 mg/dL, and there was urine urobilinogen and bile pigments. Hemoglobin was 4mg/dL and serum creatinine was 3mg/dL. Which of the following tests is of least impoance to diagnose this case -
Ans. is 'b' i.e., Serum ceruloplasmin level o Serum ceruloplasmin measurement is useful in the diagnosis of Wilson's disease, but Wilson's disease in the above patient can easily be ruled out because in Wilson's disease there is no renal involvement, where as the patient in question is having renal involvement (Serum Creatinine 3 mg/dL). o Lepto spiral antibody level Leptospiral antibody measurement is useful in the diagnosis of leptospirosis. o The symptomatic profile of the patient is very similar to that of severe leptospirosis (Weil's syndrome). C/F of Weil's syndrome o Jaundice o Hemorrhagic diathesis o Hepatomegaly o Spleenomegaly o Hemolysis o Rhabdomyolysis o Congestive hea failure o Pulmonary involvement o Renal failure (During 2nd wk).
G-6-PD level in blood
Serum ceruloplasmin
Reticulocyte count
Leptospiral antibody level