Postgrad Med J 2001;77:529-530
( August )
Self assessment questions
Generalised oedema, lethargy, personality disturbance,
and recurring nightmares in a young
girl
N D Hawkesa, D Mutimerb, G A O Thomasa
a Department of
Gastroenterology, University Hospital of Wales, Cardiff, UK, b Liver Unit, Queen
Elizabeth Hospital, Birmingham, UK
Correspondence to: Dr
Neil Hawkes, Department of Gastroenterology, Ward A7, University
Hospital of Wales, Heath Park, Cardiff CF14 4XN, UK
neilhawkes@doctors.org.uk
Submitted 1 November 2000;
Accepted 2 March 2001
| The first 150 words of the full text of this article appear below. |
A 17 year old girl presented with a six
week history of loose, yellow motions, marked leg swelling, increased
shortness of breath, lethargy, and decreased exercise tolerance. She
had gained 10 kg in weight in four months. Her mother commented that
over the past nine months she had been somewhat depressed and withdrawn and had suffered from recurring nightmares.
Six weeks before admission, she had complained of left sided abdominal
discomfort, polyuria, and haematuria and was given a one week course of
co-amoxyclav. She had been otherwise fit and well. She was taking no
regular medication apart from an oral contraceptive pill which had been
started two years previously. She was a non-smoker and drank little alcohol.
Examination revealed generalised swelling, with marked bilateral leg
oedema. Cardiovascular, respiratory, and neurological examination were
unremarkable. The abdominal veins were prominent and striae were
present over the lower abdomen, although she was not jaundiced and
. . . [Full text of this article]
