Lethargic patient with hepatocirrhosis — more than meets the eye


Mateusz Maligłówka, Aleksandra Sojka, Anna Bartecka, Łukasz Bułdak, Bogusław Okopien

A 42-year-old man with hepatocirrhosis was admitted to the department of internal medicine as a matter of urgency due to qualitative disturbances of consciousness. For the last 40 days, the patient had been on a drinking binge. The medical history included chronic viral hepatitis C and alcohol dependence syndrome. On the admission, a physical examination revealed drowsiness, psychomotor sluggishness, features of dehydration, and bradycardia without symptoms of cardiopulmonary failure The symptoms presented by our patient were typical for exacerbation of hepatocirrhosis. Nevertheless, insufficient response to the first-line treatment and medical history taken from the family, with a delay, directed the diagnostic process to check the less common, endocrinological causes that could be responsible for the patient’s condition. This report underlines the importance of taking the medical history from the family, especially in patients with disturbances in consciousness and necessity for a broad differential diagnostic process concerning the functioning of glands in people with autoimmune diseases.

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