Elevated WBC, distended abdomen, weightgain, mild fatty liver, bedridden. Suggestions?
Patient: My husband is 43 yrs old and has felt bad for close to 3 weeks now. He had elevated WBC about 10 days ago and they thought maybe sinus infxn & put him on Bactrim & prednisone . After a week his wbc was still 13. That may or may not be connected to the rest. He has had a distended abdomen to the point that at night when he s lying down he has a hard time breathing because he says he feels full . He also feels like his gut is swollen after he eats. He has had an almost 20lb weight gain in the past month. After 3 visits to MD and being told liver function tests were normal but cholesterol was high, we went to the ER. They said today his SGPT was 80 ( it was 31 last wed), also said that US & xrays did not show any fluid or anything else. Said they saw a CT from almost a yr ago that showed he had mild fatty liver & suspicious of NASH. No one ever told us that then. Today they said yes it s there but did not recheck to see if it was worse & said as stated above that his SGPT was way high and may need to be rechecked in a week or 2 and maybe see a GI but thats all they said they could do. He feels really rotten, dont have the energy to get out of bed for more than 10 minutes, has been that way for almost 3 weeks, and now feels like he cant even get any help. Any suggestions? Could this potentially become life threatening? Doctor: Hello, Thanks for the query to H.C.M.  Forum. There was elevated level of W B C but the level as you mentioned ( 13 000 c mm) is not very high . This level may be due to any mild  degree infection. Prednisolone  in itself causes fluid retention ,so please mention the the  dosage of prednisolone took your husband. Now his sgpt level is high  80 I U ,however this raised level is not an alarming condition and not so specific . As you stated that your husband is bed ridden  and feeling so tiredness and even breathlessness, so evaluation of diagnosis is very important . Further you mentioned that ultrasound is  normal at  normal at this time . Further stated that there is no fluid in abdomen . I would like to say that there is a very serious disorder according to your stated history of illness . In my opinion please consult another physician and get his opinion as this time condition is not good. In early stage if NASH ( NONALCOHOLIC STEATOHEPATITIS) fatigue & weakness are most important symptoms. While further symptoms are weight gain and cirrhosis . So don't delay. Good luck. Dr. HET