{"id":2445,"date":"2023-01-24T13:46:56","date_gmt":"2023-01-24T12:46:56","guid":{"rendered":"https:\/\/angh.net\/abstracts\/un-cas-clinique-qui-casse-des-briques\/"},"modified":"2023-01-24T13:46:56","modified_gmt":"2023-01-24T12:46:56","slug":"un-cas-clinique-qui-casse-des-briques","status":"publish","type":"post","link":"https:\/\/angh.net\/abstracts\/un-cas-clinique-qui-casse-des-briques\/","title":{"rendered":"Un cas clinique qui casse des briques !"},"content":{"rendered":"<p><strong>2022<\/strong><\/p>\n<p><em>Nadia Darwane, Isabelle Rosa, Mathias Vidon, Anne Wampach<\/em><\/p>\n<p><strong>H\u00e9patologie <\/strong>&#8211; \u00a02022-05-02 &#8211;\u00a0CC &#8211;<\/p>\n<p>________________________________<\/p>\n<p>Mme M-A, 52 ans, se pr\u00e9sente \u00e0 votre consultation fin Ao\u00fbt 2021 adress\u00e9e par son m\u00e9decin traitant, pour ict\u00e8re avec prurit.<\/p>\n<p>Elle n\u2019a pas d\u2019ant\u00e9c\u00e9dents m\u00e9dicaux-chirurgicaux, a 2 enfants en bonne sant\u00e9, ne fume pas, ne consomme pas d\u2019alcool.<\/p>\n<p>D\u00e9but Ao\u00fbt 2021, dans les suites d\u2019une infection \u00e0 COVID-19, elle a pr\u00e9sent\u00e9 un ict\u00e8re avec prurit, sans l\u00e9sion cutan\u00e9e, associ\u00e9 \u00e0 une perte de poids de 4 kg, pour lequel elle a consult\u00e9 son m\u00e9decin traitant. Il n\u2019existe pas de prise de m\u00e9dicaments, pas de consommation de drogues, elle n\u2019a jamais voyag\u00e9 en dehors de la France hormis pour aller au Portugal.<br \/>\nLe bilan biologique r\u00e9alis\u00e9 le 04\/08\/2021 montrait : GB 6,8 G\/L CRP 1 mg\/l Hb 12,1 g\/dl ASAT 3N ALAT 5N PAL 2N GGT N bilirubine totale 30 \u00b5mol\/l.<br \/>\nLe bilan biologique r\u00e9alis\u00e9 le 28\/08\/2021 montrait : GB 6,9 G\/L CRP < 0,6 mg\/l Hb 12 g\/dl ASAT 40 UI\/L ALAT 34 UI\/L PAL 4N GGT 1,5N bilirubine totale 277 \u00b5mol\/l dont 246 de bilirubine conjugu\u00e9e TP 69%. S\u00e9rologies VIH, VHB, VHC, VHA, VHE n\u00e9gatives, s\u00e9rologies EBV CMV profil immunis\u00e9.\nElle vous ram\u00e8ne \u00e9galement les r\u00e9sultats d\u2019une \u00e9chographie abdominale r\u00e9alis\u00e9e en ville le 17\/08\/2021 : foie r\u00e9gulier non dysmorphique, pas d\u2019ascite, pas de dilatation des voies biliaires intra ni extra h\u00e9patiques, v\u00e9siculaire biliaire alithiasique.\n\nL\u2019examen clinique en consultation ne retrouve qu\u2019un ict\u00e8re cutan\u00e9o-muqueux avec d\u2019importantes l\u00e9sions de grattage. Elle p\u00e8se 43 kg contre 47 kg fin Juillet 2021, pour une taille de 1m61.\n\nIntrigu\u00e9 par cette patiente, vous poursuivez l\u2019enqu\u00eate diagnostique avec d\u2019autres examens compl\u00e9mentaires : un bilan d\u2019auto-immunit\u00e9 qui s\u2019av\u00e8re \u00eatre normal, et une IRM des voies biliaires \u00e9galement normale.\n\nParall\u00e8lement \u00e0 ce bilan, le tableau clinique et biologique de la patiente commence \u00e0 s\u2019am\u00e9liorer spontan\u00e9ment\u2026\n\nQue vous inspire ce tableau clinique ? Comment avanceriez-vous pour confirmer ou infirmer vos hypoth\u00e8ses diagnostiques ?\n\nSuite au prochain \u00e9pisode !\n<\/p>\n","protected":false},"excerpt":{"rendered":"<p>2022 Nadia Darwane, Isabelle Rosa, Mathias Vidon, Anne Wampach H\u00e9patologie &#8211; \u00a02022-05-02 &#8211;\u00a0CC &#8211; ________________________________ Mme M-A, 52 ans, se pr\u00e9sente \u00e0 votre consultation fin Ao\u00fbt 2021 adress\u00e9e par son m\u00e9decin traitant, pour ict\u00e8re avec prurit. Elle n\u2019a pas d\u2019ant\u00e9c\u00e9dents m\u00e9dicaux-chirurgicaux, a 2 enfants en bonne sant\u00e9, ne fume pas, ne consomme pas d\u2019alcool. D\u00e9but [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[3],"tags":[35],"class_list":["post-2445","post","type-post","status-publish","format-standard","hentry","category-hepatologie","tag-35"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.2 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Un cas clinique qui casse des briques ! - Abstracts des congr\u00e8s de l&#039;ANGH<\/title>\n<meta name=\"description\" content=\"ANGH R\u00e9sum\u00e9s congr\u00e8s H\u00e9patologie Gastroent\u00e9romogie Hepatology Gastroenterology Etudes cliniques Clinical study\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/angh.net\/abstracts\/un-cas-clinique-qui-casse-des-briques\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Un cas clinique qui casse des briques ! 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