Abstract

PYELONEPHRITIS IN HEMOCHROMATOSIS PATIENT WITH CHRONIC LIVER DISEASE

Stelvin Sebastian*, Aby Paul, Sanjo Saijan and Joel Joby

Abstract

Haemochromatosis is an inherited disorder in which iron overload leads to increased chance of invasive bacterial infection. A 48 year old male patient was admitted in the medical ward with chief compliants of fever, abdominal pain, dysuria and backache. His medical history was Chronic liver disease with portal hypertension, varicoses, Antral and duodenal erosion, Diabetes mellitus. He was a mild alcoholic, stopped 1 year back. Elevated serum ferritin(800ng/ml), a-fetoprotein (180ng/ml). Urine culture shows the he avy growth of Ecoli (urine), staphylococcus aureus(sputum), CT evidence of focal lesion in liver, nephromegaly consistent with pyelonephritis, since iron overload may cause hepatotoxicity, hepatocarcinogenecity, and compromise the ability of phagocytes it should need to adjust dose(child pugh score=grade c), avoid iron supplements from own medications, proper antibiotic need to be provided to prevent the infection and phlebotomy has to be suggested to minimize the iron overload.

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