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Suffering From Acute Jaundice. Should I Be Concerned About High ESR And Haemoglobin Level?

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Posted on Wed, 28 Nov 2012
Question: Hi My Dad is 67 years of age, Recently he had been hospitalised for acute jaundice.Post that the biliburin level was always 1.5 & his heamoglobin a week back was 8.So he was adiced by a gastro to take the below tests
Complete Heamogram
Random Blood Sugar Test
Blood Urea Test
Creatinine Test
Liver Function Test
HBAIC test
HBSAG (Elisa) Test
XCV (Elisa) Test
U.Routine test
Reticolocyte Count test
Electrophorosis (Serum) Test
Peripheral Blood Smear Test

All the above tests are normal. His ESR is high measuring around 100 & his heamoglobin has increased to 9. Is there a cause of concern.....

doctor
Answered by Dr. Sadiq Mughal (3 hours later)
Hi XXXXXXX

Thanks for sharing your concern with is.

I am presuming that your 67 year old Dad, had an attack of acute Hepatitis,(the cause of which you have not mentioned)along with acute renal insufficiency( that is what I can understand from history)and bilirubin is 1.5, which is nearly normal (Normal is upto 0.9).
His hemoglobin has improved from 8gm/dl to 9gm/dl.
His gastroenterologist advised him a battery of investigations, which, according to you are all normal, except the ESR,which is markedly raised (100).
Increased ESR is a sign of inflammatory condition somewhere in body, but doesn’t tell you where inflammation is located.
There are many causes for raised ESR,but markedly raised ESR more 100 usually has an obvious cause.
Most common causes for markedly increased ESR are:
No 1 Infection.
It is the leading cause of extremely elevated ESR.
No 2 Collagen vascular Disease;
Commonly polymyalgia rheumatic and temporal arteritis
No 3 Anaemia.
No 4 Renal Disease.
No 5 Metastatic Malignant Tumor

Out of the five most common causes of markedly raised ESR, your Dad is having three, that is infection ,renal disease and anemia.
You have not mentioned in history cause of his hepatitis and his liver function test, from which one can assess and how advanced liver disease he has? Or, how much he has recovered from hepatitis.
However improvement in haemoglobin and decrease in bilirubin are good sign and indicate that you dad is recovering from Hepatitis as well as from renal insufficiency.
I would like to see complete investigation profile of your Dad to comment on his health status.
I pray for an early recovery for your Dad.
Best regard.

Above answer was peer-reviewed by : Dr. Aparna Kohli
doctor
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Follow up: Dr. Sadiq Mughal (10 hours later)
Dear Sir,

I am in Mumbai & my DAD is in Kerala. The reports are with him. I will try to get all the reports to Mumbai & post it to you but that will take some time.

Thanks a lot for your support & advice.

XXXXXXX
doctor
Answered by Dr. Sadiq Mughal (2 hours later)
Hello XXXXXXX

I appreciate your concerns. You can take your time and post the details to me. You can either use upload option of this website or mail to my attention (Attn: Dr. Sadiq Mugal) and post it to YYYY@YYYY

As I have already mentioned decreasing bilirubin and improvements in haemoglobin is sign of recovery from hepatitis.

Take care of your Dad and I wish him early recovery

Regards

Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Sadiq Mughal (29 minutes later)
Dear Dr XXXXXXX

Thank u very much. I will post the details once i receive the same. Just for your information as far his history is concerned,

He was admitted in the hospital on the 13th of Sept'12 with high fever & weakness. After his fever came down which was due to congestion in the chest, there was some discomfort in the stomach after which it was diagnised jaundice. He was given very high antibiotics for 2 weeks in the hospital & he has been on these antibiotics till now as we speak. Since last week he actually started feeling the urge to have food & he has started having very little food because of the restrictions one has when the have jaundice.

The above is the brief history how the problem started.

Thanks
XXXXXXX
doctor
Answered by Dr. Sadiq Mughal (6 hours later)
Hi XXXXXXX

Thanks for posting detailed history of your dad.

I have gone through the detailed history of your Dad.

Kindly post investigations of your dad at your earliest, so that two (history and investigation) can be put together to reach at a conclusion regarding condition of your Dad.

Take care.
Regards
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Sadiq Mughal

Critical Care Specialist

Practicing since :1992

Answered : 1661 Questions

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Suffering From Acute Jaundice. Should I Be Concerned About High ESR And Haemoglobin Level?

Hi XXXXXXX

Thanks for sharing your concern with is.

I am presuming that your 67 year old Dad, had an attack of acute Hepatitis,(the cause of which you have not mentioned)along with acute renal insufficiency( that is what I can understand from history)and bilirubin is 1.5, which is nearly normal (Normal is upto 0.9).
His hemoglobin has improved from 8gm/dl to 9gm/dl.
His gastroenterologist advised him a battery of investigations, which, according to you are all normal, except the ESR,which is markedly raised (100).
Increased ESR is a sign of inflammatory condition somewhere in body, but doesn’t tell you where inflammation is located.
There are many causes for raised ESR,but markedly raised ESR more 100 usually has an obvious cause.
Most common causes for markedly increased ESR are:
No 1 Infection.
It is the leading cause of extremely elevated ESR.
No 2 Collagen vascular Disease;
Commonly polymyalgia rheumatic and temporal arteritis
No 3 Anaemia.
No 4 Renal Disease.
No 5 Metastatic Malignant Tumor

Out of the five most common causes of markedly raised ESR, your Dad is having three, that is infection ,renal disease and anemia.
You have not mentioned in history cause of his hepatitis and his liver function test, from which one can assess and how advanced liver disease he has? Or, how much he has recovered from hepatitis.
However improvement in haemoglobin and decrease in bilirubin are good sign and indicate that you dad is recovering from Hepatitis as well as from renal insufficiency.
I would like to see complete investigation profile of your Dad to comment on his health status.
I pray for an early recovery for your Dad.
Best regard.