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Yellow Coloured Skin, Enlarged Spleen And Liver In The Child. Hepatitis C And B Negative. MCV Virus. Does High Heamoglobin Affect The Child?

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Posted on Thu, 4 Oct 2012
Question: my son 2 months and 6 days suffer from yellow color in skin and found conjcted probilin initilly 2.9 and after 2 weeks we found the spleen is large 7cm and the liver is large than normal.
we stopped breast feeding and he is in milk without luctoz
doctor ask to check for hepetis c and b but result negative.
he has mcv virus what to do now please help
i am the father suffering from hemoglobein high. i denote blood every 6 months . is this effecting my child case.
please till me why this enlarge and analysis said too much toxic material in blood
doctor
Answered by Dr. Ketan Vagholkar (2 hours later)
Dear XXXXXXX,

I can understand the stress on you. From the reports of your son it appears that he is suffering form CMV infection. The presence of hepatosplenomegaly in 1-5 month old infants is
indicative of congenital or perinatal CMV infection. It could have caused from the mother through the birth canal or via breast milk. The virus has adverse effects on every system of the body of the infant.

What your son now needs is to undergo an evaluation of the extent of involvement of the various systems, whether it is ongoing infection or passed infection. This may include antibody, antigen testing, pcr for blood viral load if antigen detected, CT (computed tomography) brain, Ultrasound of abdomen, bronchalveolar washings for lung disease etc. Once a baseline assessment is done then treatment can be commenced. This usually comprises of 2 components:
1. General supportive care with special reference to nutrition and preventing further infections with other organisms.
2. Antiviral therapy by way of a medicine called ganciclovir. This will act on the viral particles.
3. If immunity is a bit weak the CMV Ig that is ready made antibodies should be given.

The specialist whom you should contact in your country is pediatric hematologist/gastroenterlogist.

Regarding your blood problem , from the history it appears to be perhaps hemochromatosis. However your history details are not adequate for me to comment on your diagnosis.

I hope my analysis answers all your doubts and serves as a road map for treating your son.
With regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ketan Vagholkar (5 hours later)
thank doctor for your consultation.

I just would like to know how this virus reach mother. Is it from cat scratch because they have cats at house and the mother was attacked by one of them during pregnancy. or is it because of delivery unclean tools. I want to know what to do with the mother. should we make test. does it effect her next pregnancy.

the yellow color in his skin and pupil drcreases (almost none) and the general health of the child improves. The doctor says that his result improved and we should keep watching in 3 weeks time and do the test again.

should we keep quite for 3 weeks or do other tests you mentioned. We did ultrasound twice and found the sizes are decreasing.

mother stopped breast feeding. We are giving him s26 without luctoz. should we continue on this since his health improving. does it hurt him to take normal s26 with luctoz.
doctor
Answered by Dr. Ketan Vagholkar (17 hours later)
Dear XXXXXXX,
Thanks for writing back.
As long as your son is responding well , continue with the same protocol till he becomes absolutely normal. Do not change the current protocol. You should continue giving him s26 without lactose as he is recovering right now. We can hold on to the tests temporarily and repeat them after 3 weeks.
CMV is not transmitted by cats. The mode of CMV transmission from person to person is entirely unknown but is presumed to occur through bodily fluids. Infection requires close, intimate contact with a person secreting the virus in their saliva, urine, or other bodily fluids. CMV can be transmitted via breast milk, and also occurs through receiving transplanted organs or blood transfusions. Although CMV is not highly contagious, it has been shown to spread in households and among young children in day care centers.
Regarding testing of the mother, I would suggest that an ELISA be done. This test will help measure antibody levels in the mother. Both IgG and IgM levels ( types of antibodies) need to be tested. If there is a four fold rise in the IgG antibody levels and a significant level of IgM antibody, meaning equal to at least 30% of the IgG value, or virus is cultured from a urine or throat specimen, the findings indicate that an active CMV infection is present. In that case, her next child ( if she conceives right now) will also be affected.
I hope this clears all your doubts and helps you in resolving the issue.
With Regards
Note: For further follow up on digestive issues share your reports here and Click here.

Above answer was peer-reviewed by : Dr. Aparna Kohli
doctor
Answered by
Dr.
Dr. Ketan Vagholkar

Gastroenterologist, Surgical

Practicing since :1989

Answered : 883 Questions

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Yellow Coloured Skin, Enlarged Spleen And Liver In The Child. Hepatitis C And B Negative. MCV Virus. Does High Heamoglobin Affect The Child?

Dear XXXXXXX,

I can understand the stress on you. From the reports of your son it appears that he is suffering form CMV infection. The presence of hepatosplenomegaly in 1-5 month old infants is
indicative of congenital or perinatal CMV infection. It could have caused from the mother through the birth canal or via breast milk. The virus has adverse effects on every system of the body of the infant.

What your son now needs is to undergo an evaluation of the extent of involvement of the various systems, whether it is ongoing infection or passed infection. This may include antibody, antigen testing, pcr for blood viral load if antigen detected, CT (computed tomography) brain, Ultrasound of abdomen, bronchalveolar washings for lung disease etc. Once a baseline assessment is done then treatment can be commenced. This usually comprises of 2 components:
1. General supportive care with special reference to nutrition and preventing further infections with other organisms.
2. Antiviral therapy by way of a medicine called ganciclovir. This will act on the viral particles.
3. If immunity is a bit weak the CMV Ig that is ready made antibodies should be given.

The specialist whom you should contact in your country is pediatric hematologist/gastroenterlogist.

Regarding your blood problem , from the history it appears to be perhaps hemochromatosis. However your history details are not adequate for me to comment on your diagnosis.

I hope my analysis answers all your doubts and serves as a road map for treating your son.
With regards