Human placental lactogen (hPL) and β-human chorionic gonadotropin (β-hCG) in gastric aspirates and sera of 24 patients with malignant (12 patients) and non-malignant (12 patients) conditions of the stomach were studied. In patients with cancer of the stomach, hPL and β-hCGwere found to be present in gastric aspirate at higher frequency than in serum. The concentration of these hormones in gastric aspirate was higher than in serum. In 2 patients with duodenal ulcer β-hCGwas found to be present in gastric aspirate, 1 of them having the hormone in circulation as well, while none of the 12 patients with non-malignant conditions of the stomach showed presence of hPL in their gastric aspirate or serum.
A 22-year-old male presented with febrile illness, jaundice and tested positive for hepatitis A antibody. Along with these he was having hemolytic anemia and subsequently developed liver failure. This raised suspicion of Wilson's disease, which was confirmed by Kayser-Fleischer ring, raised serum and 24-hour urinary copper excretion. He was successfully treated with plasmapheresis so it is very crucial to investigate underlying chronic liver disease like Wilson's disease in appropriate clinical setting of hemolytic anemia and liver dysfunction. A timely diagnosis and prompt treatment with the plasmapheresis can be life-saving. To our knowledge this a first case report from India with Wilson's disease complicated by hepatitis A superinfection. This case demonstrates that relevant guidelines to be evolved for HAV vaccination in the susceptible population.
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