| Provisional Diagnosis | - | Raynaud's Lt UL ?Thoracic outlelt obstruction yndrome ?Vasculitis Liver Dysfn ?Auto immune |
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| Final Diagnosis | - | Cryoglobulin induced Raynaud's LUL HCV infection |
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| History and Findings | - | Shock like pain Lt UL paroxysmal in nature s/o Raynaud's x 12yrs.H/o jaundice 3 epidodes in ths past & also in the family.Premarietal sex+,non alcoholic.MRI LS spine 5/4/11 diffuse annular disc bulge L4 L5,L5 S1 MRI Cervical spine 5/5/11 normal,MRI Brain normal |
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| Investigation | - | Hb-16.2,ESR-14,platelet-349.0,CRP-2.26,Creat-1mg,uric-6.3,ca-9.7,P-4.24,GGT-153.1,SGPT-120.6,SGOT-47.5,A/g-4.64/3.4,ALP-84,Ck-350.3,TSH-1.88,ATg-0.91,TPO-1,26,HbA1c-5.8%, ANA-neg,ceruloplasmin-38.12(normal)Fe-173.89,HBSAg,anti HCV,HIV screen neg,VDRL NR,TPHA neg,Doppler neck vessel normal,Doppler Lt UL arteries normal,USG neck normal,Cryoglobulins +ve,ECG-Wnl,cxr-Normal,anti HCV ELISA Neg,HCV RNA PCR qualitative+ve,HCV viral load quantitative < 15 +ve |
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| Treatment | - | Ecospirin/UDCA/Silymarin |
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| Follow Up | - | Pt asymptomatic/LFT improving |
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