Question 1

I have been suffering from acute Hepatitis E infection for the past 3 weeks. My liver enzymes have decreased significantly but are still above the normal range. However, my bilirubin has remained very high at 18 for the past 2 weeks, having risen from 2.13 to 6.23 to 18.77. My attending physician has suggested steroids to help reduce bilirubin. Are steroids safe to use in this situation, and if taken, is there a risk of a rebound increase in bilirubin after a few days or weeks? My PT/INR had also increased but is now normal. Please advise on whether I should take steroids.

Question 2

Please advise the criticality of this clinical pathology report at present and in the future. What treatment should be taken as prevention is better than cure? My test results are bilirubin direct 0.40 mg/dl with a range of 0 to 0.3, bilirubin indirect 1.4 mg/dl with a range of 0 to 1.1, and bilirubin total 1.80 mg/dl with a range of 0.2 to 1.3.

Question 3

Hi, I am very tense as my report shows high PDW, high RDW, low PCT, and high bilirubin. Please see the report and tell me whether this is very serious. I had a kidney stone problem, and most stones were expelled through urine; only one small stone is left. I am having gastric issues. Three months ago, I had severe gastric problems, but after taking rabeprazole for 45 days, the symptoms decreased. My KFT and iron reports are normal. Please advise?

Mildly raised bilirubin with normal enzymes (SGPT/SGOT) is okay post fever. You are recovering well. Keep hydrated and rest.

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