Seeing Ms. Fang's condition getting worse day by day, she seemed to become depressed, indifferent, depressed, and had poor sleep. Her boyfriend was ready to change to another hospital and was already contacting all kinds of relatives and friends.

The gynecologist himself was also very upset. When he checked the rounds, he saw Ms. Fang was in a low spirit and had poor sleep. Don’t be afraid of mental problems. After all, normal people can’t stand such a big disease.

On this day, Ms. Fang's boyfriend found the doctor and said that he would find that the patient's palm would tremble. Is there something wrong?

It can be seen that he is very nervous. For so many days, he probably hasn't had a good rest and his eye sockets are almost trapped in.

When the gynecologist heard this, he was immediately alert. Could it be that hepatic encephalopathy had occurred!

Hepatic encephalopathy is mentioned repeatedly during consultation by gastroenterologists. We must avoid related aggravation factors to avoid sharp decline in liver function or even hepatic encephalopathy. The so-called hepatic encephalopathy refers to severe loss of liver function, which causes brain dysfunction due to various reasons (mainly increased blood ammonia). Patients will initially change their personality, mental abnormalities, and wing-like tremors on both upper limbs. In severe cases, they will soon become drowsy, behavioural abnormalities (disheveled clothes, urination and defecation everywhere), and even fall into a coma and die.

The patient is trembling now and is in poor spirits recently. Is it really hepatic encephalopathy?

But it wasn't right. The blood ammonia I checked yesterday was still normal. Why did he have hepatic encephalopathy? No, I have to ask a gastroenterologist to come over again, and even transferred to their department for treatment. The gynecologist rushed to the ward quickly while thinking.

The Department of Gastroenterology rushed over again and checked the patient.

Ms. Fang was tired at this time and her face turned yellow. She did have slight tremors on her palms.

In addition to palm tremors, the gastroenterology department also discovered a strange phenomenon.

When the doctor was talking to Ms. Fang, she found that her facial expression was weird and she seemed to be smiling. Sometimes there were some movements that seemed to be dancing on her hands. This shouldn't be true. She was so sick that she still had the heart to practice dancing.

Doctor, is she... mentally malfunctioning? The patient's boyfriend asked the gastroenterologist behind the ward. He always thought that the patient was seriously ill and had a lot of mental stress and collapsed. It was so pitiful.

Strange.

Suddenly, the gastroenterologist thought of a more rare disease and felt a surge of mood, both excited and scared.

The patient seems to have mental changes. Judging from the patient's current liver function, it is unlikely to be hepatic encephalopathy, and the blood ammonia is not high, which is not supported. How can ordinary cirrhosis have mental abnormalities?

Unless a disease.

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In addition to causing mental symptoms and neurological symptoms, this disease can also lead to cirrhosis. No wonder I couldn't find the cause of cirrhosis in the patient before. It turned out that it was so hidden. It was also because I was careless. The digestive physician couldn't help but feel upset.

In order not to increase the psychological burden on patients and their families, the gastroenterologist privately told the gynecologist that it may be degeneration of the liver nucleus, which will lead to cirrhosis and mental and neurological abnormalities.

The gynecologist is confused. She has never heard of this disease before.

Yes, let’s ask a neurologist to come and have a look. Degeneration of the liver bean-like nucleus is a rare hereditary disease. Due to the lack of a certain gene, it causes copper metabolism disorders in the patient’s body (yes, in addition to iron, there is also copper in the human blood). Deposition of some copper in the liver will lead to cirrhosis. Deposition of the brain bean-like nucleus will lead to brain dysfunction, and deposition in the kidney will lead to renal abnormalities. In addition, there is a very typical change. When copper is deposited near the cornea, it will cause eye abnormalities. During a slit lamp examination, you will find that there is a green-brown ring at the junction of the cornea and the sclera, called the k-f ring. This is the most typical sign of degeneration of the liver bean-like nucleus. There will be no other diseases, and this is the only one. The digestive doctor will become more and more excited the more he says.

On the same day, a neurologist was invited to come over, comprehensively evaluate the patient's condition, and agreed to consider the degeneration of the liver bean-shaped nucleus. Immediately took blood to test for serum copper, certroplasmin, etc., and I also asked the ophthalmologist to perform a slit lamp examination for the patient.

Under the slit lamp, the patient has this typical k-f ring in both eyes.

Since then, the patient's diagnosis has almost been clear.

I also have to do a skull MRI, the neurologist said. I had an appointment for MRI early in the morning, but because there were too many people in line and I didn’t make an appointment for a long time, I didn’t do it. This time the director called the imaging department directly and asked me to help me get in the queue to do it in advance.

The results of the head MRI also came out, and the bilateral basal ganglia, pons and midbrain had symmetric patchy patch-like t1 length t2 abnormal signal shadows.

The serum copper results were also released, which was significantly reduced. Later, a liver copper test was performed, and Ms. Fang's liver copper content was much higher than that of normal people.

Finally, the truth was revealed.

The patient's cirrhosis is caused by the degeneration of the liver bean-like nucleus. This name sounds strange, but it is actually the liver degeneration, the brain bean-like nucleus degeneration, and the degeneration of the liver bean-like nucleus. It is caused by the lack of genes, which leads to copper metabolism disorders and copper accumulation in these places.

Looking back, the patient's amenorrhea is probably caused by degeneration of the hepatocephala nucleus, which may affect the pituitary gland, or it may be caused by cirrhosis, which leads to decreased hormone inactivation and amenorrhea. It is not just the primary gynecological and endocrine problems. How can Chinese medicines be cured by just a few months of Chinese medicine? However, it is not ruled out that some Chinese medicines such as rhubarb, coptis chinensis, Houttuynia cordata, etc. can diuresis or expel copper and have certain effects.

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(The red dot is the pituitary gland in the brain)

Even if the diagnosis is clear, Ms. Fang cannot cure it because it is a genetic disease. Ms. Fang's aunt died of cirrhosis and might have this disease, but there is no evidence of death.

The main treatment is to reduce copper intake, such as nuts, chocolate, peas, corn, mushrooms, etc., and you can no longer eat them. Then you can prevent the absorption of copper. Using some iron agents can compete to inhibit the absorption of copper in the intestines and promote the excretion of feces. In addition, the key is copper excretion treatment. Many drugs such as d-penicillamine, etc. can promote the excretion of copper in the blood and tissue fluid, which is the key to treatment.

In addition, Ms. Fang has developed mental and neurological symptoms and needs to undergo corresponding symptomatic treatment.

If this disease can be detected early and treated in time, most of the patients can live well. A few cases of delayed and delayed may cause severe cirrhosis, liver failure and death.

After one month of treatment, the patient's overall condition recovered well.

Later, as everyone expected, Ms. Fang's menstruation returned. The intimate couple in the ward was envied by many people, thinking that this should be the appearance of love. Only a few doctors and the parties involved knew that it was indeed not easy to live.
Chapter completed!