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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Tonsillitis With Pus Pockets And Gallbladder Sludge?

My 17 yr.old grandson got what seemed like tonsiliti a mo. ago-had pus pockets on his tonsils-went and had a throat culture for strept that came back negative-then about a week later developed jaundice and has gone to a pediatric gastorenterologist-she has run all the tests for hep ABC that came back negative-also mono tests--did 2 ultrasounds and saw gallbladder "sludge" and put him on ursodil {sp} and did a liver biopsy and an MRI recently-his enzymes and billirubin are way up- They are very upset as they cant seem to find out the cause.-Meanwhile he is so yellow . He has a low grade temp and diarrhea-he has had Vit K intrvenously and also an injection of vit K. -He is 5"11 and weighed 145 now is down to 128-They have sent the liver biopsy to have a 2nd opinion on it-they are leaning toward Wilson's disease- Is there anything else that can be done to find out the cause? they also checked for cyclomegalovirus{sp} and that came back negative-
Tue, 28 Jan 2014
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General Surgeon 's  Response
HI. Wilson's disease is usually manifested in this age group only. There is no totally reliable test for Wilson's disease, but levels of ceruloplasmin and copper in the blood, as well of the amount of copper excreted in urine during a 24-hour period, are together used to form an impression of the amount of copper in the body. The gold standard or most ideal test is a liver biopsy. So let us wait till the second opinion is sought. MRI of liver would have ruled out other causes of jaundice. Additionally one can go for the MRI of the brain. Can you please post other reports and the treatment going on at the moment?
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What Causes Tonsillitis With Pus Pockets And Gallbladder Sludge?

HI. Wilson s disease is usually manifested in this age group only. There is no totally reliable test for Wilson s disease, but levels of ceruloplasmin and copper in the blood, as well of the amount of copper excreted in urine during a 24-hour period, are together used to form an impression of the amount of copper in the body. The gold standard or most ideal test is a liver biopsy. So let us wait till the second opinion is sought. MRI of liver would have ruled out other causes of jaundice. Additionally one can go for the MRI of the brain. Can you please post other reports and the treatment going on at the moment?