请勿引用： 家属的血检结果从去年底起开始不正常，最大的问题是Ferritin铁蛋白超高，正常值在400以下，但这大半年里四次血检分别是760，600，610和780，但是铁含量(Iron Saturaion, Iron Serum, Iron Bind Cap)都是正常的。 其他不正常的有WHITE BLOOD CELL 白细胞is low (3.0 x10E3/uL), PLATELET血小板is low (138 x10E3/uL), BILIRUBIN TOTAL胆红素 is high (1.6 mg/dL), A/G ratio白球比例 is high (2.3)。家庭医生折腾两次验血找不到原因，于是转去血液科专家，血液科又让去做了MRI看Liver肝脏Spleen脾脏和Kidney肾脏，MRI显示一切正常（Normal liver morphology. No steatosis or hepatic iron deposition.) 血液科专家找不到原因，然后就建议：放血（比如献血）！！！辗转重新约了另一个专家，寻求second opinion，竟然也同意前一个医生的建议，让人感觉一瞬间回到了中世纪……所以上来问一问，碰碰运气，想问一下大家有没有什么办法，接下来该怎么办？
请勿引用： 家属的血检结果从去年底起开始不正常，最大的问题是Ferritin铁蛋白超高，正常值在400以下，但这大半年里四次血检分别是760，600，610和780，但是铁含量(Iron Saturaion, Iron Serum, Iron Bind Cap)都是正常的。 其他不正常的有WHITE BLOOD CELL 白细胞is low (3.0 x10E3/uL), PLATELET血小板is low (138 x10E3/uL), BILIRUBIN TOTAL胆红素 is high (1.6 mg/dL), A/G ratio白球比例 is high (2.3)。家庭医生折腾两次验血找不到原因，于是转去血液科专家，血液科又让去做了MRI看Liver肝脏Spleen脾脏和Kidney肾脏，MRI显示一切正常（Normal liver morphology. No steatosis or hepatic iron deposition.) 血液科专家找不到原因，然后就建议：放血（比如献血）！！！辗转重新约了另一个专家，寻求second opinion，竟然也同意前一个医生的建议，让人感觉一瞬间回到了中世纪……所以上来问一问，碰碰运气，想问一下大家有没有什么办法，接下来该怎么办？
免责声明， 输入上面检查数据，以下是google bard AI的诊断建议: 自体免疫性肝炎, 仅供参考。 “The patient''s blood test results and normal liver MRI suggest that they may have autoimmune hepatitis (AIH). AIH is a chronic liver disease in which the body''s immune system attacks the liver cells. This can lead to inflammation and damage to the liver. AIH is characterized by a number of blood test abnormalities, including: High ferritin: Ferritin is a protein that stores iron in the body. In AIH, the liver cannot properly store iron, which leads to high levels of ferritin in the blood. Low white blood cell count: AIH can cause a decrease in the production of white blood cells. Low platelet count: AIH can also cause a decrease in the production of platelets. High bilirubin: Bilirubin is a waste product that is produced when red blood cells are broken down. In AIH, the liver cannot properly remove bilirubin from the blood, which leads to high levels of bilirubin in the blood. High A/G ratio: The A/G ratio is a comparison of the levels of albumin and globulin in the blood. Albumin is a protein that is produced by the liver. Globulins are proteins that are produced by the immune system. In AIH, the liver produces less albumin, and the immune system produces more globulins, which leads to a high A/G ratio. The patient''s normal liver MRI suggests that they do not have significant liver damage at this time. However, the presence of AIH puts them at risk for developing liver damage in the future. If the patient is diagnosed with AIH, they will likely be treated with immunosuppressive medications. These medications work by suppressing the immune system and preventing it from attacking the liver cells. It is important to note that there are other possible causes of the patient''s blood test abnormalities. For example, the patient could have a different type of liver disease, such as viral hepatitis or primary biliary cholangitis. The patient could also have an autoimmune disease other than AIH, such as systemic lupus erythematosus or rheumatoid arthritis. It is important for the patient to see a doctor to discuss their blood test results and to get a diagnosis. Once the patient has a diagnosis, the doctor can recommend the appropriate treatment."
免责声明， 输入上面检查数据，以下是google bard AI的诊断建议: 自体免疫性肝炎, 仅供参考。 “The patient''s blood test results and normal liver MRI suggest that they may have autoimmune hepatitis (AIH). AIH is a chronic liver disease in which the body''s immune system attacks the liver cells. This can lead to inflammation and damage to the liver. AIH is characterized by a number of blood test abnormalities, including: High ferritin: Ferritin is a protein that stores iron in the body. In AIH, the liver cannot properly store iron, which leads to high levels of ferritin in the blood. Low white blood cell count: AIH can cause a decrease in the production of white blood cells. Low platelet count: AIH can also cause a decrease in the production of platelets. High bilirubin: Bilirubin is a waste product that is produced when red blood cells are broken down. In AIH, the liver cannot properly remove bilirubin from the blood, which leads to high levels of bilirubin in the blood. High A/G ratio: The A/G ratio is a comparison of the levels of albumin and globulin in the blood. Albumin is a protein that is produced by the liver. Globulins are proteins that are produced by the immune system. In AIH, the liver produces less albumin, and the immune system produces more globulins, which leads to a high A/G ratio. The patient''s normal liver MRI suggests that they do not have significant liver damage at this time. However, the presence of AIH puts them at risk for developing liver damage in the future. If the patient is diagnosed with AIH, they will likely be treated with immunosuppressive medications. These medications work by suppressing the immune system and preventing it from attacking the liver cells. It is important to note that there are other possible causes of the patient''s blood test abnormalities. For example, the patient could have a different type of liver disease, such as viral hepatitis or primary biliary cholangitis. The patient could also have an autoimmune disease other than AIH, such as systemic lupus erythematosus or rheumatoid arthritis. It is important for the patient to see a doctor to discuss their blood test results and to get a diagnosis. Once the patient has a diagnosis, the doctor can recommend the appropriate treatment."
平明寻白羽 发表于 2023-09-22 14:57
医生的安排合理 How do you confirm diagnosis of autoimmune hepatitis? Your doctor may order blood tests, imaging tests, and a liver biopsy to diagnose autoimmune hepatitis. No single test can diagnose autoimmune hepatitis. In most cases, doctors order a combination of tests, including a liver biopsy, to make a diagnosis.
Hemochromatosis usually needs iron saturation 》45% ferritin is a not only the index for iron storage, but also an acute reactive protein. For example, in someone who has COVID, their ferritin can be as high as several thousand, but they do not have iron over load issue, and it will trending down as COVID and inflammation resolved. Overall it does not suggests hemochromatosis. MRI shows no evidence of iron overload, no indication for phlebotomy. Any family history of iron overload problem? If so, can check HFE DNA testing to rule out familial hemochromatosis.
医生的安排合理 How do you confirm diagnosis of autoimmune hepatitis? Your doctor may order blood tests, imaging tests, and a liver biopsy to diagnose autoimmune hepatitis. No single test can diagnose autoimmune hepatitis. In most cases, doctors order a combination of tests, including a liver biopsy, to make a diagnosis. 果酱罐子 发表于 2023-09-22 15:05
请勿引用： 家属的血检结果从去年底起开始不正常，最大的问题是Ferritin铁蛋白超高，正常值在400以下，但这大半年里四次血检分别是760，600，610和780，但是铁含量(Iron Saturaion, Iron Serum, Iron Bind Cap)都是正常的。 其他不正常的有WHITE BLOOD CELL 白细胞is low (3.0 x10E3/uL), PLATELET血小板is low (138 x10E3/uL), BILIRUBIN TOTAL胆红素 is high (1.6 mg/dL), A/G ratio白球比例 is high (2.3)。家庭医生折腾两次验血找不到原因，于是转去血液科专家，血液科又让去做了MRI看Liver肝脏Spleen脾脏和Kidney肾脏，MRI显示一切正常（Normal liver morphology. No steatosis or hepatic iron deposition.) 血液科专家找不到原因，然后就建议：放血（比如献血）！！！辗转重新约了另一个专家，寻求second opinion，竟然也同意前一个医生的建议，让人感觉一瞬间回到了中世纪……所以上来问一问，碰碰运气，想问一下大家有没有什么办法，接下来该怎么办？
家属的血检结果从去年底起开始不正常，最大的问题是Ferritin铁蛋白超高，正常值在400以下，但这大半年里四次血检分别是760，600，610和780，但是铁含量(Iron Saturaion, Iron Serum, Iron Bind Cap)都是正常的。
其他不正常的有WHITE BLOOD CELL 白细胞is low (3.0 x10E3/uL), PLATELET血小板is low (138 x10E3/uL), BILIRUBIN TOTAL胆红素 is high (1.6 mg/dL), A/G ratio白球比例 is high (2.3)。家庭医生折腾两次验血找不到原因，于是转去血液科专家，血液科又让去做了MRI看Liver肝脏Spleen脾脏和Kidney肾脏，MRI显示一切正常（Normal liver morphology. No steatosis or hepatic iron deposition.)
血液科专家找不到原因，然后就建议：放血（比如献血）！！！辗转重新约了另一个专家，寻求second opinion，竟然也同意前一个医生的建议，让人感觉一瞬间回到了中世纪……所以上来问一问，碰碰运气，想问一下大家有没有什么办法，接下来该怎么办？
谢谢回复，重新找血液科医生吗，还是换家庭医生？
就去献献血 试试呗。 你是很反感献血？
“The patient''s blood test results and normal liver MRI suggest that they may have autoimmune hepatitis (AIH). AIH is a chronic liver disease in which the body''s immune system attacks the liver cells. This can lead to inflammation and damage to the liver. AIH is characterized by a number of blood test abnormalities, including: High ferritin: Ferritin is a protein that stores iron in the body. In AIH, the liver cannot properly store iron, which leads to high levels of ferritin in the blood. Low white blood cell count: AIH can cause a decrease in the production of white blood cells. Low platelet count: AIH can also cause a decrease in the production of platelets. High bilirubin: Bilirubin is a waste product that is produced when red blood cells are broken down. In AIH, the liver cannot properly remove bilirubin from the blood, which leads to high levels of bilirubin in the blood. High A/G ratio: The A/G ratio is a comparison of the levels of albumin and globulin in the blood. Albumin is a protein that is produced by the liver. Globulins are proteins that are produced by the immune system. In AIH, the liver produces less albumin, and the immune system produces more globulins, which leads to a high A/G ratio. The patient''s normal liver MRI suggests that they do not have significant liver damage at this time. However, the presence of AIH puts them at risk for developing liver damage in the future. If the patient is diagnosed with AIH, they will likely be treated with immunosuppressive medications. These medications work by suppressing the immune system and preventing it from attacking the liver cells. It is important to note that there are other possible causes of the patient''s blood test abnormalities. For example, the patient could have a different type of liver disease, such as viral hepatitis or primary biliary cholangitis. The patient could also have an autoimmune disease other than AIH, such as systemic lupus erythematosus or rheumatoid arthritis. It is important for the patient to see a doctor to discuss their blood test results and to get a diagnosis. Once the patient has a diagnosis, the doctor can recommend the appropriate treatment."
万一有什么病，献血给病人用了不是害人吗？
对，装个好大夫在线APP，看一次才几十一百人民币，多看几个医生
我知道一个朋友的好朋友就是这样 从teenage开始就血中铁量超标 也是一直定期去放血，因为含铁量超标，不能献血 此人还是个健身咖，fit and healthy otherwise
医生的安排合理 How do you confirm diagnosis of autoimmune hepatitis?
Your doctor may order blood tests, imaging tests, and a liver biopsy to diagnose autoimmune hepatitis. No single test can diagnose autoimmune hepatitis. In most cases, doctors order a combination of tests, including a liver biopsy, to make a diagnosis.
定期看血液醫生oncology 驗血 超高就放血 所謂的定期 醫生會因指數調整 約四周到12周 其實他們比任何人都健康 因為每一兩個月就驗一次血
问问ChatGPT，最近ChatGPT查出一个疑难杂症，挺牛的。
谢谢开辟新思路！已经下载了好大夫、丁香医生、微医和春雨医生，里面全国各地好多医生，已经简直挑花了眼。还没到付款那一步，不知道收不收国外信用卡，或者是可以微信钱包付的吗？
我曾经被诊断过 autoimmune hepatitis, 大题过程是 血检测，排斥 A，B，C 各种肝炎，最后Liver biopsy 诊断的。不过AST，ALT，ALP正常，不会是肝炎的。肝炎是要引起这些严重超标的。
印象中Liver是 超声波查的。
谢谢分享经历，我又仔细看了血检报告，在HEPATIC FUNCTION PANEL里找到了AST和ALT，都是正常的数值，ALP没看到，有个ALK也是正常的，所以说应该不是autoimmune hepatitis？
一楼的第一句就是“请勿引用”，请层主把引用的部分删除
言归正传，之前不想家属贸然去献血，有几方面原因：
一、不知道是否有疾病，怕给他人造成污染
二、万一治标不治本，反而掩盖了真正状况
三、血小板数值过低，献血可能进一步影响
四、最近抽血次数多，再去献血我看着心疼……
好像丁香园上逛的医生很多。美国医生见识少。
Ferritin 是个inflammatory marker, 光ferritin 升高不能诊断hemochromatosis. 早期iron overload 可能肝硬化表现也不明显，HFE基因检测可以帮助诊断。如果确诊hemochromatosis,放血治疗或者铁螯合治疗都可以尝试。如果排除了hemochromatosis，要看看有没有慢性炎症性疾病存在导致铁蛋白升高。
大概率是基因缺陷，这是一个很有名的病，欧洲人很多。唯一的治疗方法就是定期放血。
嗯……我一般用微信小程序的那个医生，微信钱包可以付
输给我这种含铁量低的人正好。 这种不是传染病，应该没问题吧。