Case 138

Medical History

35-year-old male patient attended in a hospital complaining of fatigue, weight loss and diarrhea for 8 months. On physical examination, he presents ascites and edema of lower limbs. There are not jaundice, rash, gynecomastia and telangiectasias. Previous history of splenectomy (hepatosplenic schistosomiasis) 11 years ago. Laboratory tests results: Albumin 2.2 g/dL; Total Cholesterol 429 mg/dL; AST 70 IU/L; ALT 71 IU/L; ALP 247 IU/L; GGT 229 IU/l. Serology positive for HBsAg, Anti-HBc IgG, Anti-HBE and Anti HAV IgG. Proteinuria (5,94g/24 hr); Urinalysis: hematuria (+ +/4 +). O&P negative.


Based on clinical history and images from microscopy, we can affirm that this patient has clinical signs of, except:

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