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61 yrs old known DM on ameryl HTN on amlodipine
for 10 yrs or more,
Presented with left side weakness, slurred speech, deviation of the mouth with nausea
Dark urine for 2 days before, with Vague abd pain, CT brain showed thrombosis MCA,
Pt also jaundiced
CBC low HP 7.8 and high retics blood film
neutrophilia and pitted cells no malaria plt normal
KFT normal ALT, AST normal
Indirect hyperbilrubenimia LDH 1000 CK high
Cardiac enzymes normal ECG normal Pt desaturating in room air down to 80s no SOB no
destress BP stable, RBS 16
Blood gas normal
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