8. Case of Autoimmune HepatitisHistory of Presenting Complaint: A 63-year-old male patient developed lethargy, weakness, and poor appetite in June 2021 after his first vaccine dose in February 2021. He was diagnosed with post-vaccine autoimmune hepatitis.
K/C/O HTN and DM
Pathology Reports: Bilirubin – 11.6; SGOT and SGPT – 800. Alkaline phosphatase – increased slightly. Smooth muscle antibody found positive ++ Anti-nuclear antibody – strongly positive + Total Immunoglobulin – 3000+.
CT scan and MRI: Mild stenotic type of change, with non-obstructive jaundice.
Treatment Plan: Treated with methylprednisolone, leading to normalization of bilirubin (0.9) and SGPT/SGOT (25).
Presenting Complaint: Four days ago, he developed severe fatigue, limb weakness, and dark urine; yellow discoloration of the eyes. Bilirubin was 6.4 and SGPT/SGOT ~600, so prednisolone 30 mg was restarted. HbA1c is 8 due to steroids.
Nature: Sensitive, mild, and accommodating. Helpful, and socially committed.
Stress (last 2 years): As society chairman, he discovered financial embezzlement by the secretary, leading to prolonged conflict. He experienced severe stress, night-time rumination, and despair for about a year. Currently, he feels detached and indifferent, saying he no longer cares about the issue.
Mind State: Anger triggered when blamed or ignored. Not aggressive and remains outwardly calm even when angry.
On Observation: Very weak and drowsy, slow in reacting. Put on a lot of weight due to steroids.
Physical Generals: Desires spicy, sour, juicy things++, fruits+; thermally warm agg.; urine dark yellow colored; perspires on the chest and back.
Past History: Bilateral renal stones, lithotripsy done; Urticaria.
Family History: Mother – Renal tumor; Father – COPD
AnalysisPhatak’s Materia Medica
Indifferent to everything. APATHETIC; from unequal struggling with adverse circumstances, mental and physical; obtuse, or torpid; with tendency to diarrhoea or sweatiness.
Comment: The above indications are an important state of acids, which is why they are often compared with sarcodes, as the two can appear very similar. Phosphoric acid reflects emotional burnout from overexertion, leading to exhaustion, indifference, and apathy. Before prescribing, key symptoms such as desire for fruit juices, despair, indifference, and marked fatigue should be confirmed.
Rx: Phosphoric acid 30C B. D. for 10 days followed by Phosphoric acid 200C B. D. for 2 days
Follow up on 2nd Dec 2021: Overall weakness has improved by about 30%, but symptoms relapsed, requiring steroid increase from 5 mg to 30 mg; currently on 25 mg Wysolone. Experiences intermittent electric shock–like pain in the left lateral thigh lasting 30–60 seconds, worse in the evening and at night (previously present as well). Head cloudiness and mildly elevated blood sugar due to steroids. Mentally, less irritable.
Pathology Reports: Hb – 13.3; SGPT – 276; SGOT – 119; Hepatitis antibody B – 184.87; Glucose fasting – 229; Alkaline phosphatase – 163; Gamma GT – 677; Bilirubin total – 1.97; Bilirubin direct – 1.76. Hepatitis A – reactive.
Follow up on 23rd Dec 2021: 40–50% better with less weakness and good appetite. Steroid-induced high sugars are controlled on insulin (16 U morning, 8 U night) and Janumet, while on Wysolone 20 mg daily. Vision is cloudy with increased eye power, and electric shock–like pain has reduced by ~70%. With LM potencies, he was feeling much better. Pathology Reports: Blood Sugar – 123; SGPT – 190; SGOT – 101; S. Bilirubin – T – 1.95; S. Bilirubin – D – 1.03.
Rx: Phosphoric acid 1M; Phosphoric acid LM6 O. D. for 30 days.
Insulinum 30C O. D. for 30 days
Follow up on 12th Jan 2022: Overall improvement with reduced weakness, good energy, and ability to work. Occasional finger cramps and mild current-like thigh pain. Visual cloudiness has decreased but persists. Mental state is stable. Pathology Reports: T bilirubin – 1.4; D. Bilirubin – 0.9; I. Bilirubin – 0.5.
To counteract the side effects of Wysolone such as dropsy, weakness, and obesity,
Cortisone 30C B. D. for 7 days (as a phasic remedy) was prescribed.
**Tautopathy started by RP Patel (India):
Potentisation of allopathic medicine in Homeopathic form.
Rx: Phosphoric acid 1M followed by Phosphoric acid LM7 O. D. for 15 days.
Cortisone 30C O. D. for 15 days
Follow up on 3rd Feb 2022: Overall, feeling better. Steroids doses are being tapered. Physical generals well maintained. Pathology Reports: Hb – 13.6; Bilirubin T – 1.23; Bilirubin Direct – 0.87; SGPT – 97; SGOT – 50; Gamma – 167.
Summary of Pathology Reports