Case 38-1980: A 44-Year-Old Man with Thrombocytosis, Hypoalbuminemia, and Gastrointestinal Bleeding

Presentation of Case A 44-year-old man was admitted to the hospital because of gastrointestinal bleeding. There was a long history of alcohol abuse, accompanied by a seizure disorder that was controlled with phenytoin sodium. Five years before admission peripheral edema developed. One year later ascites was found, and results of tests of liver function were slightly abnormal. Three years before entry the patient discontinued phenytoin sodium, and two weeks later he returned to this hospital because of confusion that followed a grand-mal seizure. On physical examination he appeared chronically ill and confused. The liver and spleen were not felt, and . . .