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Q. I started to have symptoms of jaundice, diarrhea and fatigue after cannabis smoking. What to do?

Answered by
Dr. Bhavin Bhupendra Vasavada
and medically reviewed by Dr. K Shobana
This is a premium question & answer published on Feb 01, 2021

Hi doctor,

I am a male with normal weight. I do not drink alcohol but I have a habit of cannabis smoking. It did it for a couple of years with short intermittent pauses for two to three weeks. I started to have symptoms of jaundice, diarrhea, and fatigue at the end of the month. I do not had any other previous symptoms on that month. I do not have any other diseases. My transaminase was normal and it was checked during the routine blood work. I have attached the reports. I did an abdominal CT with contrast and the result was normal. Plasmapheresis was done and a liver function test was also done. I had an AST of 800, ALT of 450, and total bilirubin was 12 mg/dL. After three days, I had an AST of 1010, an ALT of 505, and had total bilirubin of 14 mg/dL. During this period, I had a weight loss of 10 to 15 kilograms and my appetite was normal. I want to know my differential diagnosis and prognosis. Please suggest.

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#

Hi,

Welcome to icliniq.com.

Please send the reports of prothrombin time and international normalized ratio. You can have a diagnosis of acute or chronic liver failure where the acute component can occur due to cannabis and the chronic component can be due to hepatitis B induced with chronic liver disease. Please send your HBV (hepatitis B) DNA (deoxyribonucleic acid) quantitative report.

Thank you doctor,

I have sent the reports asked by you. I am willing to add an upper GI endoscopy report and it was with normal results.

#

Hi,

Welcome back to icliniq.com.

The reports are good. You have acute or chronic liver failure due to acute HBV infection or due to the use of cannabis. I suggest you stop using Cannabis and wait for 15 days. Repeat liver function test. If there is no decrease, then you need to do a liver biopsy to confirm the diagnosis. Liver biopsy is done with the liver USG (ultrasound) guided with a needle and the removed tissue is examined under a microscope. Report to the doctor when you have a change in consciousness or drowsiness or an increase in sleepiness.


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