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Dig Dis Sci. 2014 May;59(5):933-6. doi: 10.1007/s10620-014-3114-6. Epub 2014 Apr 2.

A case of jaundice of obscure origin.

Author information

1
Division of Gastroenterology and Hepatology, Department of Medicine, University of New Mexico School of Medicine, Albuquerque, NM, USA, Fahadkhan527@gmail.com.

Abstract

BACKGROUND:

Idiopathic painless jaundice with significant elevations in serum transaminases, occurring in a previously healthy patient, invokes a circumscribed set of possibilities including viral hepatitis, auto-immune hepatitis (AIH) and drug-induced liver injury (DILI).

METHODS:

In this described case, common causes of cholestatic jaundice were considered including drug-induced liver injury, viral causes of hepatitis, and auto-immune antibodies. Biliary obstruction was excluded by appropriate imaging studies. Liver biopsy was obtained, though not definitive.

RESULTS:

After detailed investigation failed to reveal a cause of the jaundice, an empiric trial of steroids was initiated on the possibility that our patient had antibody-negative AIH and not DILI, with an associated grave prognosis.

CONCLUSIONS:

Empiric treatment with prednisone led to rapid resolution of jaundice and to the conclusion that the correct diagnosis was antibody-negative AIH.

PMID:
24691629
DOI:
10.1007/s10620-014-3114-6
[Indexed for MEDLINE]
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