A case of jaundice of obscure origin.

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.

• Authors: Fahad M Khan, Joseph Alcorn, Joshua Hanson
• Journal: Digestive diseases and sciences (Dig Dis Sci) Vol. 59 Issue 5 Pg. 933-6 (May 2014) ISSN: 1573-2568 [Electronic] United States
• PMID: 24691629 (Publication Type: Case Reports, Journal Article)

Chemical References

• Glucocorticoids
• Prednisone

Topics

• Female
• Glucocorticoids (therapeutic use)
• Hepatitis, Autoimmune (complications, diagnosis, drug therapy)
• Humans
• Jaundice (diagnosis, etiology, pathology)
• Middle Aged
• Prednisone (therapeutic use)