â– Presented with fatigue and anorexia since 3mnths
â– Was evaluated elsewhere and was found to have deranged LFT
â– She resorted to CAMs following which she had yellowish discolouration of eyes and urine associated with intense pruritus
â– Currently pruritus resolved, but jaundice persists
â– No H/o GI bleed/ abdominal distention/ Joint pains/ skin rash
On evaluation
■HB – 11.5
■PLATELET – 1.6L
■S.IgG – 3699
■ANA profile – negative
■Anti LKM1 – negative
■ASMA – negative
■AMA – negative
■ANCA – negative
■UGI scopy – no varices
■Fibroscan – CAP- 223, E(kpa) – 46.1
■USG abdomen(28/09/20) – Altered and coarse echotexture of liver and caudate lobe hypertrophy
â– Borderline splenomegaly (12.5cms)
■USG abdomen (16/11/20) – Nodular liver with altered echogenicity and minimal ascites
MRCP(02/10/20)
Mild altered liver parenchymal signal intensity
Mild splenomegaly
Normal biliary system
■Liver biopsy- Marked areas of necrosis with loss of hepatic parenchyma and bile ductular reaction with moderate mixed inflammation – DDs – AIH /IgG4 related sclerosing cholangitis/DILI.
â– She was started on Wysolone 40mg 4weeks ago
â– Currently asymptomatic except for persistent jaundice