Don’t Miss the BoAAT: Correctly Diagnosing Acute-on-Chronic Liver Disease
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A 48-year-old male with diabetes and hyperlipidemia was referred to the Hepatology Outpatient Clinic with acute elevation in serum concentrations of liver enzymes. During preoperative evaluation for an elective knee arthroplasty 10 months previously, he had been diagnosed with cirrhosis, based on thrombocytopenia and the finding of a nodular liver as assessed by ultrasound scanning. The cirrhosis was presumed due to nonalcoholic fatty liver disease; his primary care physician managed the patient. Subsequently, he had an acute elevation of serum concentrations of liver enzymes and was referred to the Hepatology Clinic for further evaluation.
The patient complained of having a poorly defined pain in his right upper quadrant for 8 weeks. He recalls having had an upper respiratory tract illness treated with amoxicillin 10–12 weeks before presentation. On review, he had no other symptoms. He was living a relatively normal healthy life, devoid of symptoms or previous illness other than...
KeywordsAlpha 1 Antitrypsin Deficiency Cirrhosis Acute-on-Chronic Liver Disease Elevated Liver Enzymes
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