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A Case of Jaundice of Obscure Origin

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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.

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Conflict of interest

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Authors and Affiliations

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

    Fahad M. Khan & Joseph Alcorn

  2. Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM, USA

    Joshua Hanson

  3. Department of Gastroenterology and Hepatology, MSC10-5550, 1 University of New Mexico, Albuquerque, NM, 87131, USA

    Fahad M. Khan

Authors
  1. Fahad M. Khan
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  2. Joseph Alcorn
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  3. Joshua Hanson
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Corresponding author

Correspondence to Fahad M. Khan.

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Khan, F.M., Alcorn, J. & Hanson, J. A Case of Jaundice of Obscure Origin. Dig Dis Sci 59, 933–936 (2014). https://doi.org/10.1007/s10620-014-3114-6

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  • DOI: https://doi.org/10.1007/s10620-014-3114-6

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