Gastroenterology MCQ 130

on with 0 comments

AUTOIMMUNE HEPATITIS ( Postgraduate Medicine)An 19 year-old beer-drinking college student develops nausea, vomiting and jaundice four weeks after returning from a one-week visit to Guatemala during Spring Break. He received no immunoprophylaxis prior to his travel. Serum ALT is 1400 U/L, serum bilirubin is 9 mg/dL, and IgM anti-HAV is detected. He recovers over the next 6 weeks with nearly normal ALT levels (48 U/L) and serum bilirubin of 1.8 mg/dL. Four weeks later he is referred to you because of increasing jaundice, bilirubin 7 mg/dL, re-elevation of serum ALT (420 U/L), and concern about the diagnosis by the primary care practitioner. The patient reports symptoms similar to those at the outset of his illness. Serologic studies reveal persistent presence of IgM anti-HAV. Additional studies include absence of markers of active HBV or HCV infection. IgG level and albumin are normal as is prothrombin time and alkaline phosphatase. An ANA is negative.
The most likely diagnosis at this point is:

a) recurrent acute alcoholic hepatitis

b) autoimmune hepatitis

c) acute hepatitis E

d) relapsing hepatitis A


Category: Gastroenterology MCQs



Post a Comment

Is there something you wish to add? Have something to say? Feel free to leave a comment.