Today we had a patient with unremarkable PMH presenting with jaundice. LFTs were in the 1000s, a clinical scenario with limited DDx. They ultimately had liver biopsy and diagnosed with autoimmune hepatitis.

Take home points:

  • Pale/grey stools and dark urine are associated with conjugated (and not unconjugated) hyperbilirubinemia with narrower DDx

  • AST/ALT > 1,000 has a limited differential, including drug-induced liver injury, autoimmune hepatitis, and viral hepatitis

  • Recognize the types of autoimmune hepatitis (including DIAH and overlap syndromes) with their associated antibodies and different prognosis / treatment


Some more information can be found here AAH – 10.11