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