A jaundiced 35- year- old white prostitute was evaluated for fatigue. Laboratory results were as foll What is the most likely diagnosis?

Complete blood count (CBC)—within normal limits
Urinalysis—2+ bilirubin
Renal function tests (BUN and creatinine)—within normal limits
Liver function tests—liver enzymes and bilirubin elevated
Electrolytes and glucose—within normal limits
Antinuclear antibody (ANA)—positive, speckled pattern
Antimitochondrial antibody—negative
Antismooth muscle antibody—positive
Antineutrophil cytoplasmic antibody (ANCA)—negative
Hepatitis A virus antibody—negative
Hepatitis B surface antigen—negative
Antibody to hepatitis B core antigen—negative
Antibody to hepatitis C antigen—negative
Anti-HIV—negative

Question

A jaundiced 35- year- old white prostitute was evaluated for fatigue. Laboratory results were as foll What is the most likely diagnosis?

Complete blood count (CBC)—within normal limits
Urinalysis—2+ bilirubin
Renal function tests (BUN and creatinine)—within normal limits
Liver function tests—liver enzymes and bilirubin elevated
Electrolytes and glucose—within normal limits
Antinuclear antibody (ANA)—positive, speckled pattern
Antimitochondrial antibody—negative
Antismooth muscle antibody—positive
Antineutrophil cytoplasmic antibody (ANCA)—negative
Hepatitis A virus antibody—negative
Hepatitis B surface antigen—negative
Antibody to hepatitis B core antigen—negative
Antibody to hepatitis C antigen—negative
Anti-HIV—negative

Quizplus · Accepted Answer

The presence of elevated liver enzymes and bilirubin, along with positive antinuclear antibody (ANA) in a speckled pattern and positive antismooth muscle antibody, are indicative of autoimmune hepatitis. The negative tests for viral hepatitis (A, B, and C) and the specific autoantibody profile help differentiate it from other conditions like primary sclerosing cholangitis, systemic lupus erythematosus (SLE), and primary biliary cirrhosis.

A Jaundiced 35- Year- Old White Prostitute Was Evaluated for Fatigue