A rare cause of painful hepatomegaly

A 50-year-old female was admitted to our inpatient service due to abdominal pain, nausea, and progressive fatigue. The symptoms started a few weeks before hospitalization when she was treated with oral antibiotics for a dental infection. Vitals were normal. Physical examination showed an enlarged liver and bilateral leg edema. Medical history included smoldering myeloma (diagnosed a few weeks before admission), autoimmune thyroiditis (since 2018), and Sjogren ’s syndrome (since 2020). Labs demonstrated leukocytosis (15x109/L, with an upper limit of normal [ULN] of 11x109/L), normocytic anemia (hemoglobin 11 g/dl), normal platelet count, international normalized ratio of 1.5, normal bilirubin, slight elevation of aspartate aminotransferase (66 U/L; ULN: 45 U/L), normal alanine aminotransferase, significant increases in gamma-glutamyltransferase (241 U/L; ULN: 45 U/L) and alkaline phosphatase (ALP: 404 U/L; ULN: 214 U/L), and a modest increase in C-reactive protein (14 mg/L; ULN: 5 mg/L).
Source: Journal of Hepatology - Category: Gastroenterology Authors: Tags: What Is Your Diagnosis? Source Type: research