1 Incomplete hepatitis B immunization, maternal carrier status and increased risk of liver diseases: A 20-year cohort study of 3.8 million vaccinees Hepatology, February 7, 2014 Evidence Based Medicine
2 Entecavir lamivudine in chronic hepatitis B patients with severe acute exacerbation and hepatic decompensation Journal of Hepatology, April 23, 2014
3 Measured versus estimated total liver volume to preoperatively assess the adequacy of the future liver remnant: Which method should we use? Annals of Surgery, November 1, 2013
4 Iron metabolic disorder in chronic hepatitis C: Mechanisms and relevance to hepatocarcinogenesis Journal of Gastroenterology and Hepatology, December 6, 2013
5 Liver stiffness measurement versus liver biopsy to predict survival and decompensations of cirrhosis among HIV/hepatitis C virus-coinfected patients AIDS, October 8, 2013 Review Article
Question: A 55-year-old woman in Chicago with known polycythemia rubra vera is admitted to the hospital because of the onset 4 days ago of right upper quadrant pain, followed by progressive abdominal distention and weight gain of 20 pounds. Her husband notes that her eyes look yellow. Physical exam is normal except: liver edge 10 cm below right costal margin, and shifting dullness. Labs studies are normal except hemoglobin 18 gm/dL, WBC count 15,200, bilirubin 12.6 mg/dL; AST 490; ALT 520; alkaline phosphatase 1.5 x upper limit. Acute hepatitis profile and all autoimmune markers are negative. An ultrasound report describes an enlarged liver without focal lesions or duct dilatation and massive ascites. The spleen is enlarged. Hepatic vessels were “abnormal.” Which requires further consideration?