Male 45 years

Known Hepatitis C also has positive autoanibodies-?Autoimmune hepatitis.

Female 42 years

Abnormal normal liver functions. Asked for more information - PBC plus overlap autoimmune hepatitis (positive AMA strongly) and raised IGT along with touch up ALT and cholestatic LFTs. Medication = Naproxen. Viral screen negative. Alcohol consumption is very little. No family history.

Female 55 years

Patient with abnormal elevated ALT (86), normal Alk Phos. ? aetiology of abnormal river function tests. No alcohol. Negative autoantibodies, alpha 1 antitrypsin and viral screen. Possible type 2 diabetes.

Male 34 years

3x core liver biopsies obtained. The second fragmented (hence did a third). Derranged LFTs. Non targetted approach, biopsies from the right lobe. Non-fatty appearances of the liver or USS.

Gained extra information: The patient had a 2 year history of mildly elevated LFT and is known to have inflammatory bowel disease. Serology is negative. The last LFTs were back to normal. What else may you ask for?

Male 66 years

Derranged LFTs. Known NASH. HIV positive patient. 2x core biopsies from right liver lobe. 1yr hx deranged LFTs hepatocellular (ALT>500 and increased). Liver screen negative. Probable NAFLD - USS fatty liver and hepatosplenonnegaly. ?DILD - Truvada, Raltegravir, Dapsone. ? NASH, ?DILI - Ishak grading please.

Female 77 years

Derranged LFTs. Jaundiced. Hepatitis screen negative. ?seronegative hepatitis. Right liver lobe core biopsies. 1st core was good, second and third were tiny fragments, and 4th was good core.

Additional information: 'Presented with painless jaundice. Acute hepatitis on bloods and jaundiced (ALT 1700, bill >200). Not encepahlopathic and no coagulopathy. Had travelled recently to Turkey but form what recall was not unwell there. No recent abx/new meds. N fit and well. Liver screen negative: Hep A, B, C, E, EBV, CMV negative. Autoabx and A1AT normal. CT abdo: no liver abnormalities, ducts ok'.