RT Book, Section
A1 Smith, Mindy A.
A1 Mathai, Angie
A2 Usatine, Richard P.
A2 Smith, Mindy A.
A2 Mayeaux, Jr., E.J.
A2 Chumley, Heidi S.
SR Print(0)
ID 1164347716
T1 Liver Disease
T2 The Color Atlas and Synopsis of Family Medicine, 3e
YR 2019
FD 2019
PB McGraw-Hill Education
PP New York, NY
SN 9781259862045
LK accessmedicine.mhmedical.com/content.aspx?aid=1164347716
RD 2024/04/24
AB A  64-year-old  woman  presents  with  complaints  of  itchy  skin  and  fatigue.  She  is  noted  on  physical  examination  to  have  scleral  icterus  and  jaundice  (Figure  63-1).  Laboratory  testing  revealed  elevated  liver  enzymes,  particularly  the  serum  alkaline  phosphatase  and  γ-glutamyltranspeptidase,  and  positive  antinuclear  and  anti-mitochondrial  antibodies.  A  liver  biopsy  confirmed  primary  biliary  cirrhosis.  Two  months  later,  she  vomited  up  some  blood  and  on  endoscopy  was  found  to  have  esophageal  varices  from  her  portal  hypertension  (Figure  63-2).