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Cryptogenic cirrhosis: or is it? An unusual case of portal hypertension
  1. Jan E Leyden1,
  2. Seamus Looby2,
  3. Christian Gulmann3,
  4. Stephen E Patchett1
  1. 1Department of Gastroenterology & Hepatology, Beaumont Hospital/Royal College of Surgeons in Ireland, Dublin, Ireland
  2. 2Department of Radiology, Beaumont Hospital/Royal College of Surgeons in Ireland, Dublin, Ireland
  3. 3Department of Pathology, Beaumont Hospital/Royal College of Surgeons in Ireland, Dublin, Ireland
  1. Correspondence to Dr Jan Leyden, Department of Gastroenterology & Hepatology, Beaumont Hospital/Royal College of Surgeons in Ireland, Dublin, Ireland; janleyden{at}eircom.net

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Clinical presentation

The patient presented with a 5-week history of abdominal swelling and malaise. She had no medical history apart from a mastectomy for breast cancer 21 years earlier. She consumed 6 units of alcohol per week. Physical examination revealed moderate ascites. Laboratory values were: bilirubin 49 (0–17) μmol/l; aspartate aminotransferase 80 (<35) U/l; alanine aminotransferase 190 (<35) U/l; γ-glutamyltranferase 252 (<58) U/l; alkaline phosphatase 386 (42–121), prothrombin time (PT) 17.9 s/ international normalised ratio (INR) 1.45, serum albumin 30 mg/l and platelet count 95×109/litre. The ascitic fluid cytology was benign. A viral, autoimmune …

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