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Nutmeg liver, fever and elevated liver enzymes in a young man
  1. Aleksandar Gavrić1,
  2. Rok Dežman2,
  3. Branislava Ranković3,
  4. Marija Ribnikar1,
  5. Borut Štabuc1
  1. 1 Department of Gastroenterology and Hepatology, University Medical Center Ljubljana, Ljubljana, Slovenia
  2. 2 Institute of Radiology, University Medical Center Ljubljana, Ljubljana, Slovenia
  3. 3 Institute of Pathology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
  1. Correspondence to Aleksandar Gavrić, Department of Gastroenterology and Hepatology, University Medical Center Ljubljana, Ljubljana, Slovenia; aleksandar.gavric{at}kclj.si

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A 27-year-old man was admitted to our department because of persistent symptoms of fever, dyspnoea, dry cough, elevated C reactive protein (CRP) (258 mg/L), leucocytosis (17×109/L), peripheral eosinophilia (29%) and elevated liver enzymes (alanine aminotransferase (ALT) 518.2 U/L; aspartate aminotransferase (AST) 192.4 U/L; total bilirubin 1.6 mg/dL direct bilirubin 0.7 mg/dL; alkaline phosphatase 115.9 U/L and gamma glutamyl transferase (GGT) 119,4 U/L). His medical history was unremarkable except for surgery that he underwent 3 weeks ago for his left radius and ulna fracture. Since the surgery, he has been taking paracetamol and sodium metamizole. Empirical antibiotic therapy was initiated.

Chest X-ray revealed small left and large right pleural effusion. CT was performed due …

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Footnotes

  • Contributors AG designed the study; collected, analysed and interpreted the data; and wrote and reviewed the manuscript. RD interpreted the data; and provided the venography and CT photographs; and reviewed the manuscript. BR interpreted the data; and provided histological photographs; reviewed the manuscript. MR analysed and interpreted the data; and reviewed the manuscript. BŠ reviewed the manuscript.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.

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