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A 21-year-old man was referred with haematochezia for 1 month and scleral icterus for 4 days. His history was unremarkable except chronic anaemia. Physical examination showed scleral icterus, pale conjunctivas, and melanosis on his lips, buccal mucosa and fingers (figure 1). Blood test revealed decreased haemoglobin 7.7 g/dl (normal, 12–16) and elevated white cell count 14.1×103/μl (4–10×103). Liver function tests revealed …
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