Unusual Etiology for Transaminitis

An infection with Enterobius vermicularis (pinworm) commonly affects the gastrointestinal (GI) tract. The ectopic localization of an enterobius infectious is rare, especially in the liver. We report the case of a 37-year-old man who presented to the gastroenterology clinic with abdominal pain and was found to have elevated transaminases. Workup for acute/chronic liver disease was unrevealing. He underwent endoscopic evaluation showing a live pinworm in the colon. He was treated with albendazole with improvement in GI symptoms and resolution of his transaminitis. There are scarce reports in the literature describing pathognomonic, clinical, imaging, and laboratory findings for pinworm infection. Here, we attempt to review the literature for hepatic involvement with an enterobius infection and discuss the findings via this case.