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An adolescent girl with abnormal liver profile
1Division of Medicine and Gastroenterology, Our Lady of Mercy Medical Center, New York Medical College, Bronx, NY 10466, USA.
Postgraduate Medical Journal
|July 31, 1998
Summary
This case highlights a young adult with abnormal liver function tests, revealing a positive hepatitis B surface antibody (anti-HBs) indicating past vaccination or resolved infection, with no evidence of active viral hepatitis.
Area of Science:
- Hepatology
- Infectious Diseases
- Internal Medicine
Background:
- Evaluating abnormal liver function tests in young adults is crucial for early diagnosis and management.
- Hepatitis B virus (HBV) infection can present with varied serological profiles.
Observation:
- A 17-year-old student presented with elevated liver enzymes, scleral icterus, and hepatomegaly.
- Serological tests were negative for acute Hepatitis A, B, C, and core IgM.
- The patient had a positive Hepatitis B surface antibody (anti-HBs) and negative Hepatitis B surface antigen (HBsAg).
Findings:
- The patient's serological profile suggests immunity to Hepatitis B, likely from prior vaccination or resolved infection.
- Abnormal alkaline phosphatase and hepatomegaly were noted, warranting further investigation for non-viral causes.
Implications:
- This case underscores the importance of a comprehensive serological workup for abnormal liver function tests in adolescents.
- It highlights that a positive anti-HBs with negative HBsAg in the absence of acute viral markers can indicate resolved HBV infection or vaccination, not active disease.