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A 58-year-old woman, who had been treated for rheumatoid arthritis with leflunomide for 10 weeks, presented with abdominal pain and jaundice. She developed fulminant hepatic failure over the course of 2 months and died while being worked up for liver transplant. The liver was smaller than normal (weight 800 grams) with a wrinkled capsule; sectioning revealed a dark red appearance with variegated yellow and green nodules.
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Biliary cirrhosis, secondary
• Budd-Chiari syndrome
• Herpes simplex hepatitis
• Micronodular cirrhosis
• Sclerosing hyaline necrosis
• Submassive hepatic necrosis
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