College of American Pathologists

2012 — January Case of the Month

Posted January 20, 2012


CAP Foundation January Online Case of the Month

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An otherwise healthy 70-year-old man presented with abrupt onset of fever and abdominal pain. His medication history included aspirin and acetaminophen. Laboratory studies showed marked elevation of AST and ALT (>1000 U/L) and an abnormal coagulation profile. Serological studies for hepatitis A, B and C as well as autoantibodies were negative. Renal failure and encephalopathy developed, and the patient died. An autopsy showed an enlarged liver with extensive hemorrhagic necrosis.

The master list with the correct answer

  • Acetaminophen toxicity
  • Acute ischemic necrosis
  • Budd-Chiari syndrome
  • Fulminant Wilson disease
  • Herpes simplex virus hepatitis

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  • Appropriate diagnosis
  • Critique
  • References

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