A 77-year-old male with a history of sick sinus syndrome status post pacemaker placement, ulcerative colitis, hypertension, and type 2 diabetes mellitus was referred by his primary medical doctor for jaundice and pruritus. His doctor noted newly elevated liver enzymes alkaline phosphatase (ALP) 672 U/L, total bilirubin (BR) 5.0 mg/dL, alanine aminotransferase (ALT) 77 U/L, and aspartate aminotransferase (AST) 63 U/L. When he presented to the liver clinic, his total bilirubin increased to 20 mg/dL. On review of his records, a trend of abnormal liver enzymes was noted with no prior workup.
Today's Reader
Jared Fehlman is an Internal Medicine Resident at Huntington Health Hospital in Pasadena, California.
About Dr. Raj
Dr Raj is a quadruple board certified physician and associate professor at the University of Southern California. He was a co-host on the TNT series Chasing the Cure with Ann Curry, a regular on the TV Show The Doctors for the past 7 seasons and has a weekly medical segment on ABC news Los Angeles.
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