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 BOF 59

 

   

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BOF: 59

A 40-year-old female is admitted with a history of haematemesis and melaena. Apart from an itch, she had previously been well. She was not on any medication. She smoked 5 cigarettes a day and drank 8 units of alcohol per week.

On examination her skin looked pigmented, there were xanthelasma on her eyelids.  Her liver and spleen were enlarged. There were no other abnormalities detected on examination.

Investigations

Hb 12.8 g/dL

WBC 6.0 x109 /L

Platelets 120

Sodium 138 mmols/L

Potassium 4.2 mmols/L

Urea 12 mmols/L

Corrected calcium 1.9 mmol/L

Phosphate 0.6 mmol/L

Glucose 5.3 mmol/L

Bilirubin 12 mmol/L

ALT 32 U/L

Alkaline phosphatase 300 U/L

In this patient which one of the following would give you the diagnosis?

a)      AMA (antimitochondrial antibody)

b)      SMA (smooth muscle antibody)

c)      LKM (liver kidney antibody)

d)      SLP/LP soluble liver antigen

e)      PANCA

 

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