WSI24-485-Case-1
48-year-old woman with history of breast cancer (2022 diagnosis, status post resection and chemotherapy finished 2024, currently on Lupron/Letrozole), diabetes, BMI 30, pulmonary valve stenosis, and no alcohol use since 2022, presenting with abnormal liver enzymes and abnormal liver imaging. Most recent labs (Apr2026) showed AST 32, ALT, 29, Alk Phos 147, tBili 0.5, albumin 4.6, and globulin 3.2, as well as normal ANA, A1 antitrypsin, and mitochondrial M2 Ab. Portal pressure gradient was calculated as 16 mm Hg (consistent with CSPH, with highest HV pressure of 10mmHg and lowest PV pressure of 25mmHg) by EUS. Liver stiffness by EUS elastography ~7kPa left liver, ~13 kPa right liver. Also found small (<5mm) esophageal varices.
Steatohepatitis with prominent centrizonal inflammation, fibrosis, ballooning degeneration and ducular reaction (Grade 2, Stage 2 of 4)(Brunt Scoring System).
Copper dry weight of <10 mcg/g (reference value of <50) .
July 21, 2026 1:00:00 PM
