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Study discovers mixed hepatocellular-cholestatic injury in immunocompetent adults, suggesting diagnostic challenges.
Acute hepatitis C virus infection commonly causes hepatocellular injury and is often asymptomatic. A mixed hepatocellular-cholestatic pattern mimicking biliary obstruction in immunocompetent patients is uncommon—a 40-year-old woman presented with jaundice and right upper quadrant pain. Laboratory evaluation showed alanine transaminase and aspartate aminotransferase greater than 10 times the upper limit of normal, with conjugated hyperbilirubinemia and elevated alkaline phosphatase. Discordance between biochemical findings and nonobstructive imaging prompted magnetic resonance cholangiopancreatography, which confirmed a patent biliary tree and allowed endoscopic retrograde cholangiopancreatography avoidance. Hepatitis C virus RNA detection after a recent negative hepatitis panel confirmed acute seroconversion. The patient improved with supportive care without biliary intervention.
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Latif et al. (2026) studied this question.
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