To differentiate the suspicious cause of conjugated hyperbilirubinemia with transaminitis in 1000s we decided to do a liver biopsy.A liver Biopsy was performed and it demonstrated subtotal hepatic necrosis with severe inflammation and a very small amount of iron and fibrosis in the liver (Table 2). PCR of blood identifies a single mutation C282Y identified. She is being treated with phlebotomy and her liver enzymes improve significantly.
Table 2: