A 35 year old male presented to you with h/o persistent elevation of ALT lasting for more than 6 months. He remains asymptomatic during this period. Other parameters in LFT was normal including ALP, bilirubin and albumin. Diagnostic evaluation in this scenario includes all the given tests, EXCEPT:
Correct Answer: Antimitochondrial antibody (AMA)
Description: Here LFT is abnormal for 6 months. So it is chronic. So hemochromatosis, autoimmune hepatitis, chronic HCV etc are to be ruled out. AMA is an autoimmune marker used to diagnose primary biliary cirrhosis, which will present with elevation in ALP. So the correct answer is AMA. Ref: Harrisons Principles of Internal Medicine, 18th Edition, Page 2524-25
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