Lab Studies:
UA: cloudy and orange, large bilirubin, small ketones
CBC: WBC 3,570
CMP: AST 1521, ALT 3384, total bilirubin 5.4, AP 250
After the results of the initial work-up above, JC was directly admitted to the hospital for further evaluation and monitoring. Further diagnostic testing as follows:
Normal amylase, lipase, ammonia, coagulopathy panel, acetaminophen and salicylate levels, and UDS.
Positive hepatitis A IgM antibody, negative hepatitis B and C serologies. Positive EBV IgM and IgG antibodies to viral capsid, negative antibody to early antigen, positive IgG antibody to nuclear antigen. Negative CMV serologies.
Other Studies:
A right upper quadrant ultrasound revealed mild hepatomegaly and visible porta hepatis nodes, suggestive a reactive process. No other abnormalities noted.
Consultations:
Discussed with pediatric gastroenterology
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