Chief presenting complaints A 72-year-old woman presented to the hospital for acute liver failure and ulcerative colitis. Medical history The patient’s medical history was significant for rheumatoid arthritis and lupus. She also underwent trans-jugular liver biopsy, which revealed that she suffered from steatohepatitis, minimal fibrosis, cholestasis, and anisonucleosis, which was in alignment with methotrexate-induced hepatotoxicity. The patient also had ulcerative colitis for ten years and has been taking medications for it. Drug history: The patient was managed on methotrexate for one year for arthritis and lupus.
Social history: The patient did not have any history of recreational drug use, alcohol use, or non-prescription health supplement use. Family history: There was no family history of liver disease. Ophthalmological assessment revealed Kayser-Fleischer rings. Other…
