Clinical scenario: An 18 yr old male presented with history altered sensorium of 2 days duration following deep jaundice of 2 weeks duration .There was no history of viral prodrome, offending drug intake. He had no past history of blood transfusion He had jaundice in early childhood which was partially evaluated at that time. Family history : 3 years back his sister died due to prolonged jaundice, un-evaluated unfortunately and also one of his cousins had died 5 years back due to liver cell failure following jaundice of 3 weeks duration. No Family screening was done.
Examination : He was conscious but not fully oriented deeply jaundiced hemodynamically stable. Abdomen exam showed gross ascites another systemic examination was normal. Evaluation: He had hemoglobin levels of 9gm/dl, platelet count of 98000 and WBC count was normal. Bilirubin levels were 20mg/dl predominantly…
