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A 24-year-old man presented with 8 months of intermittent right hypochondrial pain with fever and jaundice for 1 week. Liver function tests showed a mixed hepatitic/cholestatic pattern: alanine transaminase 579 IU/L, alkaline phosphatase 183 IU/L, gamma-glutamyltransferase 390 IU/L and bilirubin 126 μmol/L. Full blood count, C-reactive protein, urea and electrolytes, clotting, blood cultures and hepatitis screen were normal or negative.
Abdominal ultrasound (US) revealed strand-like structures within the gall bladder, but no gallstones (figure 1A,B …
Contributors JH-EK conceived the idea for the case report and wrote the first draft of the manuscript. All authors reviewed and amended the manuscript.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; internally peer reviewed.
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