title: A case of jaundice of obscure origin.
abstract: BACKGROUND
  Idiopathic painless jaundice with significant elevations in serum transaminases, occurring in a previously healthy patient, invokes a circumscribed set of possibilities including viral hepatitis, auto-immune hepatitis (AIH) and drug-induced liver injury (DILI).
  
  
  METHODS
  In this described case, common causes of cholestatic jaundice were considered including drug-induced liver injury, viral causes of hepatitis, and auto-immune antibodies. Biliary obstruction was excluded by appropriate imaging studies. Liver biopsy was obtained, though not definitive.
  
  
  RESULTS
  After detailed investigation failed to reveal a cause of the jaundice, an empiric trial of steroids was initiated on the possibility that our patient had antibody-negative AIH and not DILI, with an associated grave prognosis.
  
  
  CONCLUSIONS
  Empiric treatment with prednisone led to rapid resolution of jaundice and to the conclusion that the correct diagnosis was antibody-negative AIH.
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Medicine, University of New Mexico School of Medicine, Albuquerque, NM, USA, Fahadkhan527@gmail.com.
authors.forename: Fahad M
authors.initials: FM
authors.lastname: Khan
authors.forename: Joseph
authors.initials: J
authors.lastname: Alcorn
authors.forename: Joshua
authors.initials: J
authors.lastname: Hanson
mesh_terms: D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D019693:Hepatitis, Autoimmune / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D007565:Jaundice / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology; D008875:Middle Aged; D011241:Prednisone / Q000627:therapeutic use
chemical_list: D005938:Glucocorticoids; D011241:Prednisone