Case history
Case history
A 40-year-old asymptomatic man presents for a routine visit with an elevated alanine aminotransferase level (55 IU/mL). His mother died of hepatocellular carcinoma and he has a middle-aged sister with hepatitis B infection. He has a normal physical examination and has no stigmata of chronic liver disease.
Other presentations
It is important to recognise that hepatitis B has different clinical presentations. Patients may be asymptomatic or may have an enlarged liver or evidence of a liver mass, or stigmata of chronic liver disease. Some patients may present for the first time with symptoms of chronic hepatitis. Patients with clinical symptoms (e.g., nausea, vomiting, abdominal pain, jaundice, myalgias) may have an acute presentation of a chronic illness.
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