{
  "abstract": "A 23-year-old male patient, with a history of X-linked pseudo-obstruction requiring lifelong parenteral nutrition (PN), was referred to hepatology for evaluation of abnormal liver blood tests (bilirubin 14 umol/L (normal range 2–21 umol/L), alanine aminotransferase 119 iu/L (normal range<40 iu/L), alkaline phosphatase 309 iu/L (normal range 30–130 iu/L), albumin 33 g/L (normal range 35–50 g/L), International Normalised Ratio 1.2 (normal range <1.4) and platelets 230 10 9/L (normal range 150–400 109/L)). A full non-invasive liver screen with tests for viral hepatitis, autoimmune and hereditary liver diseases, including Wilson’s disease, alpha-1-antitrypsin disorder and haemochromatosis, was undertaken and negative. There was no history of alcohol consumption, drug exposure or risk factors for liver disease outside of PN. A FibroScan was attempted but reliable readings were not obtained despite different operators attempting the procedure. An ultrasound was undertaken but adequate views of the liver were not obtained due to bowel gas. A CT scan was then undertaken to visualise the liver (figure 1).",
  "authors": [
    {
      "affiliations": [
        "St James’s University Hospital Leeds Liver Unit, Leeds, UK"
      ],
      "name": "Imran Iqbal"
    },
    {
      "affiliations": [
        "Leeds Gastroenterology Institute, Leeds Teaching Hospitals NHS Trust, Leeds, Leeds, UK"
      ],
      "name": "Clare Donellan"
    },
    {
      "affiliations": [
        "St James’s University Hospital Leeds Liver Unit, Leeds, UK"
      ],
      "name": "Oliver D Tavabie"
    }
  ],
  "title": "Fibrosis assessment in a patient receiving lifelong parenteral nutrition",
  "uid": "2f7576e1-7c8c-5d20-8df2-75b60a8a289b"
}