A 47 year old man has had long standing jaundice, malaise and poor appetite

NEET SS
#1

A 47 year old man has had long standing jaundice, malaise and poor appetite. Over the past 6 months he has lost 2 stones in weight.
On examination he has palmar erythema, jaundiced sclerae, spider naevi, hepatomegaly and ascites.
His bloods reveal:
Bilirubin - 50 mmol/l
ALT - 150 U/l
ALP - 240 U/l
Hep C core antibody - Positive
Hep BsAg - Negative
Hep A antibody - Negative
What is the likely diagnosis?

  1. Abnormal variant hepatitis C

  2. Superimposed hepatitis E infection

  3. Hepatocellular carcinoma

  4. Hepatitis A infection

  5. Infectious mononucleosis

View Explanation

30% of patients with hepatitis C develop hepatocellular carcinoma over 30 years. 20% develop cirrhosis over 20 years.

Hepatocellular carcinoma