Haemolysis
Mildly raised immunoglobulins
ANA may be raised
Urine copper estimationZinc acetate as a chelation agent
Acute presentation may require super urgent transplant
See Chapter 21, Information: Wilson’s disease Metabolic conditions, e.g. glycogen storage disease (GSD)Hypoglycaemia, increased urate and lactate
Ultrasound: hyperechoic due to fat accumulationManagement of hypoglycaemia with corn starch
In GSD type 1 neutropenia may require granulocyte colony-stimulating factor Mitochondrial disease, e.g. POLG mutationsRaised lactateNo proven therapy Paracetamol overdoseRaised paracetamol levelsSee Information: Paracetamol overdose Drug-induced liver diseaseHistory of drug ingestion
Liver biopsy may be diagnostic
See Chapter 21, Information: Drug-induced liver diseaseExclusion of causative agent Vascular anomalies such as Budd–Chiari syndrome

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