MRCP2-1699

MRCP2-1699

A 50-year-old female presents to the emergency department with jaundice. She denies any alcohol consumption and reports no recent travel or abdominal pain. Upon examination, the patient is afebrile and has palpable tender hepatomegaly. The sclerae are icteric, but there are no signs of chronic liver disease. Initial liver function tests show:

– Bilirubin: 141 µmol/l
– ALP: 208 u/l
– ALT: 635 u/l
– Albumin: 36 g/l
– INR: 1.2

Further questioning reveals that the patient takes regular thyroxine following a thyroidectomy but no other medications. An ultrasound and viral hepatitis screen show:

– HBsAg: Negative
– HBcAb: Negative
– Hep C Ab: Negative
– Ultrasound: Smooth hepatomegaly

What is the most likely diagnosis?