{"ops":[{"insert":"A 45-year-old man is referred for further evaluation after a routine health screening revealed several abnormal laboratory test results. He is currently asymptomatic. There is no history of recent weight gain.\n\nHis medical history is only significant for elevated triglyceride levels (~250 mg\/dL) detected two years ago. He was asked to make lifestyle modifications but defaulted on follow-up after just one month.\n\nHe does not smoke, and only drinks socially, generally not more than 1 to 2 units of alcohol each month. He currently leads a sedentary lifestyle. His laboratory results are as follows:\n\nAST: 55 IU\/L (8-48)\nALT: 70 IU\/L (7-55)\nALP, Bilirubin, INR: within normal limits\nFasting plasma glucose: 190 mg\/dL (70-110)\nHbA1c: 7.5%\nTriglycerides: 175 mg\/dL (\u003C150)\nTotal cholesterol, LDL, HDL: within normal limits\nIron studies: within normal limits\nCRP, ESR: within normal limits\n\n"},{"insert":{"image":"\/storage\/case-images\/pd\/PD-M-261_en.png"}},{"insert":"\n"}]}
2
Investigate
Ultrasound abdomen
{"ops":[{"insert":"There is mild hepatomegaly, with a liver length of 17 cm in the midclavicular line. The liver shows a hyperechoic homogeneous echotexture with occasional hyperechoic focal areas suggestive of fatty infiltration.\n"}]}
Viral hepatitis screen
{"ops":[{"insert":"Negative for hepatitis B and C.\n"}]}
