SlimQuick™ - associated hepatotoxicity in a woman with alpha-1 antitrypsin heterozygosity

Figure 1 Two months earlier, our patient had normal serum alanine aminotransferase, alkaline phosphatase and total bilirubin (baseline). The peak total bilirubin level lagged 19 d behind the peak ALT and ALP levels. There was striking improvement in serum aminotransferase and total bilirubin levels after initiation of prednisone (50 mg/d). Laboratory values remained normal after prednisone therapy was discontinued. ALT: Alanine aminotransferase; ALP: Alkaline phosphatase.

Figure 2 Portal tract and lobules with marked mixed inflammation and parenchymal loss (hematoxylin and eosin staining, X100).

Figure 3 Minute alpha-1 antitrypsin positive globules in periportal hepatocytes; diffuse background staining for alpha-1 antitrypsin is also presented (alpha-1 antitrypsin stain, X200).