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A correction has been published: N Engl J Med 1993;329(25):1904.

Case Records of the Massachusetts General Hospital
Weekly Clinicopathological Exercises
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Volume 329:1108-1115 October 7, 1993 Number 15
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Case 40-1993— A 61-Year-Old Woman with Jaundice, Anemia, Thrombocytopenia, and Leukocytosis
David W. Golde, and Daniel Rubin

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Presentation of Case

A 61-year-old woman was admitted to the hospital because of fever, jaundice, hepatosplenomegaly, and gallstones.

The patient had been in stable health until three weeks earlier, when a mild chronic headache developed. One week before admission she consulted a physician, who discovered mild abnormalities on tests of liver function. Five days before entry anorexia, nausea, fatigue, and a low-grade fever developed. Two days later the patient returned to her physician, who diagnosed jaundice and admitted her to another hospital.

Laboratory studies were performed at the other hospital (Table 1). An ultrasonographic examination of the abdomen revealed gallstones, without . . . [Full Text of this Article]

Differential Diagnosis

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Dr. David W. Golde's Diagnosis

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