A 48-year-old woman has a 3-week history of fatigue as well as yellow skin and sclerae. Physical examination is unremarkable except for mild jaundice. The serum bilirubin level is 3.7 mg/dL, mostly in the unconjugated form. Liver function tests including serum AST, ALT, and alkaline phosphatase are normal. The hemoglobin level is 6.0 g/dL. After coicosteroids are administered, the jaundice resolves. Which of the following diseases is the most likely cause of hyperbilirubinemia in this patient?
High-Yield Explanation
Autoimmune hemolytic anemia Antibody- mediated erythrocyte destruction -Severe anemia. Intravascular hemolysis - Increase unconjugated bilirubin, which exceed the capacity of the hepatocyte to conjugate bilirubin. Ameliorated by treatment with coicosteroids. The other choices are parenchymal liver diseases that manifest primarily as conjugated hyperbilirubinemia and are unresponsive to steroids