Clinical vignette A 33-year-old Caucasian male was admitted to hospital with recent onset of
jaundice of 2–3 weeks duration. He reported heavy use of alcohol for the last 10 years with
the last drink a day prior to the onset of symptoms. At admission, he was alert and oriented to
time, place, and person, and was deeply jaundiced. His laboratory profile can be
summarised as follows: haemoglobin 12.1 g/dl, white blood cell count 18,700 with 81%
neutrophils, serum bilirubin 33 (direct 22) mg/dl, aspartate aminotransferase 147 IU/L …