A 20-year-old female student presents with a 1-week history of nausea, vomiting, and anorexia. She returned 2 weeks ago from a trip to Guatemala. On physical examination, her temperature was 100.3°F, clear chest, and she had mild jaundice and a palpable, tender liver. Her CBC was normal, and her liver function tests are as follows: Serum total bilirubin 3.1 mg/dL. Serum aspartate aminotransferase 1100. Serum alanine aminotransferase 1900. Serum alkaline phosphatase 112. What is the most likely lab test to confirm your diagnosis?
A- IgM antibody to hepatitis A virus
B- Antibody to hepatitis B surface antigen
C- Antibody to hepatitis C virus
D- DNA for Epstein-Barr virus
E- Serum anti-mitochondrial antibodies
Answer:
This patient has typical presentation of hepatitis A virus infection. His recent travel, short incubation period and mode of infection in addition to lab results confirm this diagnosis. The only option that is almost always positive in hepatitis A virus recent infection is IgM antibody to hepatitis A virus.
The correct answer is A