(A) Graph showing the changes in liver function tests over time for case 1, with a summary of systemic treatments given over time. (A) Graph showing the.

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(A) Graph showing the changes in liver function tests over time for case 1, with a summary of systemic treatments given over time. (A) Graph showing the changes in liver function tests over time for case 1, with a summary of systemic treatments given over time. The right y-axis refers to bilirubin levels, the left y-axis refers to ALP and ALT levels. (B) Photomicrograph of a representative H&E section from a liver biopsy in case 1. This section shows severe hepatic steatosis, and includes portal tracts without discernible bile ducts. (C) Photomicrograph showing cytokeratin 7 immunohistochemistry of a representative section from a liver biopsy in case 1. This confirms the absence of bile ducts, and demonstrates slight and focal intermediate hepatobiliary phenotype. ALP, alkaline phosphatase; ALT, alanine aminotransferase; CS, corticosteroids; M, mycophenolate mofetil; U, ursodeoxycholic acid; ULN, upper limit of normal. Gary Joseph Doherty et al. ESMO Open 2017;2:e000268 Copyright © European Society for Medical Oncology. All rights reserved.