Nonalcoholic fatty liver disease as a risk factor for cytomegalovirus hepatitis in an immunocompetent patient: A case report

Table 1 Laboratory trend

	Day 1	Day 2	Day 3 (discharge day)
Hemoglobin (range 12.0-16.0 g/dL)	14.6	12.8	12.6
White blood count (range 4.8-10/8 k/µL)	11.4	8.9	9.0
Platelet count (range 150-400 k/µL)	173	156	162
Serum sodium (range 135-145 mEq/L)	133	133	133
Serum bicarbonate (range 24-30 mEq/L)	25	22	22
Blood urea nitrogen (range 8-26 mg/dL)	6	5	4
Creatinine, serum (range 0.5-1.5 mg/dL)	0.91	0.73	0.81
Protein, serum (g/dL) (range 6.0-8.5 g/dL)	6.7	5.8	5.8
Albumin, serum (g/dL) (range 3.4-4.8 g/dL)	3.1	2.6	2.6
Alanine aminotransferases (range 5-40 unit/L)	319	234	200
Aspartate aminotransferase (range 9-48 unit/L)	210	130	118
Alkaline phosphatase (range 53-128 unit/L)	372	302	314
Total bilirubin (range 0.2-1.2 mg/dL)	1	1.2	1.1
Direct bilirubin (range 0-0.3 mg/dL)	0.4	0.4	0.4

Table 2 Hepatitis workup

Test	Result
Hepatitis A IgM	Negative
Hepatitis Be Antigen	Negative
Hepatitis Be antibody	Negative
Hepatitis C	Negative
Hepatitis E antibody IGG	Detected
Hepatitis E antibody IGM	Negative
HIV antibody	Negative
Blood culture	Negative
Urine culture	Negative
Pregnancy test, Urine	Negative
Serum CMV DNA PCR (normal range < 200.00 IU/mL)	13700 IU/mL
Cytomegalovirus IgM (normal range < 29.9 U/mL)	47.7AU/mL
Influenza A and B rapid test	Negative
Epstein-Barr virus DNA PCR (Negative)	Negative
HIV-1/2 antibody/antigen	Negative
SARS-COV-2 IGM/IGG	Negative
Acetaminophen (range 10-30 µg/mL)	< 10 µg/mL
Antinuclear antibodies	Negative
Anti-smooth muscle antibody	Negative
Anti-mitochondrial	Negative
Tissue transglutaminase antibody	Negative
Liver kidney microsomal assay (negative range ≤ 20.0 units)	< 20.0 units
Ferritin	384 ng/mL
Erythrocyte sedimentation rate (range 0-30.0 mm/h)	16 mm/h
24 h Urine Copper (3.0-45.0 µg/d)	48 µg/d
C-reactive protein (0.00-0.80 mg/dL)	5.8 mg/dL

CMV: Cytomegalovirus; PCR: Polymerase chain reaction; SARS-COV-2: Severe acute respiratory syndrome coronavirus; IGG: Immunoglobulin G.