subacute hepatic failure/ cryptogenic liver disease

one six year old girl  suffering from jaundice . kg ring negative, hbsAg,HCV, hep b hep E, Hep A all are negative, AI market negative, viral markers negative,CXR dorsal spine normal, ECHO normal no evidance of post embyrotoxon, moderate ascites diuretics now stopped spleen 9 cm enlarged pv  8 mm HV normal  ceruloplasmin urine 33ug/4 hrs no history of sensorium ,bleed from any site

UGIE gr 1x3 eso vx mild pHG +

non alcoholic family . now guide what is the disease

[Thomas D Schiano, MD]

unsure.  may be a metabolic disease that has decompensated as pt appears to have sub-fulminant liver failure, acute worsening of chronic disease.  they may be require transplantation if option available before infection occurs which is often terminal event.  good luck.