August 1st 2007
A 4-year-old Hispanic boy was referred to our facility because of elevated levels of alanine trans- aminase (ALT) and aspartate transaminase (AST), which were detected during an evaluation of transient abdominal pain while the boy was in Puerto Rico. He was otherwise in perfect health; a review of systems was negative. His past medical history and birth history were noncontributory. Immunizations, including hepatitis B, were up-to-date. The family history was significant for tuberculosis and rheumatoid arthritis.