Fig. 1.

Liver function test and histology of liver biopsy.

(A) Graph showing the trend of bilirubin (μmol/L) and alanine aminotransferase (U/L) before and after starting treatment with budesonide on 1-June 2021. (B) H&E-stained section of liver biopsy at 200x magnification showing a portal tract with portal inflammation and interface damage. (C) Higher magnification (400x) of the portal and interface inflammatory cells showing aggregates of plasma cells, lymphocytes and few eosinophils. (D) Within the liver parenchyma (200x magnification), there is lobulitis with clusters of plasma cells, rosette formation and apoptotic hepatocytes. (E) The Masson’s trichrome stain (100x magnification) showed pale green staining of the portal regions with a lack of elastic fibres seen on orcein stain (inset, 100x magnification), consistent with recent young fibrosis. Elastic fibres appear black on orcein stains and are usually absent in normal portal tracts. Old fibrosis type collagen contains elastic fibres and is a useful indicator of chronicity on histology. (This figure appears in color on the web.)