Answer

Acute viral hepatitis

An initial approach to the workup of any liver disease is to determine the acuteness of symptoms. Viral hepatitis is the one of the most common causes of acute onset of jaundice.

Drug-induced liver injury

Medications are another common causes of acute liver injury. Clinicians need to be meticulous in obtaining a history of medication use including over-the-counter medications, herbal remedies, and alternative medicines.

Primary biliary cirrhosis

Primary biliary cirrhosis (PBC) is a chronic cholestatic liver disease. In general, patients with PBC do not become symptomatic until the fourth or fifth decade of life, and the onset of symptoms is usually insidious. The acute presentation in this young patient is not consistent with PBC.

Hereditary hemochromatosis

Hemochromatosis is a chronic hepatocellular disease involving excessive iron accumulation in the liver and other organs. The onset of symptoms in female patients is usually after menopause. The acute onset of symptoms, the relatively young age, and the gender of the patient are not consistent with hemochromatosis.

Choledocholithiasis

Although a common bile duct stone (choledocholithiasis) is an acute condition that may be associated with jaundice, it is usually accompanied by severe right upper quadrant pain, a feature absent in the present case.