This article has no abstract; the first 100 words appear below. Foreword In this Journal feature, information about a real patient is presented in stages (boldface type) to expert clinicians from several specialties, who respond to the information, sharing their reasoning with the reader (regular type). The authors' commentary follows. Stage A 62-year-old woman was admitted to the hospital because of abnormal liver-function tests. She had a history of acute myelogenous leukemia and had undergone transplantation of T-cell–depleted allogeneic bone marrow two years earlier. The patient had had mildly increased aminotransferase levels since the transplantation. Four months before admission, the levels of alkaline phosphatase and bilirubin became elevated, presumably because of chronic graft-versus-host disease. Findings on computed tomography (CT) and ultrasonography of the abdomen were negative for disease in the hepatic parenchyma or biliary tree. Stage On the day of admission, during a routine appointment, the patient's total bilirubin level . . .
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