Recurrent acute liver failure in infancy - a novel SCYL1 mutation: A case report

Table 1 Clinical timeline: Episodes of acute liver failure

Age	Trigger	Key laboratory findings	Treatment	Outcome
19 months	Fever + URTI; antibiotics and paracetamol given	ALT: 1840, AST: 2210, Bili: 340 μmol/L, GGT: 18 (low), INR: 2.8, pancytopenia	Corticosteroids, IV fluids, nutritional support	Partial improvement; no normalisation
21 months	Febrile illness	ALT: 980, AST: 1140, Bili: 210, GGT: 20, INR: 2.1	Supportive care; steroids repeated	Partial improvement; ongoing enzyme elevation
22 months	Febrile UTI	ALT: 2100, AST: 2450, Bili: 380 μmol/L, INR: 3.1, GGT: 24, Plt: 62	Antibiotics + supportive care	Ongoing follow-up; genetic counselling initiated

URTI: Upper respiratory tract infection; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; Bili: Total bilirubin; GGT: Gamma-glutamyl transferase; INR: International normalized ratio; IV: Intravenous; UTI: Urinary tract infection; Plt: Platelets.