A 20-year-old female with...

A 20-year-old female presented with a history of left-sided abdominal discomfort, persisting for 8 to 10 months. The pain was dull, and aching, with no radiation or specific movement triggers. The patient's vital signs were stable upon examination, but pallor was evident. Physical examination revealed a significantly enlarged spleen, located 7 cm from the left costal margin, and the liver was not palpable. Cardiovascular, respiratory, and central nervous system examinations were normal. Further evaluation through a complete blood count showed Hb levels at 8.5 g/dL, a TLC of 2750/mm3, DLC (N: 58% L: 38% M: 2% E: 2%), and a platelet count of 90,000/µL. An abdominal ultrasound revealed the liver measuring 13.2 cm with a slightly altered echotexture, a spleen measuring 19.6 cm with a normal echotexture, a portal vein diameter of 14 mm at the porta hepatis, and a splenic vein diameter of 15 mm. Infectious disease tests for HIV, HBV, and HCV were all negative. Additionally, serum ceruloplasmin (34 mg/dL), ferritin (32.9 ng/ml), and anti-nuclear antibody (ANA) tests were within normal limits. LFTs showed normal levels of serum glutamic oxaloacetic transaminase/serum glutamic pyruvic transaminase (SGOT/PT), a serum alkaline phosphatase (S. ALP) at 74 U/L, and a serum protein level of 7.2 g/dL. Prothrombin time/international normalized ratio (PT/INR) was within the normal range. The liver biopsy revealed hepatocytes displaying focal fat accumulation, small fibrous bands separating liver tissue, and a localized infiltration of lymphocytes and mononuclear cells.