<s>[INST] Your thoughts would be appreciated : 19yr White Female, Elevated LFT since April 09, recent test GGT355, ALP232, ALT107, AST55. All others within average incl Tot Bili at 11. R.B.C. 5.34. Liver biopsy not bad. PANCA Pos. APC Pos.  Enlarged bulky spleen 11.4x6x11.6cm, with no focal lesion.Fatty Liver. Contracted Gallbladder. MRI nothing outstanding, thin bile duct walls. Crohns in family history but endoscopy & colonoscopy clear. Took prednisalone which doubled LFT results. Non drinker and non drug user. Had knee surgery 2008. [/INST] Hi,Thanks for asking.Based on your query, my opinion is as follows.1. Possible vasculitis associated with bile duct injury.2. Liver function near normal. Mild obstruction seen at level of bile ducts. Immunosuppression necessary to avoid further damage.3. Complete hemogram essential to evaluate for hemolytic anemia. Need further clinical details and lab results for further opinion.Hope it helps.Any further queries, happy to help again. </s>