“…During physical examination, patients may not have signs of underlying liver disease or show jaundice and the signs typical of chronic liver disease, including telangiectasis, palmar erythema, hepatosplenomegaly, and collateral blood flow, among others. 17 A family history of autoimmune disease is common in 40% of cases, and approximately 20% of patients show associated autoimmune alterations, either at the time of diagnosis or during the course of the disease. These include thyroiditis, inflammatory bowel disease, hemolytic anemia, vitiligo, celiac disease, insulin-dependent diabetes, etc.…”