Unusual presentation of eosinophilic fasciitis (EF) with a raised ALT

Thomas Batty*, Shuja Majeed, Christina Wlodek, Harsha Gunawardena

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review


Eosinophilic fasciitis (EF) is a syndrome of unknown aetiology characterised by progressive collagenous thickening of the subcutaneous fascia. Limb oedema can precede the skin thickening and induration classically associated with EF. We describe a case of EF in a 31-year-old woman who presented to her general practitioner with lower limb oedema and stiffness. Blood tests in primary care showed a persistently raised alanine transferase (ALT). No hepatic cause for her raised ALT was found despite investigation. The unusual manner of her presentation led to delay in her referral to the autoimmune connective tissue disease (CTD) clinic. This case illustrates the importance of considering autoimmune CTD such as EF in young patients presenting with limb oedema and raised ALT, as early treatment influences prognosis and functional recovery.

Original languageEnglish
Article numbere227369
Number of pages4
JournalBMJ Case Reports
Issue number1
Early online date22 Dec 2018
Publication statusPublished - Dec 2018


  • connective tissue disease
  • dermatology
  • liver disease
  • rheumatology


Dive into the research topics of 'Unusual presentation of eosinophilic fasciitis (EF) with a raised ALT'. Together they form a unique fingerprint.

Cite this