One week later, the patient developed fever with chills and rigors, worsening cholestasis clinically and biochemically (total bilirubin 48 mg/dl, ALP 901 IU/L) with relatively normal liver enzymes (AST 55 U/L, ALT 91 U/L, GGT 43 U/L), raised inflammatory markers (C-reactive protein 36 mg/dl), and neutrophil leukocytosis (white blood cell count 14,400/mm3 with 80% neutrophils). The gene discussed is GPT; the disease is cholestasis.