His liver dysfunction soon progressed to ALF as elevation of transaminases (AST 870 U/l, ALT 263 U/l) with reduction of protein synthesis (PT-INR 1.53) and hypoalbumininema (albumin 2.47 g/dl), remarkable anemia (hemoglobin 6.3 g/dl), and thrombocytopenia (platelet count 19,000/μl) (Fig. 1C). This evidence concerns the gene ALB and anemia (phenotype).