Acute Myelomonocytic Leukemia: A Rare Cause of Painless Jaundice.

Acute myelomonocytic leukemia (AMML) is a rare and aggressive subtype of acute myeloid leukemia with varying clinical manifestations. Although hepatic involvement in AMML is commonly seen, cholestatic hepatitis as a primary manifestation of the disease is very rare. In the present case, our elderly patient presented with predominant signs of cholestasis, including jaundice, nausea, and vomiting. However, after a thorough diagnostic workup that ruled out obstructive, viral, or drug-induced etiologies, the presence of severe thrombocytopenia prompted further investigation. Flow cytometry was ultimately utilized to diagnose our patient with AMML. This case highlights that laboratory evidence of hematological abnormalities, including thrombocytopenia, could aid in diagnosing unexplained cholestasis outside the recommended workup.