A 43-year-old female presents with a 6-month history of vagu…
A 43-year-old female presents with a 6-month history of vague right upper quadrant discomfort. The patient denies any relation of pain to meals and describes it as a dull constant discomfort. The patient was diagnosed with type 2 diabetes mellitus 1 year ago, which is controlled with diet. She does not smoke but admits to drinking a glass of wine less than 3 times per month. She denies any medications except for over-the-counter acetaminophen, which she takes occasionally for joint pains. She does not have any family history of chronic liver disease. There is no history of blood transfusions in the past. On physical examination, the patient is obese with a BMI of 31; BP 140/90 mm Hg. The liver is palpable 3 cm below the right costal margin and is slightly tender. No other signs of chronic liver disease are evident. Pertinent laboratory test results include: serum AST 64 U/L ↑, serum ALT 70 U/L ↑, serum AST/ALT < 1, serum Alk phos 112 U/L, serum total bilirubin 1.0 mg/dL, serum albumin 3.6 g/dL, serum ferritin 48 ng/ml, serum iron 100 ug/dL, and negative Hepatitis A, B, and C serology. Based on this information, which of the following conditions is the most likely cause of this patient’s liver disease?