A 10-week-old girl was admitted for evaluation and management of acute fulminant hepatic failure. She had been healthy until she presented with acholic stool and jaundice at the age of 9 weeks. A work up showed ALT 787 U/L, total bilirubin 14.9 mg/dL, and severe coagulopathy with an INR of 3.4. Metabolic disorders and autoimmune liver disease were ruled out. Though viral etiology was strongly suspected, serologies were negative for Hepatitis A, B, and C viruses, Ebstein-Barr virus, cytomegalovirus, etc. She underwent plasma exchange to control coagulopathy. Her

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