Case Presentation: A 70-year-old female with a medical history of fibromyalgia on Duloxetine, Systemic Lupus Erythematosus, and Paget’s disease admitted to the hospital for altered mentation was found to have elevated ALT 54 U/L, AST 63 U/L, normal bilirubin, and gamma glutamyl transferase. The mild elevation in Alkaline Phosphatase (ALP) 175 U/L was secondary to [...]