A 6-Year-Old Boy Is Brought to the Emergency Department Due

A 6-year-old boy is brought to the emergency department due to abrupt-onset vomiting, lethargy, and altered mental status.  For 4 days, the patient has had a fever, cough, and rhinorrhea, which were treated symptomatically with aspirin.  He has no prior medical conditions, and his family history is unremarkable.  Vital signs are normal.  The patient is stuporous and does not respond to verbal commands.  Hepatomegaly is present.  There is no jaundice.  Laboratory results are as follows: Which of the following is the most likely cause of this patient's presentation?

A) Accumulation of a misfolded protein within hepatocytes
B) CD8⁺ T-cell-mediated destruction of viral infected hepatocytes
C) Depletion of intracellular reduced glutathione
D) Excessive formation of superoxide in hepatocytes
E) Mitochondrial damage leading to impaired fatty acid metabolism

Correct Answer:

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