A 14 year old student was brought to the school-based health center by their aid after noticing her skin color was “off.” She was visibly yellow but complained of no other symptoms. Mom was called and she was agreeable to labs, which were drawn at the time of visit. The next day the SBHC medical provider received several critical labs and called her parents to bring her to the hospital immediately to be evaluated. The student was admitted to the local hospital and was found to have an enlarged liver with very abnormal labs, but they were unable to figure out what was the cause. She was then transferred to a large children’s hospital about 2 hours away where she was seen by a liver specialist. She had a liver biopsy and was diagnosed with Autoimmune Hepatitis, something very rare for her age. She needs bi-weekly labs, lifelong medication, and close follow up. Her parents and the patient are so grateful to the school-based health center that they were able to see her immediately and get her the help that she needed. We continue to follow her closely and she can get her labs at the SBHC, so she doesn’t need to miss school.