Affiliation:
1. Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology and Reproductive Medicine , Renaissance School of Medicine at Stony Brook University , Stony Brook , NY , USA
Abstract
Abstract
Objectives
Acute glycogenic hepatopathy (AGH) is a rare complication of poorly controlled diabetes mellitus. This is the first report in the English literature describing accurate diagnosis and management of AGH during pregnancy.
Case presentation
A 46 year-old gravida 4 para 2 presented at 30 weeks gestation with uncontrolled diabetes, ketoacidosis, and severe hypertension. Euglycemia and normotension were achieved within 24 h of admission but serum transaminase levels which had been normal on admission increased to a very high level over several days, and then resolved spontaneously.
Conclusions
AGH may occur during pregnancy and should be considered in the context of chronic poorly controlled overt diabetes, rapid normalization of maternal blood glucose levels following high dose insulin therapy, and unexplained new-onset serum transaminase levels elevation. Accurate diagnosis is important because the correct treatment is conservative management, not delivery.
Subject
Obstetrics and Gynecology,Embryology,Pediatrics, Perinatology and Child Health
Reference8 articles.
1. Mauriac, P. Gros ventre, hepatomegalie, troubles de las croissance chez les enfants diabetiques traits depuis plusieurs annes parl’insuline. Gax Hebd Med Bordeaux 1930;26:402–10.
2. Tsujimoto, T, Takano, M, Nishiofuku, M, Yoshiji, H, Matsumura, Y, Kuriyama, S, et al.. Rapid onset of glycogen storage hepatomegaly in a type-2 diabetic patient after a massive dose of long-acting insulin and large doses of glucose. Intern Med 2006;45:469–73. https://doi.org/10.2169/internalmedicine.45.1548.
3. Bronstein, HD, Kantrowitz, PA, Schaffner, F. Marked enlargement of the liver and transient ascites associated with the treatment of diabetic acidosis. N Engl J Med 1959;261:1314–8. https://doi.org/10.1056/nejm195912242612603.
4. Khoury, J, Zohar, Y, Shehadeh, N, Saadi, T. Glycogenic hepatopathy. HBPD International 2018;17:113–8. https://doi.org/10.1016/j.hbpd.2018.02.006.
5. Silva, M, Marques, M, Cardoso, H, Rodrigues, S, Andrade, P, Peixoto, A, et al.. Glycogenic hepatopathy in young adults: a case series. Rev Esp Enferm Dig 2016;108:672–6. https://doi.org/10.17235/reed.2016.3934/2015.