Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/12034
Title: Acute hepatic decompensation precipitated by pregnancy-related catabolic stress: a rare mimic of acute liver failure.
Authors: Sinclair, Marie;Ket, Shara;Testro, Adam G;Gow, Paul J;Angus, Peter W
Affiliation: Liver Transplant Unit Victoria, Austin Health, Heidelberg, Victoria, Australia.
Issue Date: 1-Feb-2014
Citation: Obstetrics and Gynecology; 123(2 Pt 2 Suppl 2): 480-3
Abstract: Abnormal liver function tests are common in pregnancy; however, liver failure is rare. Pregnancy is a catabolic state that can precipitate illness in patients with underlying metabolic disorders.A 19-year-old woman presented at 14 weeks of gestation with an alanine transaminase of 2,252 international units/L (less than 30), an international normalized ratio of 6.9 (0.9-1.2), and an ammonia of 58 micromole/L (11-51 micromole/L). No cause was identified on routine investigations including liver biopsy. Biochemical and clinical deterioration prompted investigation for a metabolic disorder. Urinary orotic acid was elevated, consistent with the urea cycle disorder type 1 citrullinemia. Appropriate management (arginine supplementation and dietary protein restriction) led to rapid improvement and later delivery of a healthy neonate.This is an unusual presentation that reminds us of the importance of considering metabolic disorders during the catabolic stress of pregnancy.
Internal ID Number: 24413235
URI: http://ahro.austin.org.au/austinjspui/handle/1/12034
DOI: 10.1097/AOG.000000000000005
URL: http://www.ncbi.nlm.nih.gov/pubmed/24413235
Type: Journal Article
Subjects: Citrullinemia.complications.diagnosis
Diagnosis, Differential
Female
Humans
Liver Failure, Acute.diagnosis
Pregnancy
Pregnancy Complications.diagnosis
Young Adult
Appears in Collections:Journal articles

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