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|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.|
|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|
Liver Failure, Acute.diagnosis
|Appears in Collections:||Journal articles|
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