Please use this identifier to cite or link to this item:
Title: Acute hepatic decompensation precipitated by pregnancy-related catabolic stress: a rare mimic of acute liver failure.
Austin 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
Publication information: 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.
Gov't Doc #: 24413235
DOI: 10.1097/AOG.000000000000005
Type: Journal Article
Subjects: Citrullinemia.complications.diagnosis
Diagnosis, Differential
Liver Failure, Acute.diagnosis
Pregnancy Complications.diagnosis
Young Adult
Appears in Collections:Journal articles

Show full item record

Page view(s)

checked on Dec 2, 2022

Google ScholarTM


Items in AHRO are protected by copyright, with all rights reserved, unless otherwise indicated.