| Title |
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Acute hepatic decompensation precipitated by pregnancy-related catabolic stress: a rare mimic of acute liver failure. |
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| Author(s) |
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| Type of document |
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| OrcId |
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#PLACEHOLDER_PARENT_METADATA_VALUE# |
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#PLACEHOLDER_PARENT_METADATA_VALUE# |
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#PLACEHOLDER_PARENT_METADATA_VALUE# |
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#PLACEHOLDER_PARENT_METADATA_VALUE# |
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#PLACEHOLDER_PARENT_METADATA_VALUE# |
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| DOI |
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10.1097/AOG.000000000000005 |
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| Abstract |
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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. |
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| Link |
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| Citation |
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Obstetrics and Gynecology; 123(2 Pt 2 Suppl 2): 480-3 |
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| Jornal Title |
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Obstetrics and Gynecology |
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