ACUTE FATTY LIVER OF PREGNANCY MASQUERADING AS HELLP SYNDROME
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2018, Vol 5, Issue 19
Abstract
PRESENTATION OF THE CASE A 28-year-old woman, G2P1L1 at 34-weeks gestation was admitted to our hospital with a history of generalized pruritus for 2 weeks. She also complained of malaise, nausea, vomiting, and yellow coloured urine since last ten days. There was no history of fever. She had no respiratory/urinary/neurological complaints. Antenatal history was uneventful. She had no documented evidence of systemic hypertension. Supportive treatment for acute viral hepatitis was given at a private clinic and she was referred to us for further care. Physical examination revealed a well-nourished, somnolent, but easily arousable woman. Her temperature was 36.7°C, pulse rate was 104/min, respiratory rate 20/ min, and blood pressure 120/80 mmHg. She was oriented to person, place, and time, and her focal neurological findings were non-contributory. She was icteric, with mild edema of the legs. Abdomen was no tender. Complete blood counts revealed a haemoglobin: 11g/ dl, total leucocyte count: 10, 400/cumm, and platelet count: 96, 000/cumm. Peripheral smear did not show haemolysis and serum lactate dehydrogenase (S.LDH) levels was high/ Liver function tests showed aspartate aminotransferase: 208 U/l, alanine aminotransferase: 304 U/l, total bilirubin: 18.3 mg/dl, direct bilirubin: 12.7 mg/dl, alkaline phosphatase: 532 U/l, total protein: 6g/dl, and albumin: 2.6 g/dl. Biochemical tests revealed blood urea: 40 mg/dl, serum creatinine: 2.5 mg/dl, serum glucose: 60 mg/dl, and serum ammonia: 106 μmol/L. Coagullogram revealed a prothrombin time of 60 seconds with international normalized ratio (INR) of 3.2, fibrinogen: 62 mg/dl, and fibrin degradation products (FDP): 360 μg/ml. Urine analysis showed mild proteinuria. Serology tests like HBsAg, HCV, and HIV were all negative.
Authors and Affiliations
Santhosh Narayanan, Divya Prakash, Gomathy Subramaniam, Lakshminarayanan Lakshminarayanan
Keywords
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- EP ID EP557444
- DOI 10.18410/jebmh/2018/335
- Views 95
- Downloads 0
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