Postpartum acute fatty liver of pregnancy: a case report
Abstract Background Acute fatty liver of pregnancy can be a very dramatic clinical event with significant risk of mortality to healthy women. The pathogenesis is still unknown. It usually occurs in the third trimester or in the immediate postpartum period. The clinical presentation is very variable....
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| Format: | Article |
| Language: | English |
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BMC
2018-06-01
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| Series: | Journal of Medical Case Reports |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13256-018-1593-3 |
| _version_ | 1819100593390616576 |
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| author | Naser Al-Husban Oqba Al-Kuran Amal Al Helou |
| author_facet | Naser Al-Husban Oqba Al-Kuran Amal Al Helou |
| author_sort | Naser Al-Husban |
| collection | DOAJ |
| description | Abstract Background Acute fatty liver of pregnancy can be a very dramatic clinical event with significant risk of mortality to healthy women. The pathogenesis is still unknown. It usually occurs in the third trimester or in the immediate postpartum period. The clinical presentation is very variable. Medical staff have to be very cautious even regarding a minor complaint of feeling unwell. Skin rash has not been reported as one of the initial presentations of acute fatty liver of pregnancy. It is best treated in a center with a multidisciplinary approach. Admission to the intensive care unit is recommended. Case presentation We report a case of a 20-year-old Middle Eastern Arabic woman who developed an acute fatty liver of pregnancy. She was not known to have any medical disease. She had had two previous uncomplicated deliveries. She developed acute fatty liver of pregnancy on the first day after an uncomplicated normal vaginal delivery of a healthy male newborn. She started to have nonitchy skin rash over her abdomen and upper limbs. Then she started to feel unwell. Twelve hours later, she developed epigastric and right upper quadrant abdominal pain, followed by jaundice, nausea, and vomiting. She developed recurrent hypoglycemic attacks, hemolytic anemia, coagulopathy, and hepatorenal syndrome. Conclusions The clinical presentation of acute fatty liver of pregnancy is very variable and nonspecific. Skin rash can be a new presenting symptom of acute fatty liver of pregnancy. Immediate suspicion of the diagnosis, appropriate investigations, and urgent initiation of therapy in an intensive care unit and by a multidisciplinary team resulted in a good outcome with no adverse health consequences for our patient. |
| first_indexed | 2024-12-22T01:05:14Z |
| format | Article |
| id | doaj.art-3294d1304a724621aef13995d3b5a39e |
| institution | Directory Open Access Journal |
| issn | 1752-1947 |
| language | English |
| last_indexed | 2024-12-22T01:05:14Z |
| publishDate | 2018-06-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Medical Case Reports |
| spelling | doaj.art-3294d1304a724621aef13995d3b5a39e2022-12-21T18:44:06ZengBMCJournal of Medical Case Reports1752-19472018-06-011211610.1186/s13256-018-1593-3Postpartum acute fatty liver of pregnancy: a case reportNaser Al-Husban0Oqba Al-Kuran1Amal Al Helou2Obstetrics & Gynecology Department, Faculty of Medicine, University of Jordan and Jordan University HospitalObstetrics & Gynecology Department, Faculty of Medicine, University of Jordan and Jordan University HospitalObstetrics & Gynecology Department, Faculty of Medicine, University of Jordan and Jordan University HospitalAbstract Background Acute fatty liver of pregnancy can be a very dramatic clinical event with significant risk of mortality to healthy women. The pathogenesis is still unknown. It usually occurs in the third trimester or in the immediate postpartum period. The clinical presentation is very variable. Medical staff have to be very cautious even regarding a minor complaint of feeling unwell. Skin rash has not been reported as one of the initial presentations of acute fatty liver of pregnancy. It is best treated in a center with a multidisciplinary approach. Admission to the intensive care unit is recommended. Case presentation We report a case of a 20-year-old Middle Eastern Arabic woman who developed an acute fatty liver of pregnancy. She was not known to have any medical disease. She had had two previous uncomplicated deliveries. She developed acute fatty liver of pregnancy on the first day after an uncomplicated normal vaginal delivery of a healthy male newborn. She started to have nonitchy skin rash over her abdomen and upper limbs. Then she started to feel unwell. Twelve hours later, she developed epigastric and right upper quadrant abdominal pain, followed by jaundice, nausea, and vomiting. She developed recurrent hypoglycemic attacks, hemolytic anemia, coagulopathy, and hepatorenal syndrome. Conclusions The clinical presentation of acute fatty liver of pregnancy is very variable and nonspecific. Skin rash can be a new presenting symptom of acute fatty liver of pregnancy. Immediate suspicion of the diagnosis, appropriate investigations, and urgent initiation of therapy in an intensive care unit and by a multidisciplinary team resulted in a good outcome with no adverse health consequences for our patient.http://link.springer.com/article/10.1186/s13256-018-1593-3Fatty liverPregnancyLiver dysfunctionPostpartumSkin rash |
| spellingShingle | Naser Al-Husban Oqba Al-Kuran Amal Al Helou Postpartum acute fatty liver of pregnancy: a case report Journal of Medical Case Reports Fatty liver Pregnancy Liver dysfunction Postpartum Skin rash |
| title | Postpartum acute fatty liver of pregnancy: a case report |
| title_full | Postpartum acute fatty liver of pregnancy: a case report |
| title_fullStr | Postpartum acute fatty liver of pregnancy: a case report |
| title_full_unstemmed | Postpartum acute fatty liver of pregnancy: a case report |
| title_short | Postpartum acute fatty liver of pregnancy: a case report |
| title_sort | postpartum acute fatty liver of pregnancy a case report |
| topic | Fatty liver Pregnancy Liver dysfunction Postpartum Skin rash |
| url | http://link.springer.com/article/10.1186/s13256-018-1593-3 |
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