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Acute fatty liver in pregnancy
A C I T L Tan1, J H J M van Krieken, W H M Peters
1Department of Gastroenterology, University Medical Centre St Radboud, Nijmegen, The Netherlands. a.tan@hccnet.nl
The Netherlands Journal of Medicine
|February 8, 2003
Summary
Acute fatty liver of pregnancy requires careful diagnosis, especially differentiating it from pre-eclampsia and HELLP syndrome. Liver function normalizes postpartum, and this case found no beta-oxidation defects in mother or child.
Area of Science:
- Hepatology
- Obstetrics
- Maternal-Fetal Medicine
Background:
- Acute fatty liver of pregnancy (AFLP) presents with liver abnormalities in the third trimester.
- Differential diagnosis includes (pre-)eclampsia and HELLP syndrome, often posing clinical challenges.
- Liver biopsy, though rarely performed during pregnancy, can aid diagnosis.
Observation:
- A case of AFLP is presented with significant liver dysfunction, including decreased albumin and prolonged prothrombin time.
- These liver test abnormalities showed a slow but steady return to normal following delivery.
- Diagnostic testing for mitochondrial fatty acid beta-oxidation disorders was conducted on both mother and child.
Findings:
- The patient's liver function tests gradually normalized postpartum.
- No underlying disorders in beta-oxidation of mitochondrial fatty acids were identified in the mother.
- Similarly, the infant showed no evidence of beta-oxidation defects.
Implications:
- This case highlights the importance of considering AFLP in pregnant patients with unexplained liver dysfunction.
- While beta-oxidation defects are implicated in AFLP etiology, their absence in this case suggests other contributing factors.
- Postpartum recovery of liver function is a key characteristic of AFLP, supporting conservative management.