Chronic pericardial constriction induced severe ischemic hepatitis manifesting as hypoglycemic attack

Area of Science:

• Hepatology
• Cardiology
• Endocrinology

Background:

• Ischemic hepatitis, or shock liver, presents as a transient rise in serum transaminases, often linked to cardiac failure.
• Constrictive pericarditis is a condition affecting the heart's outer lining.

Observation:

• A patient with a history of constrictive pericarditis presented with hypoglycemia and altered consciousness.
• The patient subsequently developed ischemic hepatitis, with rapidly normalizing transaminases but progressive jaundice.

Findings:

• The patient ultimately died from multiple organ failure.
• Hypoglycemia, secondary to impaired gluconeogenesis in a compromised liver, is a rare but serious complication of constrictive pericarditis.

Implications:

• This case underscores the complex interplay between cardiac and hepatic function.
• Recognizing hypoglycemia as a potential complication of constrictive pericarditis is crucial for timely intervention.
• Further research into the mechanisms linking constrictive pericarditis to hepatic dysfunction and hypoglycemia is warranted.