Isolated fatty liver from prolonged propofol use in a pediatric patient with refractory status epilepticus

Area of Science:

• Anesthesiology and Critical Care Medicine
• Pediatric Neurology

Background:

• Propofol is a common sedative/hypnotic in intensive care.
• It's frequently used for refractory status epilepticus in pediatric and adult patients.
• Prolonged infusions carry risks, including fatty liver and extrahepatic complications.

Observation:

• A pediatric patient with refractory status epilepticus received a prolonged propofol infusion.
• The patient developed pathologically confirmed fatty liver.
• Notably, this occurred without the commonly associated extrahepatic manifestations.

Findings:

• This case presents isolated, pathologically confirmed fatty liver in a pediatric patient receiving prolonged propofol infusion for status epilepticus.
• It suggests that fatty liver can manifest independently of other known propofol-related extrahepatic side effects.

Implications:

• This finding expands the understanding of propofol's potential adverse effects, particularly in pediatric critical care.
• Clinicians should consider isolated fatty liver as a possible complication of prolonged propofol use, even without other signs.
• Further research is needed to elucidate the mechanisms and prevalence of isolated propofol-induced fatty liver.