Glycogen hepatopathy in type-1 diabetes mellitus: A case report

作     者：Yuvaraj Singh Susant Gurung Maya Gogtay 

作者机构：Internal MedicineSaint Vincent HospitalWorcesterMA 01604United States 

出 版 物：《World Journal of Hepatology》 (世界肝病学杂志（英文版）（电子版）)

年 卷 期：2022年第14卷第2期

页      面：471-478页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

基　　金：Centers for Disease Control and Prevention United States Agency for International Development World Health Organization National Center for Immunization and Respiratory Diseases 

主　　题：Glycogen Mauriac Hepatic Steatosis Diabetes Type 1 Case report 

摘      要：BACKGROUND It has been studied that fluctuating glucose levels may superimpose glycated hemoglobin in determining the risk for diabetes mellitus(DM)*** non-alcoholic steatohepatitis(NASH)remains a predominant cause of elevated transaminases in Type 2 DM due to a strong underplay of metabolic syndrome,Type 1 DM can contrastingly affect the liver in a direct,benign,and reversible manner,causing Glycogen hepatopathy(GH)-with a good *** SUMMARY A 50-year-old female with history of poorly controlled type 1 DM,status post cholecystectomy several years ago,and obesity presented with nausea,vomiting,and abdominal *** vitals at the time of admission were *** physical examination,she had diffuse abdominal *** finger-stick glucose was 612 mg/dL with elevated ketones and low *** labs revealed abnormal liver studies:AST 1460 U/L,ALP:682 U/L,ALP:569 U/L,total bilirubin:0.3mg/dL,normal total protein,albumin,and prothrombin time/international normalized ratio(PT/INR).A magnetic resonance cholangiopancreatography(MRCP)demonstrated mild intra and extra-hepatic biliary ductal dilation without evidence of *** subsequently underwent a diagnostic ERCP which showed a moderately dilated CBD,for which a stent was *** for viral hepatitis,Wilson’s Disease,alpha-1-antitrypsin,and iron panel came back *** to waxing and waning transaminases during the hospital course,a liver biopsy was eventually done,revealing slightly enlarged hepatocytes that were PAS-positive,suggestive of glycogenic *** treatment of hyperglycemia and ensuing strict glycemic control,her transaminases improved,and she was *** With a negative hepatocellular and cholestatic work-up,our patient likely had GH,a close differential for NASH but a poorly recognized ***,first described in 1930 as a component of Mauriac syndrome,is believed to be due to glucose and insulin levels *** echo