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

World Journal of Hepatology 2022年第2期14卷 471-478页

作者： Yuvaraj Singh susant gurung Maya Gogtay Internal Medicine Saint Vincent HospitalWorcesterMA 01604United States

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

关键词： Glycogen Mauriac Hepatic Steatosis Diabetes Type 1 Case report

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