Two Fatty Liver Conditions Masquerading as Autoimmune Hepatitis

• Published in: Case reports in hepatology Vol. 2021; pp. 1 - 5
• Main Authors: Hendrie, Jonathan David, Blumer, Mary Crouse, Fenton, Hubert Henry, Abrams, Gary Anthony
• Format: Journal Article
• Language: English
• Published: New York Hindawi 09-03-2021; Hindawi Limited
• Subjects: Abdomen; Antibodies; Antigens; Biopsy; Blood; Case Report; Case reports; Creatinine; Fatty acids; Fetuses; Gallbladder diseases; Gestational age; Hepatitis; Hypoglycemia; Laboratories; Liver transplants; Metabolism; Metabolites; Mortality; Pathophysiology; Patients; Postpartum period; Pregnancy; Ultrasonic imaging; Vomiting; Womens health
• ISSN: 2090-6587; 2090-6595
• DOI: 10.1155/2021/8820350

Acute fatty liver of pregnancy (AFLP) is a rare obstetric condition that classically presents in the third trimester or early postpartum period and can lead to liver failure and death. Only six second trimester AFLP cases have been reported in the English literature. We present the earliest case of AFLP at 15 weeks of gestation confounded by a high titer anti-nuclear antibody (ANA >1 : 1280) and concern for autoimmune hepatitis. Our patient had intrauterine fetal demise with prompt dilation and evacuation. Sepsis and multisystem organ failure ensued, and she was transferred to a liver transplant center where she expired without further intervention.