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

作　　者：Yuvaraj Singh Susant Gurung Maya Gogtay 

机构地区：[1]Internal Medicine,Saint Vincent Hospital,Worcester,MA 01604,United States

出　　处：《World Journal of Hepatology》2022年第2期471-478,共8页世界肝病学杂志（英文版）（电子版）

摘　　要：BACKGROUND It has been studied that fluctuating glucose levels may superimpose glycated hemoglobin in determining the risk for diabetes mellitus(DM)complications.While 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 prognosis.CASE 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 pain.Her vitals at the time of admission were stable.On physical examination,she had diffuse abdominal tenderness.Her finger-stick glucose was 612 mg/dL with elevated ketones and low bicarbonate.Her 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 choledocholithiasis.She subsequently underwent a diagnostic ERCP which showed a moderately dilated CBD,for which a stent was placed.Studies for viral hepatitis,Wilson’s Disease,alpha-1-antitrypsin,and iron panel came back normal.Due 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 hepatopathy.With treatment of hyperglycemia and ensuing strict glycemic control,her transaminases improved,and she was discharged.CONCLUSION With a negative hepatocellular and cholestatic work-up,our patient likely had GH,a close differential for NASH but a poorly recognized entity.GH,first described in 1930 as a component of Mauriac syndrome,is believed to be due to glucose and insulin levels fluctuation.Dual echo magnetic resonance imaging sequencing and com

关 键 词：GLYCOGEN Mauriac HEPATIC STEATOSIS Diabetes Type 1 Case report 

分 类 号：R587.1[医药卫生—内分泌]