scholarly journals Adrenal Insufficiency as a Cause of Acute Liver Failure: A Case Report

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Jamshid Vafaeimanesh ◽  
Mohammad Bagherzadeh ◽  
Mahmoud Parham
Keyword(s):  
Case Report ◽  
Liver Failure ◽  
Adrenal Insufficiency ◽  
Liver Enzymes ◽  
Liver Involvement ◽  
Endocrine Disorders ◽  
Severe Fatigue ◽  
Elevated Liver Enzymes ◽  
Good General Condition ◽  
And Function

Introduction. Many diseases and conditions can contribute to elevated liver enzymes. Common causes include viral and autoimmune hepatitis, fatty liver, and bile duct diseases, but, in uncommon cases like liver involvement in endocrine disorders, liver failure is also seen. Adrenal insufficiency is the rarest endocrine disorder complicating the liver. In the previously reported cases of adrenal insufficiency, mild liver enzymes elevation was seen but we report a case with severe elevated liver enzymes and liver failure due to adrenal insufficiency. Based on our knowledge, this is the first report in this field.Case Report. A 39-year-old woman was referred to emergency ward due to drowsiness and severe fatigue. Her laboratory tests revealed prothrombin time: 21 sec, alanine aminotransferase (ALT): 2339 IU/L, aspartate aminotransferase (AST): 2002 IU/L, and ALP: 90 IU/L. No common cause of liver involvement was discovered, and eventually, with diagnosis of adrenal insufficiency and corticosteroid therapy, liver enzymes and function became normal. Finally, the patient was discharged with good general condition.Conclusion. With this report, we emphasize adrenal insufficiency (primary or secondary) as a reason of liver involvement in unexplainable cases and recommend that any increase in the liver enzymes, even liver failure, in these patients should be observed.

scholarly journals Haemolysis, elevated liver enzymes and low platelets: Diagnosis and management in critical care

2021 ◽  
pp. 175114372110254
Author(s):  
Evangelia Poimenidi ◽  
Yavor Metodiev ◽  
Natasha Nicole Archer ◽  
Richard Jackson ◽  
Mansoor Nawaz Bangash ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Critical Care ◽  
Liver Failure ◽  
Hellp Syndrome ◽  
Seizure Control ◽  
Liver Enzymes ◽  
Kidney Injury ◽  
Definitive Treatment ◽  
Multisystem Disease ◽  
Elevated Liver Enzymes

A thirty-year-old pregnant woman was admitted to hospital with headache and gastrointestinal discomfort. She developed peripheral oedema and had an emergency caesarean section following an episode of tonic-clonic seizures. Her delivery was further complicated by postpartum haemorrhage and she was admitted to the Intensive Care Unit (ICU) for further resuscitation and seizure control which required infusions of magnesium and multiple anticonvulsants. Despite haemodynamic optimisation she developed an acute kidney injury with evidence of liver damage, thrombocytopenia and haemolysis. Haemolysis, Elevated Liver enzymes and Low Platelets (HELLP) syndrome, a multisystem disease of advanced pregnancy which overlaps with pre-eclampsia, was diagnosed. HELLP syndrome is associated with a range of complications which may require critical care support, including placental abruption and foetal loss, acute kidney injury, microangiopathic haemolytic anaemia, acute liver failure and liver capsule rupture. Definitive treatment of HELLP is delivery of the fetus and in its most severe forms requires admission to the ICU for multiorgan support. Therapeutic strategies in ICU are mainly supportive and include blood pressure control, meticulous fluid balance and possibly escalation to renal replacement therapy, mechanical ventilation, neuroprotection, seizure control, and management of liver failure-related complications. Multidisciplinary input is essential for optimal treatment.

scholarly journals HELLP syndrome, a difficult diagnosis: a case report

2019 ◽  
Vol 8 (4) ◽  
pp. 1686
Author(s):  
Shweta Pradhan ◽  
Somen Bhattacharjee
Keyword(s):  
Case Report ◽  
Hellp Syndrome ◽  
Liver Enzymes ◽  
Severe Thrombocytopenia ◽  
Atypical Presentation ◽  
Third Trimester ◽  
Diagnostic Dilemma ◽  
Present Case Report ◽  
Elevated Liver Enzymes ◽  
Low Platelet Count

HELLP is an acronym that refers to a syndrome characterized by Haemolysis with a microangiopathic blood smear, Elevated Liver enzymes, and a Low Platelet count.  Recent studies suggested that some women will develop HELLP without the manifestations of classical symptoms. Authors present the case of a 22-year-old normotensive primigravida who went into severe thrombocytopenia and haemolysis leading to DIC, finally the diagnosis of normotensive HELLP syndrome was made. Present case report attempts to illustrate the diagnostic dilemma that a clinician faces in diagnosing an atypical presentation of HELLP syndrome. Management of jaundice during pregnancy especially in third trimester remains a dilemma for the obstetrician because of its varied aetiology, unpredictable prognosis and guarded perinatal outcome. Authors therefore recommend a rational stepwise approach toward the diagnosis of HELLP syndrome and its atypical presentation.

Fulminant liver failure resulting from massive hepatic infarction associated with hemolysis, elevated liver enzymes, and low platelets syndrome

2016 ◽  
Vol 42 (10) ◽  
pp. 1375-1378 ◽  
Author(s):  
Masato Yoshihara ◽  
Michinori Mayama ◽  
Mayu Ukai ◽  
Sho Tano ◽  
Yasuyuki Kishigami ◽  
...  
Keyword(s):  
Liver Failure ◽  
Liver Enzymes ◽  
Fulminant Liver Failure ◽  
Hepatic Infarction ◽  
Elevated Liver Enzymes

scholarly journals Poisoning with Soranjan (Colchicum): a case report

2021 ◽  
Vol 4 (2) ◽  
pp. 01-05
Author(s):  
Amir Noyani ◽  
Mitra Rahimi ◽  
Fatemeh Razavi ◽  
Mahtab Hajian
Keyword(s):  
Case Report ◽  
Chest Pain ◽  
Respiratory Distress ◽  
Broad Spectrum ◽  
Liver Enzymes ◽  
Shortness Of Breath ◽  
Broad Spectrum Antibiotic ◽  
Severe Nausea ◽  
Elevated Liver Enzymes ◽  
Patient’S History

Introduction: Colchicine, which is derived from a herb called Colchicum is a medication used to treat gout. Colchicum itself can act as a deadly toxic herb in the case of over dose. This is a case report study which investigates a patient who was poisoned with Colchicum (Soranjan, what it is called in Iran). Description: The patient was a 44-year-old man who came to the emergency poisoning ward after a day of mountaineering and eating Soup. He had severe nausea and vomiting. The patient was admitted to the ICU two days later with a toxic general condition, complaining of chest pain, nausea, vomiting and shortness of breath. The patient lab tests showed elevated liver enzymes and pancytopenia. The patient respiratory distress developed and physician had to intubate the patient. The patient was treated with antibiotics, GCSF for pancytopenia and antioxidant to protect the liver. Conclusion: The patient responded to broad spectrum antibiotic, antifungal and GCSF. paying attention to the patient’s history was the key of success to diagnosis.

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