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Postpartum fatal fulminant hepatic failure presenting with persistent hypoglycemia due to acute fatty liver of pregnancy

1 Department of Medicine, Guru Teg Bahadur Hospital, Delhi, India
2 Department of Obstetrics and Gynaecology, Guru Teg Bahadur Hospital, Delhi, India

Correspondence Address:
Anant Parasher,
House No. 14/8, Model Town, Khandsa Road, Opposite Shivaji Nagar Police Station, Gurugram - 122 001, Haryana
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jmedsci.jmedsci_179_20

Acute fatty liver of pregnancy (AFLP) is a sudden and devastating illness which occurs mostly around the 36th week of gestation in pregnant females. It is characterized by microvesicular fatty infiltration of the liver which eventually results in encephalopathy and hepatic failure. It carries significant perinatal and maternal mortality and requires early diagnosis and intervention to prevent maternal and fetal death. The foremost cause of AFLP is thought to be due to a mitochondrial dysfunction in the oxidation of fatty acids leading to their continuous accumulation in the hepatocytes. Early diagnosis is extremely important and the only definitive therapy is delivery. Here, we present the case of a 28-year-old pregnant female presenting with abdominal pain, vomiting, and jaundice who was diagnosed with AFLP and gradually worsened postpartum. Due to persistent hypoglycemia and rapidly developing fulminant hepatic failure, the patient expired 5 days after admission.


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