clinical-gastroenterology-digestive-diseases2017-posters

Volume 7, Issue 6 (Suppl)

J Gastrointest Dig Syst, an open access journal

ISSN: 2161-069X

Page 73

December 07-08, 2017 Madrid, Spain

International Conference on Clinical Gastroenterology & Hepatology

International Conference on Digestive Diseases

CO-ORGANIZED EVENT

A 24-year old female with indeterminate hyperacute liver failure: A case report

Maria Elizabeth Ching

and

Marie Antoinette Lontok

St. Luke’s Medical Center - Global City, Philippines

Background:

Acute liver failure (ALF) in young age is rare, yielding limited known data in its pathophysiology andmanagement.

ALF refers to sudden massive hepatic necrosis with encephalopathy and impaired synthetic function without pre-existing

cirrhosis.

Case Description:

A previously healthy 24 year old female with a history of lacrimal gland tumor on chronic oral prednisone

(40 mg) for a year was admitted for acute decreased sensorium, generalized jaundice, tea-colored urine, anorexia and

undocumented fever. Interval between jaundice and encephalopathy was hyperacute (<7 days).

Results:

Laboratory findings showed hyperbilirubinemia, transaminitis, elevated alkaline phosphatase, impaired coagulation

hyperammonemia and normal platelets. Extensive work-up including hepatitis panel, paracetamol, methamphetamine,

cannabinoids, benzodiazepine, barbiturates, cocaine, opiates, phencyclidine, cytomegalovirus IgM, EBV, HSV1, HSV2, C3,

anti-Sm and anti-mitochondrial antibody, LKM1, ceruloplasmin, strepA throat screen test, malarial smear and leptospiral IgM

were all unremarkable. Medical and supportive treatments were promptly provided and orthotopic liver transplantation (OLT)

was contemplated, however, cerebral edema and hemorrhage ensued on day 5 leading to demise.

Discussion:

Etiology varies widely among toxic, viral, metabolic and vascular insults. There are rare reports of ALF with

repeated steroid administration. Management consisting of intensive care should be initiated depending on the etiology and

chronicity of ALF. OLT has emerged as the only therapeutic intervention with proven benefit for patients with advanced ALF.

Conclusion:

We report a case of indeterminate hyperacute liver failure in a healthy female. Despite extensive work-up

and prompt intensive medical management, rapid clinical deterioration ensued. History of chronic steroid use might be a

precipitant, as supported by few case reports.

J Gastrointest Dig Syst 2017, 7:6(Suppl)

DOI: 10.4172/2161-069X-C1-059