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conferenceseries
.com
Volume 7, Issue 5 (Suppl)
J Gastrointest Dig Syst, an open access journal
ISSN:2161-069X
Gastroenterology 2017
November 13-14, 2017
November 13-14, 2017 | Las Vegas, USA
13
th
International Conference on
Clinical Gastroenterology, Hepatology and Endoscopy
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
A
cute liver failure (ALF) in the young is rare, yielding limited known data in its pathophysiology and management. ALF refers
to sudden massive hepatic necrosis with encephalopathy and impaired synthetic function without pre-existing cirrhosis. A
previously healthy 24-year old female with a history of lacrimal gland tumor on chronic oral prednisone (40mg) 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). Laboratory findings showed hyperbilirubinemia, transaminitis, elevated
alkaline phosphatase, impaired coagulation hyperammonemia and normal platelets. Extensive work-up including hepatitis panel,
paracetamol, methamphetamine, cannabinoids, benzodiazepene, barbiturates, cocaine, opiates, phenylcyclidine, cytomegalovirus
IgM, EBV, HSV1, HSV2, C3, anti-Sm and anti-mitochondrial antibody, LKM1, cerulopalsmin, strepA throat screen test, malarial
smear and leptospiral IgM were all unremarkable. Medical and supportive treatment were promptly provided. Orthotopic liver
transplantation (OLT) was contemplated, however, cerebral edema and hemorrhage ensued on Day 5 leading to demise. 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. 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.
Biography
Maria Elizabeth Ching graduated from the national university, University of the Philippines, BS Biology (magna cum laude) and Doctor of Medicine. Consistently inclined in
the field of research, she presented her thesis dissertation on Genetically Modified Line of Tomato in Asian Vegetable Research and Development Center,Taiwan, and the
study Computational Modeling of H275Y and N295S mutations reveals novel interactions between influenza neuraminidase and oseltamivir in the 22nd European Students’
Conference, Charité Universitätsmedizin, Berlin, Germany. She is now a third-year internal medicine resident, and currently the Residents’ Research Head in the Depart-
ment of Medicine of St Luke’s Medical center, Global City.
mariaelizabethching@yahoo.comMaria Elizabeth Ching et al., J Gastrointest Dig Syst 2017, 7:5 (Suppl)
DOI: 10.4172/2161-069X-C1-055