Clin Mol Hepatol.  2013 Dec;19(4):421-425. 10.3350/cmh.2013.19.4.421.

Three cases of glycogenic hepatopathy mimicking acute and relapsing hepatitis in type I diabetes mellitus

• Cha JH
• Ra SH
• Park YM
• Ji YK
• Lee JH
• Park SY
• Baik SK
• Kwon SO
• Cho MY
• Kim MY

• KMID: 1730889
• DOI: http://doi.org/10.3350/cmh.2013.19.4.421

Abstract

Glycogenic hepatopathy (GH) is an uncommon cause of serum transaminase elevation in type I diabetes mellitus (DM). The clinical signs and symptoms of GH are nonspecific, and include abdominal discomfort, mild hepatomegaly, and transaminase elevation. In this report we describe three cases of patients presenting serum transaminase elevation and hepatomegaly with a history of poorly controlled type I DM. All of the cases showed sudden elevation of transaminase to more than 30 times the upper normal range (like in acute hepatitis) followed by sustained fluctuation (like in relapsing hepatitis). However, the patients did not show any symptom or sign of acute hepatitis. We therefore performed a liver biopsy to confirm the cause of liver enzyme elevation, which revealed GH. Clinicians should be aware of GH so as to prevent diagnostic delay and misdiagnosis, and have sufficient insight into GH; this will be aided by the present report of three cases along with a literature review.

Keyword

Glycogen hepatopathy; Transaminase; Type I diabetes mellitus

MeSH Terms

Acute Disease
Adult
Alanine Transaminase/blood
Aspartate Aminotransferases/blood
Delayed Diagnosis
Diabetes Mellitus, Type 1/complications/*pathology
Diagnostic Errors
Female
Glycogen Storage Disease/complications/*diagnosis/ultrasonography
Hepatitis/diagnosis
Hepatomegaly/complications/*diagnosis/ultrasonography
Humans
Liver/pathology
Recurrence
Young Adult
Alanine Transaminase
Aspartate Aminotransferases