Korean J Nephrol.  2011 Sep;30(5):557-560.

Hepatic Subcapsular Steatosis in a Diabetic CAPD Patient Receiving Subcutaneous Insulin

• Lee SY
• Kim HK
• Kang SM
• Jung JK
• Song EJ
• Lee SY

Abstract

Hepatic subcapsular steatosis is a rare and unique form of fatty change in the liver. It is a specific finding in diabetic patients receiving continuous ambulatory peritoneal dialysis (CAPD) and intraperitoneal insulin treatment. Intraperitoneal administration of insulin and high glucose cause a unique pattern of fatty infiltration in the subcapsular location of the liver. We report a case of hepatic subcapsular steatosis in a diabetic CAPD patient who has not received intraperitoneal insulin. A 63-year-old diabetic woman on CAPD presented with uncontrolled blood glucose. The patient received a total amount of 44 units of NPH via subcutaneous injection. Her initial blood chemistry showed mildly increased serum lipid profiles. Abdominal CT scan images and MRI revealed characteristic findings consistent with hepatic subcapsular steatosis. We report a case of hepatic subcapsular steatosis in a diabetic patient not taking intraperitoneal insulin who recovered through strict blood sugar control without changing dialysis modality.

Keyword

Fatty liver; Peritoneal dialysis; Diabetes mellitus

MeSH Terms

Blood Glucose
Diabetes Mellitus
Dialysis
Fatty Liver
Female
Glucose
Humans
Injections, Subcutaneous
Insulin
Liver
Middle Aged
Peritoneal Dialysis
Peritoneal Dialysis, Continuous Ambulatory
Blood Glucose
Glucose
Insulin