Published online Jul 27, 2014. doi: 10.4254/wjh.v6.i7.527
Revised: May 20, 2014
Accepted: June 10, 2014
Published online: July 27, 2014
Acute fatty liver of pregnancy is a rare disease that affects women in the third trimester of pregnancy. Although infrequent, the disease can cause maternal mortality. The diagnosis is not always clear until the pregnancy is terminated, and significant complications, such as acute pancreatitis, can occur. Pancreatic involvement typically only occurs in severe cases after the development of hepatic and renal impairment. To date, little knowledge is available regarding how the disease causes pancreatitis. Treatment involves supportive measures and pregnancy interruption. In this report, we describe a case of a previously healthy 26-year-old woman at a gestational age of 27 wk and 6 d who was admitted with severe abdominal pain and vomiting. This case illustrates the clinical and laboratory overlap between acute fatty liver of pregnancy and pancreatitis, highlighting the difficulties in differentiating each disease. Furthermore, the hypothesis for this overlapping is presented, and the therapeutic options are discussed.
Core tip: A previously healthy 26-year-old woman at 27 wk and 6 d of pregnancy was referred for investigation of abdominal pain. She presented with complaints of diffuse abdominal pain with nausea and vomiting associated with hepatic and renal dysfunction. Acute fatty liver of pregnancy and severe acute pancreatitis were diagnosed. Acute fatty liver of pregnancy is rarely associated with severe acute pancreatitis, which can complicate the diagnosis. The possible mechanisms involved in this association and the current therapies are discussed, focusing on the relevant aspects to improve the management of similar cases.