Acute fatty liver in the second trimester.
BACKGROUND
Acute fatty liver of pregnancy is a rare, potentially fatal disease that occurs in the late third trimester or early postpartum period. The case of a woman with acute fatty liver in the second trimester is presented.


METHODS
A 35-year-old woman, gravida 5, para 4, presented at 22 weeks' gestation with nausea, vomiting, malaise, weight loss, and moderately elevated liver transaminase levels. The differential diagnoses included viral gastroenteritis and cholelithiasis. During the next 12 days, her transaminase levels increased, jaundice developed, her sensorium changed, and coagulopathy appeared. After the patient was transferred to a tertiary care hospital, acute fatty liver of pregnancy was diagnosed. The woman rapidly improved after delivery.


CONCLUSIONS
Although acute fatty liver of pregnancy usually occurs in the late third trimester or early postpartum period, it can occur in the second trimester.
Department of Obstetrics, Gynecology and Reproductive Sciences, University of Texas Medical School Houston, 77030, USA. mmonga@obg.med.uth.tmc.edu
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D000208:Acute Disease; D000328:Adult; D003937:Diagnosis, Differential; D005234:Fatty Liver / Q000175:diagnosis* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D011262:Pregnancy Trimester, Second; D014057:Tomography, X-Ray Computed