Hepatic subcapsular steatosis in diabetic CAPD patients treated with intraperitoneal insulin. Description of a typical pattern.
OBJECTIVE
To describe a specific imaging pattern of hepatic fatty change typical of diabetic patients on continuous ambulatory peritoneal dialysis (CAPD) treated with intraperitoneal (i.p.) insulin.


METHODS
Liver ultrasound was applied in 16 CAPD patients with insulin-dependent diabetes mellitus. Presence of hepatic subcapsular steatosis and maximum thickness of the fatty layer were recorded. Liver MR examination was made of 1 patient found to have extensive subcapsular steatosis.


RESULTS
Hepatic ultrasound revealed a typical pattern of subcapsular steatosis ("coating-of-fat") in 7/8 patients treated with i.p. insulin. None (0/8) of the diabetic CAPD patients treated with subcutaneous insulin had subcapsular steatosis.


CONCLUSIONS
Hepatic subcapsular steatosis is specific to CAPD patients on i.p. insulin treatment. To our knowledge this is the first report to describe imaging findings in this particular form of hepatic fatty change.
Kallio
T
T
Medical School, University of Tampere, and Department of Radiology, Tampere University Hospital, Tampere, Finland.
Nevalainen
P I
PI
Lahtela
J T
JT
Mustonen
J
J
Pasternack
A
A
D000328:Adult; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy; D003928:Diabetic Nephropathies / Q000628:therapy*; D015314:Dialysis Solutions; D005234:Fatty Liver / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007328:Insulin / Q000008:administration & dosage* / Q000009:adverse effects; D008099:Liver / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory; D014463:Ultrasonography
D015314:Dialysis Solutions; D007328:Insulin