Three cases of glycogenic hepatopathy mimicking acute and relapsing hepatitis in type I diabetes mellitus.
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.
Department of Internal Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea.
Jae Hwang
JH
Cha
Department of Internal Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea.
Sang Ho
SH
Ra
Department of Internal Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea.
Yu Mi
YM
Park
Department of Internal Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea.
Yong Kwan
YK
Ji
Department of Internal Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea.
Ji Hyun
JH
Lee
Department of Internal Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea.
So Yeon
SY
Park
Department of Internal Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea.
Soon Koo
SK
Baik
Department of Internal Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea.
Sang Ok
SO
Kwon
Department of Pathology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea.
Mee Yon
MY
Cho
Department of Internal Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea.
Moon Young
MY
Kim
D000208:Acute Disease; D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D057210:Delayed Diagnosis; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000473:pathology*; D003951:Diagnostic Errors; D005260:Female; D006008:Glycogen Storage Disease / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006505:Hepatitis / Q000175:diagnosis; D006529:Hepatomegaly / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006801:Humans; D008099:Liver / Q000473:pathology; D012008:Recurrence; D014463:Ultrasonography; D055815:Young Adult
D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase
Glycogen hepatopathy; Transaminase; Type I diabetes mellitus