title: Glycogenic hepatopathy in young adults: a case series.
abstract: Glycogenic hepatopathy is a rare and under-recognized complication in long-standing poorly controlled type 1 diabetes mellitus patients. This is a distinct entity from other causes of hepatomegaly and elevated liver enzymes in diabetics, such as nonalcoholic fatty liver disease. Glycogenic hepatopathy is characterized by the combination of poorly controlled diabetes, acute liver injury with marked elevation in serum aminotransferases, and the characteristic histological features on liver biopsy. It is important to distinguish this entity as it has the potential for resolution following improved glycemic control. In this report, we describe four cases of adult patients presenting elevated serum transaminases and hepatomegaly with a history of poorly controlled type I diabetes mellitus. One of the patients had also elevated amylase and lipase in the serum, without clinical or imagiologic evidence of acute pancreatitis (AP). Liver biopsy was performed in all patients and revealed glycogenic hepatopathy. Clinician's awareness of glycogenic hepatopathy should prevent diagnostic delay or misdiagnosis and will provide better insight and management for this condition.
authors.affiliation: Gastroenterology, Centro Hospitalar São João, Portugal.
authors.forename: Marco
authors.initials: M
authors.lastname: Silva
authors.affiliation: Gastroenterology, Centro Hospitalar São João, Portugal.
authors.forename: Margarida
authors.initials: M
authors.lastname: Marques
authors.affiliation: Gastroenterology, Centro Hospitalar São João, Portugal.
authors.forename: Hélder
authors.initials: H
authors.lastname: Cardoso
authors.affiliation: Gastroenterology, Centro Hospitalar São João, Portugal.
authors.forename: Susana
authors.initials: S
authors.lastname: Rodrigues
authors.affiliation: Gastroenterology department, Centro Hospitalar São João, Portugal.
authors.forename: Patrícia
authors.initials: P
authors.lastname: Andrade
authors.affiliation: Gastrenterologia, Centro Hospitalar de São João, Portugal.
authors.forename: Armando
authors.initials: A
authors.lastname: Peixoto
authors.affiliation: Pathology, Centro Hospitalar São João, Portugal.
authors.forename: Joana
authors.initials: J
authors.lastname: Pardal
authors.affiliation: Pathology, Centro Hospitalar São João, Portugal.
authors.forename: Joanne
authors.initials: J
authors.lastname: Lopes
authors.affiliation: Pathology, Centro Hospitalar São João, Portugal.
authors.forename: Fátima
authors.initials: F
authors.lastname: Carneiro
authors.affiliation: Gastroenterology, Centro Hospitalar S. João, Portugal.
authors.forename: Guilherme
authors.initials: G
authors.lastname: Macedo
mesh_terms: D000328:Adult; D057210:Delayed Diagnosis; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D003937:Diagnosis, Differential; D005260:Female; D006003:Glycogen / Q000378:metabolism*; D006801:Humans; D008107:Liver Diseases / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D008297:Male; D010349:Patient Compliance; D055815:Young Adult
chemical_list: D006003:Glycogen