title: Postpartum Acute Liver Dysfunction: A Case of Acute Fatty Liver of Pregnancy Developing Massive Intrahepatic Calcification.
abstract: The function of the liver is particularly affected by the unique physiologic milieu of the pregnancy. Pregnancy-related liver diseases encompass a spectrum of different etiologies that are related to gestation or one of its complications. Hepatic calcification, a rare entity, is usually associated with infectious, vascular, or neoplastic lesions in the liver. To the best of our knowledge, only one case of rapidly occurring pregnancy-related intrahepatic calcification has been documented in a patient with severe eclampsia or hemolysis, elevated liver enzymes and low platelet count (HELLP) syndrome. Here we present a case of immediate "postpartum" acute fatty liver of pregnancy (AFLP) in a 23-year-old hypertensive primigravida, complicated by acute renal dysfunction who developed dense intrahepatic calcification in less than a month after the initial diagnosis. A multidisciplinary approach for the management was used, to which the patient responded aptly. This case illustrates the first description of intrahepatic calcification in AFLP syndrome and highlights some of the challenges met in making the final diagnosis.
authors: Department of Internal Medicine, GMC & Hospitals, Srinagar, Kashmir 190010, India.
authors: Khalid Javid
authors: KJ
authors: Bhat
authors: Department of Internal Medicine, ASCOMS & Hospitals, Sidhra, Jammu, Jammu & Kashmir, 180017, India.
authors: Rabia
authors: R
authors: Shovkat
authors: Department of Internal Medicine, Safdarjang Hospital, Ansari Nagar, New Delhi 110029, India.
authors: Hamad Jeelani
authors: HJ
authors: Samoon
keywords: Acute fatty liver of pregnancy; Acute kidney injury; Massive intrahepatic calcification