Glycogenic hepatopathy (GH) is a disorder associated with uncontrolled diabetes mellitus, most commonly type 1, expressed as right upper quadrant abdominal. Periodic acid Schiff stain for glycogen was positive in these hepatocytes. A diagnosis of glycogenic hepatopathy was made after clinicopathological correlation. We describe a presentation of glycogenic hepatopathy in a poorly controlled type I diabetic patient. As patients with glycogenic hepatopathy.
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Furthermore, persistent reversal has been observed following pancreas transplantation [ 2 ]. This is an open access article distributed under the Creative Commons Attribution Licensewhich permits unrestricted use, distribution, and reproduction in any medium, provided the glydogenic work is properly cited.
Complete reversal of glycogen hepatopathy with pancreas transplantation: Case Reports in Hepatology. However, liver synthetic functions were usually preserved.
Glycogenic hepatopathy: A narrative review
Stored mainly in the liver and skeletal muscles, glycogen is a polymer of glucose that acts as a reservoir for glucose. It is predominantly seen in patients with longstanding type 1 diabetes mellitus and rarely reported in association with type 2 diabetes mellitus. There has been a recent report of varying degree of liver fibrosis identified in patients with GH. The hallmark of the GH is severe fluctuation in levels of glucose and administration of supraphysiologic levels of insulin to control the hyperglycemia.
As an up-regulator of glycogenolysis and a down-regulator of glycogenesis, glucagon would facilitate the breakdown of glycogen to allow the release of glucose into the bloodstream. Ultrastructural examination revealed marked glycogen accumulation in the cytoplasm and nuclei.
Spectrum of clinical manifestations hepatopxthy from asymptomatic patients to those with considerable symptoms, and rarely presents with acute liver failure. A year-old male patient was admitted to the emergency department due to loss of appetite and nausea complaints that continued for two days.
Glycogenic Hepatopathy: Resolution with Minimal Glucose Control
Martin J, Tomlinson P. The clinical symptoms and signs of GH are nonspecific, and include abdominal pain, hepatomegaly, and marked transaminases elevation resembling acute and relapsing hepatitis. Hepatomegaly resolved soon after discontinuing the steroid therapy blycogenic all patients hepatopatthy hepatomegaly. Evidence of hepatocellular injury and fibrosis would indicate increased severity and progression to actual steatohepatitis. In some patients with poorly controlled diabetes and mild abnormalities in liver function tests, it is reasonable to defer biopsy until following a trial of improved glycemic control.
Glycogenic hepatopathy: an underrecognized hepatic complication of diabetes mellitus.
Atmaca et al[ 30 ], Indian J Endocrinol Metab. A case of mauriac syndrome. Gastroenterology and hepatology Country of origin: Is a hepatic manifestation of microangiopathic disease seen in long -standing DM.
Deemer et al[ 35 ], Dual-Echo MRI; iso-intense between the in-phase and out-of-phase images, and low intensity on subtraction Glycogen deposition in the cytoplasm with swollen hepatocytes, with or without mild steatosis and fibrosis.
Reported are the clinical and pathologic features of glycogenic hepatopathy, a pathologic overloading of hepatocytes with glycogen that is associated with poorly controlled diabetes mellitus.
Cui LJ L- Editor: Hyperglycemia and overinsulinization are believed to be metabolic preconditions for hepatic glycogen accumulation in GH. GH should not be overlooked as a differential diagnosis solely due to its underrepresentation in diabetic patients.
A case of glycogenic hepatopathy developed in a patient with new-onset fulminant type 1 diabetes: NAFLD is likewise more likely to progress to fibrosis, cirrhosis and or hepatocellular carcinoma. May have varying degrees of fibrosis Radiologic and liver biopsy Lifestyle modification and pharmacologic therapies. Nonalcoholic fatty liver disease NAFLD is the most common cause of chronic liver disease for both the general and the diabetic populations today.
Open in a separate window. Additionally, GH can also be observed in adult type 1 diabetic individuals without other components of Mauriac syndrome [ 6 — 8 ]. Histopathology of a case reported by Shah et al[ 41 ]. So far, liver biopsy is the only diagnostic tool that can differentiate between the 2 conditions.
Silva et al[ 34 ], The case presented was followed up for the past three years with NAFLD diagnosis due to elevated liver enzyme levels and ultrasonographic hepatosteatosis appearance. It is typically reversible with good glycemic control and rarely progresses to mild fibrosis, but not cirrhosis.