TY - JOUR
T1 - Hepatic encephalopathy precipitated by preeclampsia in the setting of cirrhosis
T2 - A case report
AU - Fang, Mary E.
AU - Peoples, Nicholas A.
AU - Goulding, Alison N.
AU - Tolcher, Mary C.
N1 - Publisher Copyright:
© 2024
PY - 2024/3
Y1 - 2024/3
N2 - Preeclampsia and decompensated chronic liver disease are known triggers of acute hepatic dysfunction in pregnancy, rarely including hepatic encephalopathy. Differentiating the driver of acute hepatic dysfunction in patients with concomitant preeclampsia and preexisting liver disease presents a diagnostic challenge with important management implications. A 42-year-old woman, gravida 3 para 0201, at 24 1/7 weeks of gestation presented with hepatic encephalopathy, transaminitis, and hyperbilirubinemia in the setting of cirrhosis and severe new-onset preeclampsia. The preeclampsia was thought to be the leading etiology of hepatic encephalopathy, prompting emergent Cesarean delivery at 24 2/7 weeks. Hepatic encephalopathy, blood pressure, and laboratory derangements improved promptly post-delivery. Preeclampsia can trigger acute hepatic dysfunction, including hepatic encephalopathy, in the setting of previously compensated preexisting liver disease. Recognizing this association has important implications for management and treatment.
AB - Preeclampsia and decompensated chronic liver disease are known triggers of acute hepatic dysfunction in pregnancy, rarely including hepatic encephalopathy. Differentiating the driver of acute hepatic dysfunction in patients with concomitant preeclampsia and preexisting liver disease presents a diagnostic challenge with important management implications. A 42-year-old woman, gravida 3 para 0201, at 24 1/7 weeks of gestation presented with hepatic encephalopathy, transaminitis, and hyperbilirubinemia in the setting of cirrhosis and severe new-onset preeclampsia. The preeclampsia was thought to be the leading etiology of hepatic encephalopathy, prompting emergent Cesarean delivery at 24 2/7 weeks. Hepatic encephalopathy, blood pressure, and laboratory derangements improved promptly post-delivery. Preeclampsia can trigger acute hepatic dysfunction, including hepatic encephalopathy, in the setting of previously compensated preexisting liver disease. Recognizing this association has important implications for management and treatment.
KW - Chronic liver disease
KW - Cirrhosis
KW - Hypertensive disorders of pregnancy
KW - Liver dysfunction
KW - Maternal-fetal medicine
KW - Preeclampsia
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UR - http://www.scopus.com/inward/citedby.url?scp=85187987942&partnerID=8YFLogxK
U2 - 10.1016/j.crwh.2024.e00587
DO - 10.1016/j.crwh.2024.e00587
M3 - Article
C2 - 38515998
AN - SCOPUS:85187987942
SN - 2214-9112
VL - 41
JO - Case Reports in Women's Health
JF - Case Reports in Women's Health
M1 - e00587
ER -