# Acute glycogenic hepatopathy in pregnancy: a case report and literature review

## TL;DR

This paper reports the first case of acute glycogenic hepatopathy during pregnancy, highlighting its diagnosis and management.

## Contribution

The first English case report of AGH during pregnancy with accurate diagnosis and treatment guidance.

## Key findings

- AGH occurred in a pregnant woman with uncontrolled diabetes and resolved with conservative management.
- Rapid normalization of blood glucose after high-dose insulin therapy was associated with transaminase elevation.
- Correct diagnosis of AGH is crucial to avoid unnecessary delivery.

## Abstract

Acute glycogenic hepatopathy (AGH) is a rare complication of poorly controlled diabetes mellitus. This is the first report in the English literature describing accurate diagnosis and management of AGH during pregnancy.

A 46 year-old gravida 4 para 2 presented at 30 weeks gestation with uncontrolled diabetes, ketoacidosis, and severe hypertension. Euglycemia and normotension were achieved within 24 h of admission but serum transaminase levels which had been normal on admission increased to a very high level over several days, and then resolved spontaneously.

AGH may occur during pregnancy and should be considered in the context of chronic poorly controlled overt diabetes, rapid normalization of maternal blood glucose levels following high dose insulin therapy, and unexplained new-onset serum transaminase levels elevation. Accurate diagnosis is important because the correct treatment is conservative management, not delivery.