A 21-Year-Old Woman with Hepatomegaly

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Caroline R. Barry MD
Amr M. Zaki MD
Vicki Munro MD
Glenn Patriquin MD MSc
Weei-Yuarn Huang MD
Karthik Tennankore MD

Keywords

diabetes mellitus type 1, hepatomegaly, elevated liver enzymes

Abstract

We report the case of a 21-year old woman with uncontrolled diabetes mellitus type 1 presenting with tender hepatomegaly and mildy elevated liver enzymes, with negative investigations for common causes. She was diagnosed by liver biopsy with glycogenic hepatopathy, an uncommon and likely under-recognized complication of poor glycemic control. The disease is typically reversible after weeks to months of appropriate insulin therapy and is unlikely to lead to permanent liver disease. Our patient was treated with a new insulin regimen and analgesics and discharged home. Unfortunately, on follow-up imaging in our patient 10 months later, her hepatomegaly persists. Her glycemic control remains unchanged and she has since been admitted to hospital twice for episodes of diabetic ketoacidosis.
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