Department of Internal Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea.
Department of Pathology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea.
Clin Mol Hepatol. 2013 Dec;19(4):421-5. doi: 10.3350/cmh.2013.19.4.421. Epub 2013 Dec 28.
Glycogenic hepatopathy (GH) is an uncommon cause of serum transaminase elevation in type I diabetes mellitus (DM). The clinical signs and symptoms of GH are nonspecific, and include abdominal discomfort, mild hepatomegaly, and transaminase elevation. In this report we describe three cases of patients presenting serum transaminase elevation and hepatomegaly with a history of poorly controlled type I DM. All of the cases showed sudden elevation of transaminase to more than 30 times the upper normal range (like in acute hepatitis) followed by sustained fluctuation (like in relapsing hepatitis). However, the patients did not show any symptom or sign of acute hepatitis. We therefore performed a liver biopsy to confirm the cause of liver enzyme elevation, which revealed GH. Clinicians should be aware of GH so as to prevent diagnostic delay and misdiagnosis, and have sufficient insight into GH; this will be aided by the present report of three cases along with a literature review.
糖原贮积病性肝病（GH）是 1 型糖尿病（DM）患者血清转氨酶升高的不常见原因。GH 的临床症状和体征是非特异性的，包括腹部不适、轻度肝肿大和转氨酶升高。在本报告中，我们描述了 3 例血清转氨酶升高和肝肿大的患者，这些患者均有未控制的 1 型 DM 病史。所有病例的转氨酶均突然升高至正常值上限的 30 倍以上（类似于急性肝炎），随后持续波动（类似于复发性肝炎）。然而，患者没有出现任何急性肝炎的症状或体征。因此，我们进行了肝活检以确认肝酶升高的原因，结果显示为 GH。临床医生应该意识到 GH，以避免诊断延误和误诊，并对 GH 有足够的了解；这将通过本报告中的 3 个病例以及文献复习得到帮助。
