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伪装成急性胰腺炎的糖原性肝病。

Glycogenic Hepatopathy Masquerading as Acute Pancreatitis.

作者信息

Adams Steven H, Bernshteyn Michelle, Masood Umair, Corines James, Manocha Divey

机构信息

Pathology, State University of New York Upstate Medical University, Syracuse, USA.

Internal Medicine, State University of New York Upstate Medical University, Syracuse, USA.

出版信息

Cureus. 2021 Feb 17;13(2):e13397. doi: 10.7759/cureus.13397.

Abstract

Glycogenic hepatopathy (GH), defined histologically by hepatocytic glycogen accumulation without fatty change or fibrosis, is a benign reversible condition. It presents clinically as hepatomegaly with elevated liver enzymes in young diabetic (type 1) patients with poor glycemic control. We report a case of a 20-year-old female with a history of poorly controlled type 1 diabetes mellitus (T1DM) and prior pancreatitis who presented with sharp epigastric pain and hepatomegaly. She was found to have diabetic ketoacidosis with elevated lipase and amylase. Though at first her symptoms were erroneously attributed to pancreatitis, a liver biopsy showing glycogenated nuclei led to a diagnosis of GH.

摘要

糖原性肝病(GH)在组织学上定义为肝细胞糖原蓄积,无脂肪变性或纤维化,是一种良性可逆性疾病。在血糖控制不佳的年轻糖尿病(1型)患者中,临床上表现为肝肿大伴肝酶升高。我们报告一例20岁女性,有1型糖尿病(T1DM)控制不佳病史及既往胰腺炎病史,出现上腹部剧痛和肝肿大。发现她患有糖尿病酮症酸中毒,脂肪酶和淀粉酶升高。起初她的症状被错误地归因于胰腺炎,但肝脏活检显示核内糖原沉积,从而诊断为GH。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e5a/7978395/63fb9f4473f7/cureus-0013-00000013397-i01.jpg

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