Nordiyana Zainul Abidin, Ng Ying Ying, Rosnani Zakaria, Noor Aellmas Samsuddin
MBBS, Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.
MD, MMED (Fam Med), Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia. E-mail:
Malays Fam Physician. 2025 Aug 27;20:57. doi: 10.51866/cr.926. eCollection 2025.
Glycogenic hepatopathy (GH) is a rare but reversible hepatic condition associated with poorly controlled type 1 diabetes mellitus (T1DM). It results from excessive glycogen accumulation in hepatocytes, leading to hepatomegaly and elevated liver enzyme levels. We report the case of a 28-year-old man with T1DM who presented to a primary care clinic with persistent transaminitis despite discontinuation of potential hepatotoxic agents. Extensive investigations were conducted to exclude common liver pathologies, all of which returned negative. His condition improved following the intensification of insulin therapy and improvement of glycaemic control. This case underscores the role of family physicians in recognising GH as a differential diagnosis in patients with diabetes mellitus with unexplained liver enzyme abnormalities. It also highlights the importance of timely interventions to prevent unnecessary invasive investigations. Early recognition and appropriate glycaemic management in primary care can reverse the condition and minimise the need for extensive testing.
糖原性肝病（GH）是一种罕见但可逆的肝脏疾病，与1型糖尿病（T1DM）控制不佳有关。它是由肝细胞中糖原过度积累导致的，会引起肝肿大和肝酶水平升高。我们报告了一例28岁的T1DM男性患者，该患者尽管停用了可能具有肝毒性的药物，但仍因持续性转氨酶升高就诊于基层医疗诊所。进行了广泛的检查以排除常见的肝脏病变，所有检查结果均为阴性。在强化胰岛素治疗和改善血糖控制后，他的病情有所改善。该病例强调了家庭医生在将GH识别为患有不明原因肝酶异常的糖尿病患者的鉴别诊断中的作用。它还突出了及时干预以防止不必要的侵入性检查的重要性。基层医疗中的早期识别和适当的血糖管理可以逆转病情，并最大限度地减少广泛检查的必要性。
