Massive hepatic infarction in preeclampsia

Successful treatment with continuous hemodiafiltration and corticosteroid therapy

Kei Miyakoshi, Mamoru Tanaka, Akiko Ono, Akiko Ohno, Ryohei Serita, Takeshi Suzuki, Hiroshi Shinmoto, Hiroshi Morisaki, Yasunori Yoshimura

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Massive hepatic infarction associated with pregnancy is extremely rare, but is potentially fatal. A 35-year-old primigravida with mild preeclampsia developed acute right upper quadrant pain and marked elevation of liver enzymes at 26 weeks' gestation. After emergent cesarean section, her condition was complicated by oliguric renal failure and pulmonary edema with further deterioration of hepatic function (aspartate transaminase 4339 IU/L; alanine transaminase 3489 IU/L; lactate dehydrogenase 10780 IU/L). The contrast-enhanced computed tomography revealed non-enhancing low attenuation throughout the right lobe of liver, compatible with infarction. Continuous hemodiafiltration was initiated as renal support on postpartum day one. However, excessive fluid accumulation persisted, and she developed severe edema formation in both lung and systemic body surface. To ameliorate microvascular endothelial injury, corticosteroid therapy was begun on postpartum day five. Following treatment initiation, her renal and hepatic function showed steady improvement, accompanied by drastic resolution of edema formation. She was discharged five weeks postpartum with no additional treatment, and is without sequelae six months later. Massive hepatic infarction should be considered in preeclamptic patients who present acute abdominal pain and severe hepatic dysfunction, and continuous hemodiafiltration with corticosteroid therapy may improve the maternal outcome.

Original languageEnglish
Pages (from-to)453-455
Number of pages3
JournalJournal of Perinatal Medicine
Volume32
Issue number5
DOIs
Publication statusPublished - 2004

Fingerprint

Hemodiafiltration
Pre-Eclampsia
Infarction
Adrenal Cortex Hormones
Liver
Postpartum Period
Therapeutics
Edema
Kidney
Pregnancy
Acute Pain
Pulmonary Edema
Aspartate Aminotransferases
Alanine Transaminase
L-Lactate Dehydrogenase
Cesarean Section
Alanine
Abdominal Pain
Renal Insufficiency
Tomography

Keywords

  • Continuous hemodiafiltration
  • Corticosteroid
  • Hepatic infarction
  • Preeclampsia

ASJC Scopus subject areas

  • Obstetrics and Gynaecology
  • Pediatrics, Perinatology, and Child Health

Cite this

Massive hepatic infarction in preeclampsia : Successful treatment with continuous hemodiafiltration and corticosteroid therapy. / Miyakoshi, Kei; Tanaka, Mamoru; Ono, Akiko; Ohno, Akiko; Serita, Ryohei; Suzuki, Takeshi; Shinmoto, Hiroshi; Morisaki, Hiroshi; Yoshimura, Yasunori.

In: Journal of Perinatal Medicine, Vol. 32, No. 5, 2004, p. 453-455.

Research output: Contribution to journalArticle

Miyakoshi, Kei ; Tanaka, Mamoru ; Ono, Akiko ; Ohno, Akiko ; Serita, Ryohei ; Suzuki, Takeshi ; Shinmoto, Hiroshi ; Morisaki, Hiroshi ; Yoshimura, Yasunori. / Massive hepatic infarction in preeclampsia : Successful treatment with continuous hemodiafiltration and corticosteroid therapy. In: Journal of Perinatal Medicine. 2004 ; Vol. 32, No. 5. pp. 453-455.
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