Acute Fatty Liver of Pregnancy
Authors: R. J. DUMA
Journal: Annals of Internal Medicine (1965)

Case Studies1 November 1965Acute Fatty Liver of PregnancyReport of a Surviving Patient Studied with Serial Liver BiopsiesR. J. DUMA, M.D., EDMUND A. DOWLING, M.D., H. C. ALEXANDER, M.D., DYRC SIBRANS, M.D., HUGH DEMPSEY, M.D., F.R.C.P.(C), F.A.C.P.R. J. DUMA, M.D., EDMUND A. DOWLING, M.D., H. C. ALEXANDER, M.D., DYRC SIBRANS, M.D., HUGH DEMPSEY, M.D., F.R.C.P.(C), F.A.C.P.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-63-5-851 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptFatty metamorphosis of the liver associated with acute liver failure, fatal to both mother and child, was first recognized in 1934 (1). Several years later Sheehan (2) described the clinical features of this unusual syndrome and distinguished its characteristic liver histology from that of infectious hepatitis and acute yellow atrophy in pregnancy. Clinically the disorder is manifested between the thirty-sixth and fortieth week of pregnancy by the sudden onset of epigastric pain and vomiting. In rapid progression the mother suffers intense jaundice, headache, precipitous labor, and delivery of a stillborn fetus, followed by hematemesis, deepening coma, and death, usually before...References1. STANDERCADDEN HJJF: Acute yellow atrophy of the liver in pregnancy. Amer. J. Obstet. Gynec. 28: 61, 1934. Google Scholar2. SHEEHAN HL: The pathology of acute yellow atrophy and delayed chloroform poisoning. J. Obstet. Gynaec. Brit. Emp. 47: 49, 1940. CrossrefGoogle Scholar3. CULLINAN ER: Idiopathic jaundice (often recurrent) associated with subacute necrosis of the liver. St. Barth. Hosp. Rep. 69: 55, 1936. Google Scholar4. WHITACREFANG FELY: Fatty degeneration of the liver in pregnancy. Report of a case with recovery: chemical and histologic studies. JAMA 118: 1358, 1942. CrossrefGoogle Scholar5. NIXONEGELILAQUEURYAHYA WCESWO: Icterus in pregnancy. J. Obstet. Gynaec. Brit. Emp. 54. 642, 1947. CrossrefMedlineGoogle Scholar6. DILL LV: Acute yellow atrophy of the liver associated with pregnancy: a review of the literature and six cases. Obstet. Gynec. Survey 5: 139, 1950. CrossrefMedlineGoogle Scholar7. OBERLECOMPTE WBPM: Acute fatty metamorphosis of the liver associated with pregnancy. A distinctive lesion. Amer. J. Med. 19: 743, 1955. CrossrefMedlineGoogle Scholar8. MOORE HC: Acute fatty liver of pregnancy. J. Obstet. Gynaec. Brit. Emp. 63: 189, 1956. CrossrefMedlineGoogle Scholar9. DYSON BC: Fatty metamorphosis of the liver in pregnancy; report of a fatal case without jaundice. Bull. Ayer. Clin. Lab. 4: 17, 1959. MedlineGoogle Scholar10. RECANTLACY LP (eds.): Clinico-pathological conference: fulminating liver disease in a pregnant woman at term. Amer. J. Med. 35: 231, 1963. CrossrefMedlineGoogle Scholar11. SCHULTZADAMSONWORKMANNORMAN JCJSWWTD: Fatal liver disease after intravenous administration of tetracycline in high dosage. New Eng. J. Med. 269: 999, 1963. CrossrefMedlineGoogle Scholar12. LEWISTAKEDAWARREN PLMWJ: Obstetric acute yellow atrophy. Report of a case. Obstet. Gynec. 22: 121, 1963. Google Scholar13. KAHILFREDBROWNDAVIS MEHLHJS: Acute fatty liver of pregnancy. Report of two cases. Arch. Intern. Med. (Chicago) 113: 63, 1964. CrossrefMedlineGoogle Scholar14. KUNELISPETERSEDMONDSON CTJLHA: Fatty liver of pregnancy and its relationship to tetracycline therapy. Amer. J. Med. 38: 359, 1965. CrossrefMedlineGoogle Scholar15. DOWLINGLEPPER HFMH: Hepatic reactions to tetracycline. JAMA 188: 307, 1964. CrossrefMedlineGoogle Scholar16. BRIGGS RC: Tetracycline and liver disease (Letter to the Editor). New Eng. J. Med. 269: 1386, 1963. CrossrefGoogle Scholar17. LEONARD GL: Ibid. Google Scholar18. GOUGHSEARCY GSRL: Additional case of fatal liver disease with tetracycline therapy (Letter to the Editor). New Eng. J. Med. 270: 157, 1964. CrossrefGoogle Scholar19. WHALLEYADAMSCOMBES PJRHB: Tetracycline toxicity in pregnancy. JAMA 189: 357, 1964. CrossrefMedlineGoogle Scholar20. WOOLFJOHNSTONSTOKESROBERTON AJAWJFNR: Acute liver failure in pregnancy. Case report with survival of mother and child. J. Obstet. Gynaec. Brit. Comm. 71: 914, 1964. CrossrefMedlineGoogle Scholar21. DOUVRESROSENTHALMETZGERTCHERTKOFF PAWSPV: Acute fatty liver of pregnancy with hepatic coma and Mallory-Weiss syndrome: report of a case. Amer. J. Dig. Dis. 10: 306, 1965. CrossrefMedlineGoogle Scholar22. SHEEHAN HL: Jaundice in pregnancy. Amer. J. Obstet. Gynec. 81: 427, 1961. CrossrefGoogle Scholar23. FARBERLOMBARDICASTILLO EBAE: The prevention by adenosine triphosphate of the fatty liver induced by ethionine. Lab. Invest. 12: 873, 1963. MedlineGoogle Scholar24. YESNERKUNKEL RP: Preliminary observations on the effect of Aureomycin, Terramycin, tibione, combined tibione and streptomycin and Chloromycetin on the morphology of the liver in man. Yale J. Biol. Med. 23: 299, 1951. MedlineGoogle Scholar25. WRUBLELADMANBRITTCUMMINS LDAJLGAJ: Hepatotoxicity produced by tetracycline overdosage. JAMA 192: 6, 1965. CrossrefMedlineGoogle Scholar26. HUTTERERFITSCHENPOPPER FWH: Mitochondrial damage and hepatic steatosis in ethionine intoxication. Brit. J. Exp. Path. 42: 187, 1961. MedlineGoogle Scholar27. ASHWORTHLUIBELSANDERSARNOLD CTFJEN: Hepatic cell degeneration. Correlation of fine structural with chemical and histochemical changes in hepatic cell injury produced by carbon tetrachloride in rats. Arch. Path. 75: 212, 1963. MedlineGoogle Scholar28. LOUGHLINELFORDBUCHANAN REHLJM: Enzymatic synthesis of the methyl group of methionine VII. Isolation of a cobalamin-containing transmethylase (5-methyl-tetrayhdrofolate-homocysteine) from mammalian liver. J. Biol. Chem. 239: 2888, 1964. CrossrefMedlineGoogle Scholar29. VAN METERSPECTOROLESONWILLIAMS JCAJJJH: In vitro action of Aureomycin on oxidative phosphorylation in animal tissues. Proc. Soc. Exp. Biol. Med. 81: 215, 1952. CrossrefMedlineGoogle Scholar30. GEWINFRIOU HMGJ: Manifestations of vitamin deficiency during Aureomycin and chloramphenicol therapy of endocarditis due to Staphlococcus aureus. Report of a case. Yale J. Biol. Med. 23: 332, 1951. MedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Birmingham, AlabamaFrom the Departments of Medicine and Pathology, University of Alabama, and the University Hospital Medical Center, Birmingham, Ala.This study was supported in part by grants AM-08644 and HE-01725, U. S. Public Health Service, Bethesda, Md.Requests for reprints should be addressed to Hugh Dempsey, M.D., Department of Medicine, University of Alabama College of Medicine, Birmingham, Ala. 35233. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byAcute Fatty Liver of PregnancyAcute Fatty Liver of PregnancyCharacteristics of Ascites in Patients With Pregnancy-Specific Liver DiseasesAcute Fatty Liver of PregnancyACUTE FATTY LIVER OF PREGNANCYAcute Abdominal Pain in PregnancyTHE TETRACYCLINESAre changes in expression of actin genes involved in estrogen-induced cholestasis?Liver Disease of Pregnancy: Clinical AspectsLiver Disease of Pregnancy: PathologyAcute Fatty Liver of Pregnancy A Reassessment Based on Observations in Nine PatientsCAROLINE A. RIELY, M.D., PATRICIA S. LATHAM, M.D., ROBERTO ROMERO, M.D., THOMAS P. DUFFY, M.D.Liver disease in pregnancyAcute fatty liver of pregnancy: A clinicopathologic study of 35 casesHígado graso agudo del embarazo. 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