Glycogenic hepatopathy (GH) is a disorder associated with uncontrolled diabetes mellitus, most commonly type 1, expressed as right upper quadrant abdominal. Periodic acid Schiff stain for glycogen was positive in these hepatocytes. A diagnosis of glycogenic hepatopathy was made after clinicopathological correlation. We describe a presentation of glycogenic hepatopathy in a poorly controlled type I diabetic patient. As patients with glycogenic hepatopathy.

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Lifestyle modification and pharmacologic therapies. Short-term high dose steroid therapy Steroids promote elevation in glucose, gluconeogenesis, and glycogen deposition. This condition is often associated with nonalcoholic hepatosteatosis [ 1 yepatopathy, 2 ]. Summary of the major case reports in English PubMed indexed on Glycogenic hepatopathy in type 2 diabetes mellitus.

Here, a year-old case diagnosed with GH is presented with a discussion referenced to the medical literature. Patients who can demonstrate an increase in serum glucose levels after stimulation by glucagon efficiently rule out a glycogen storage disease[ 48 ].

Herpes simplex virus; VZ: Her past history was unremarkable, with normal developmental history.

Glycogenic hepatopathy: an underrecognized hepatic complication of diabetes mellitus.

Magnetic resonance elastography may have a role in evaluating the degree of fibrosis with GH and needs further gglycogenic. The bright liver of glycogenic hepatopathy.

There are fatty droplets presenting without inflammation and fibrotic changes. As an up-regulator of glycogenolysis and a down-regulator of glycogenesis, glucagon would facilitate the breakdown of glycogen to allow the release of glucose into the bloodstream. If arrows are used please ensure they appear in a different color to the background color, preferably black with a white border, or white with a black border. Bua et al[ 14 ], Dual-Echo MRI; iso-intense between the in-phase and out-of-phase images, and low intensity on subtraction.

Journal List Saudi Med J v. However, signs of recurrent liver damage after short term improvement in glycemic control have been noted and should prompt consideration of biopsy to guide further management [ 2 ]. Anorexia nervos AN is characterized by the obsessive fear of gaining weight, distorted body image, and a significantly low body weight.


Hepatosclerosis is characterized by an indolent course and is seen predominantly in female diabetic patients, although actual prevalence of this remains unknown.

Case Reports in Hepatology. No potential conflicts of interest or financial support related to this paper. Xu et al[ 28 ], All had type I diabetes mellitus with poor glycemic control. A bright liver compared to the spleen in CT scan imaging can be the clue to diagnosing GH.

Additionally, antinuclear antibody was positive in some cases, showing a mostly homogeneous speckled pattern. A patient with GH may present with hepatomegaly, abdominal pain, nausea, vomiting, and abnormal liver function tests reflecting acute liver injury [ 1 — 9 ]. A case of glycogenic hepatopathy hepatooathy in a patient with new-onset fulminant type 1 diabetes: Glycogenic hepatopathy is a benign condition that is potentially reversible within 2 to 14 weeks, both clinically and biochemically, with good glycemic control.

Case Reports in Hepatology

The phosphatase enzyme is stimulated by elevated glucose and insulin levels. Prognosis with improved glycemic control is excellent. The mechanism which metformin may have alleviated the glycogenesis, in this case, is also not precise. Parmar et al[ 27 ], Although some authors recommended the therapeutic trial of intensive insulin therapy for four weeks preceding any invasive investigations, liver biopsy is the gold standard for diagnosing GH.

NAFLD is more typically found in obese adults with T2DM secondary to insulin resistance, while GH is more common in patients with lower body mass index and pediatric patients. The exact mechanism of development of GH in T2DM with insulin resistance is poorly understood and has yet to be clarified.


It is an underrecognized entity, and awareness of this clinical condition by clinicians, including gastroenterologists, is low. Lin et al[ 17 ], MRI revealed a liver span of Physiologically, the liver takes up glucose after feeding and either utilizes it for fuel or stores it as glycogen.

Glucosephosphate is converted to glycogen by the enzyme glycogen synthase, which exists in an active dephosphorylated form and in an inactive phosphorylated form. Biopsy showed preserved liver architecture, but the hepatocytes exhibited marked cytoplasmic swelling and prominent plasma membranes. Butts et al[ 24 ], May need liver transplant in advanced cirrhosis.

The patient was then started on intensive insulin therapy. In this report, we describe the clinical, biochemical, and histopathological features in a Saudi girl with GH. The pathology is distinct from steatohepatitis. Ruschhaupt et al[ 1 ], Four cases of type 1 diabetes mellitus showing sharp serum transaminase increases and hepatomegaly due to glycogenic hepatopathy.

Auto immune hepatitis; DM: The author recommended DILI as a possibility whenever GH is suspected with concomitant use of hepatotoxic medications. Unsolicited manuscript Peer-review started: Another very rare cause of elevated liver enzymes, especially among type 1 diabetic patients, is glycogenic hepatopathy GH. Insulin activates glycogen synthase phosphatase, which is responsible for dephosphorylating and activating glycogen synthase. Hyperglycemia and hyperinsulinemia are thought to be the etiology for hepatic glycogen deposition in dumping syndrome.

Summary of the major studies in English pub med indexed on Glycogenic hepatopathy in type 1 diabetes mellitus. Interface hepatitis and portal lymphoplasmacytic infiltrate with varying degree of fibrosis.

Afterwards, the case was diagnosed with GH upon liver biopsy.