Acute fatty liver of pregnancy is a heterogeneous disorder which may occur in the absence of a detectable gene mutation for the enzyme long-chain L-3-hydroxyacyl-CoA dehydrogenase. Acute fatty liver of pregnancy has been reported to complicate several gastrointestinal disorders including viral hepatitis, chronic active hepatitis and intrahepatic cholestasis of pregnancy. A case of acute fatty liver of pregnancy in a woman with ulcerative colitis and familial hidradenitis suppurativa without a detectable gene mutation is presented. The potential role of inflammatory cytokines in precipitating acute fatty liver of pregnancy is discussed.
O'LoughlinSSweeneyECKeelanP. Persistent hypoglycaemia and severe hyponatraemia in a case of acute fatty liver of pregnancy. J Ir Med Assoc1971; 64: 45–49.
2.
EnglishNRaoJ. Acute fatty liver of pregnancy with hypoglycaemia, diabetes insipidus and pancreatitis, preceded by intrahepatic cholestasis of pregnancy. BMJ Case Rep2015; 2015: bcr2015209649–bcr2015209649.
3.
Djibre A Zohar S and Assy N. Acute fatty liver of pregnancy. GastroHepcom: 2010.
4.
LoRAustinAFreemanJ. Vasopressin in liver disease – should we turn on or off?Curr Clin Pharmacol2008; 3: 156–165.
5.
HarryRAuzingerGWendonJ. The clinical importance of adrenal insufficiency in acute hepatic dysfunction. Hepatology2002; 36: 395–402.
PrincipiMCassanoNContaldoAet al.Hydradenitis suppurativa and inflammatory bowel disease: an unusual, but existing association. World J Gastroenterol2016; 22: 4802–4811.
8.
van der ZeeHHde RuiterLvan den BroeckeDGet al.Elevated levels of tumour necrosis factor (TNF)-alpha, interleukin (IL)-1beta and IL-10 in hidradenitis suppurativa skin: a rationale for targeting TNF-alpha and IL-1beta. Br J Dermatol2011; 164: 1292–1298.
9.
Garcia-RuizIRodriguez-JuanCDiaz-SanjuanTet al.Uric acid and anti-TNF antibody improve mitochondrial dysfunction in ob/ob mice. Hepatology2006; 44: 581–591.
10.
KhanGALewisF. Acute fatty liver of pregnancy superimposed on chronic active hepatitis. Connecticut Med1995; 59: 707–710.
11.
DavisLEKornfeldM. Influenza A virus and Reye's syndrome in adults. J Neurol Neurosurg Psychiatry1980; 43: 516–521.
12.
YangZYamadaJZhaoYet al.Prospective screening for pediatric mitochondrial trifunctional protein defects in pregnancies complicated by liver disease. Jama2002; 288: 2163–2166.
13.
MaitraADomiati-SaadRYostNet al.Absence of the G1528C (E474Q) mutation in the alpha-subunit of the mitochondrial trifunctional protein in women with acute fatty liver of pregnancy. Pediatr Res2002; 51: 658–661.
