• J Reprod Med · Jul 2002

    Case Reports

    Acute fatty liver of pregnancy and acetaminophen toxicity leading to liver failure and postpartum liver transplantation. A case report.

    • Edward J Gill, Melissa J Contos, and Thomas C C Peng.
    • Departments of Obstetrics and Gynecology and of Pathology, Medical College of Virginia, Virginia Commonwealth University, Richmond, USA. egill@hsc.vcu.edu
    • J Reprod Med. 2002 Jul 1;47(7):584-6.

    BackgroundAcute fatty liver of pregnancy is a rare entity. A MEDLINE English-language search from 1966 to the present revealed no reports of acetaminophen toxicity and acute fatty liver in pregnancy.CaseAn 18-year-old, African American woman, gravida 1, presented at 33 weeks' gestation with signs and symptoms consistent with acute fatty liver of pregnancy and fetal death. Markedly elevated transaminases prompted a search for other etiologies, and acetaminophen toxicity was diagnosed. Liver biopsy revealed acute fatty liver of pregnancy and toxin-induced injury consistent with acetaminophen use. The patient's condition deteriorated, resulting in fulminant hepatic failure and requiring postpartum orthotopic liver transplantation.ConclusionThe combination of acute fatty liver of pregnancy and acetaminophen toxicity resulted in acute liver failure. Attention to clinical and biochemical parameters can lead to diagnosis and management.

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