Abstract
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Highlights
Acute fatty liver of pregnancy (AFLP) is a rare late-gestational event affecting about 1 in 10,000 to 1 in 15,000 pregnancies.[1]
Profound hypoglycaemia and jaundice are features of AFLP that could be present in other conditions such as the haemoglobinopathies.[3]
Hypoglycaemia was corrected with infusion of 50% dextrose, and she was placed on maintenance infusion of 10% dextrose. She was on normal saline alternating with dextrose infusions (3 litres every 24 hours), she was catheterized, and there was strict input and output monitoring. She was placed on 0.5mg of oral Folic acid daily, 120mg of intravenous artesunate stat 60mg in AFLP is an uncommon condition characterized by deposition of fat in the liver cells, causing destruction of hepatocytes.[1]
Summary
Acute fatty liver of pregnancy (AFLP) is an uncommon condition that manifests in the third trimester of pregnancy. Its association with vaso-occlusive crisis from Sickle Cell Anaemia is not common. A 32-year-old gravida 3 para 1+1 lady, with Sickle Cell Anaemia, had a vaso-occlusive crisis in association with AFLP at 32 weeks’ gestation, and the outcome of her management was successful. Profound hypoglycaemia and jaundice with elevated serum transaminases are recognized features of AFLP. These features may be seen in haemoglobinopathies. The simultaneous occurrence of AFLP and Sickle Cell Anaemia may result in overlap of symptoms and delay in diagnosis and treatment. It is important that care providers, especially in populations with high burden of Sickle Cell Anaemia, consider this as a differential diagnosis, especially when the jaundice is associated with profound or recurring episodes of hypoglycaemia.
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