Acute Fatty Liver of Pregnancy in 2nd Trimester
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Introduction
Acute fatty liver of pregnancy (AFLP) is an uncommon, life-threatening complication that occurs in the third trimester or early postpartum period. In the literature, only few cases of acute fatty liver of pregnancy in the second trimester were reported. Here, we report a case of AFLP with a milder clinical presentation in the second trimester.

Case Report
A 29-year-old woman, gravid 1, presented at 23 weeks' gestation with nausea, vomiting, abdominal pain, malaise, and weight loss. An ultrasound at 11 weeks' gestation determined gestational age. She was normotensive with a normal platelet count and no proteinuria. She had elevated liver transaminase levels (aspartate aminotransferase [ASAT] level 108?U/L, alanine aminotransferase [ALAT] level 104?U/L), prothrombin time [PT] 96%, negative hepatitis serology, and a negative immunologic analysis. She was treated with intravenous fluids, but we remarked a slightly aggravation of her laboratory findings ASAT 122?U/L, ALAT 248?U/L, GGT 18?U/L, PAL 118?U/L, bilirubin total/direct 23,2/17,4??mol/L, PT 76%, WBC 7800, platelets 178000, glucose 65?mg/dL, and uric acid 246??mol/L. The abdominal ultrasound showed a brilliant liver without others anomalies. Because of the doubt on diagnosis and stable clinical and biologic parameters, a liver biopsy was performed (10 days after admission) and showed a microvesicular fatty infiltration of the hepatocytes.....

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3335562/
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