caa a22 4500 37891720X CHVBK 20180305123556.0 cr unu---uuuuu 161128e20040901xx s 000 0 eng 10.1515/JPM.2004.146 doi (NATIONALLICENCE)gruyter-10.1515/JPM.2004.146 Massive hepatic infarction in preeclampsia: successful treatment with continuous hemodiafiltration and corticosteroid therapy [Elektronische Daten] [Kei Miyakoshi, Mamoru Tanaka, Akiko Ono, Akiko Ohno, Ryohei Serita, Takeshi Suzuki, Hiroshi Shinmoto, Hiroshi Morisaki, Yasunori Yoshimura] Massive hepatic infarction associated with pregnancy is extremely rare, but is potentially fatal. A 35-year-old primigravida with mild preeclampsia developed acute right upper quadrant pain and marked elevation of liver enzymes at 26 weeks' gestation. After emergent cesarean section, her condition was complicated by oliguric renal failure and pulmonary edema with further deterioration of hepatic function (aspartate transaminase 4339 IU/L; alanine transaminase 3489 IU/L; lactate dehydrogenase 10780 IU/L). The contrast-enhanced computed tomography revealed non-enhancing low attenuation throughout the right lobe of liver, compatible with infarction. Continuous hemodiafiltration was initiated as renal support on postpartum day one. However, excessive fluid accumulation persisted, and she developed severe edema formation in both lung and systemic body surface. To ameliorate microvascular endothelial injury, corticosteroid therapy was begun on postpartum day five. Following treatment initiation, her renal and hepatic function showed steady improvement, accompanied by drastic resolution of edema formation. She was discharged five weeks postpartum with no additional treatment, and is without sequelae six months later. Massive hepatic infarction should be considered in preeclamptic patients who present acute abdominal pain and severe hepatic dysfunction, and continuous hemodiafiltration with corticosteroid therapy may improve the maternal outcome. © Walter de Gruyter Human reproduction, growth & development nationallicence Gynaecology & obstetrics nationallicence Paediatric medicine nationallicence Continuous hemodiafiltration nationallicence corticosteroid nationallicence hepatic infarction nationallicence preeclampsia nationallicence Miyakoshi Kei Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan aut Tanaka Mamoru Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan aut Ono Akiko Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan aut Ohno Akiko Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan aut Serita Ryohei Department of Anesthesiology, Keio University School of Medicine, Tokyo, Japan aut Suzuki Takeshi Department of Anesthesiology, Keio University School of Medicine, Tokyo, Japan aut Shinmoto Hiroshi Department of Diagnostic Radiology, Keio University School of Medicine, Tokyo, Japan aut Morisaki Hiroshi Department of Anesthesiology, Keio University School of Medicine, Tokyo, Japan aut Yoshimura Yasunori Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan aut Journal of Perinatal Medicine Walter de Gruyter 32/5(2004-09-01), 453-455 0300-5577 32:5<453 2004 32 jpme https://doi.org/10.1515/JPM.2004.146 text/html Onlinezugriff via DOI 1 research article jats NATIONALLICENCE 856 40 https://doi.org/10.1515/JPM.2004.146 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Miyakoshi Kei Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan aut NATIONALLICENCE 700 1- Tanaka Mamoru Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan aut NATIONALLICENCE 700 1- Ono Akiko Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan aut NATIONALLICENCE 700 1- Ohno Akiko Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan aut NATIONALLICENCE 700 1- Serita Ryohei Department of Anesthesiology, Keio University School of Medicine, Tokyo, Japan aut NATIONALLICENCE 700 1- Suzuki Takeshi Department of Anesthesiology, Keio University School of Medicine, Tokyo, Japan aut NATIONALLICENCE 700 1- Shinmoto Hiroshi Department of Diagnostic Radiology, Keio University School of Medicine, Tokyo, Japan aut NATIONALLICENCE 700 1- Morisaki Hiroshi Department of Anesthesiology, Keio University School of Medicine, Tokyo, Japan aut NATIONALLICENCE 700 1- Yoshimura Yasunori Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan aut NATIONALLICENCE 773 0- Journal of Perinatal Medicine Walter de Gruyter 32/5(2004-09-01), 453-455 0300-5577 32:5<453 2004 32 jpme CC0 http://creativecommons.org/publicdomain/zero/1.0 nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-gruyter