BACKGROUND:

Acute fatty liver disease of pregnancy is a rare, life-threatening, pregnancy-specific disease of unknown cause. It presents with hepatic microsteatosis, typically manifests in the third trimester of pregnancy and is reversible postpartum. The clinical presentation is usually nonspecific, with digestive prodromes.

CLINICAL CASE:

36-year-old female patient who, after a 37th week delivery, started with febrile peaks, progressively elevated transaminase values, alterations in glycemia and coagulation, leukocytosis and hyperbilirubinemia. It was necessary to admit her to the intensive care unit. Given the persistence of the condition, the need for a liver transplant was considered, but finally it was not necessarily due to the progressive improvement secondary to antibiotic support treatment, fresh plasma transfusion, fibrinogen and vitamin K administration. The differential diagnosis was established with preeclampsia and HELLP syndrome; in the end the diagnosis of acute fatty liver of pregnancy was established.

CONCLUSIONS:

The clinical manifestation of acute fatty liver of pregnancy is highly variable and nonspecific; onset in the immediate postpartum period is possible. Multidisciplinary medical care and supportive treatment are decisive in the favorable evolution.

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