Hepatic infarction: an unusual complication of nephrotic syndrome in a patient with diabetes mellitus

Abstract

Summary: A 67 year old woman with widespread atherosclerosis and diabetic nephropathy manifested by nephrotic syndrome and moderate renal failure developed multiple hepatic infarctions. The infarctions were documented by computed tomographic scan and needle aspiration biopsy of the liver. Except for the nephrotic syndrome and the atherosclerosis no other cause of hepatic infarction was found.We suggest that hepatic infarction should be considered in the thrombotic complications ofthe nephrotic syndrome secondary to diabetic nephropathy.

Triad: diabetic ketoacidosis, elevated liver enzymes and abdominal pain— think liver infarct!

“…7 In 1990, further cases of hepatic infarction were reported in diabetic patients. 1,8,9 Although varied, presenting symptoms largely included abdominal pain and elevated serum transaminases. The confirmation of hepatic infarction has been made by hepatectomy, biopsy, or clinical course compatible with infarction with angiographic or surgical evidence of hepatic arterial abnormality.…”