DOI: 10.12890/2020_001979
Hyperemesis Gravidarum: A Benign Condition of Pregnancy or a Challenging Metabolic Disorder?
Authors
matildaflorentin@yahoo.com
Keywords
Acute kidney injury, alkalemia, hepatitis, hyperemesis gravidarum, hypokalemia, hyponatremia, hypovolemiaAbstract
Hyperemesis gravidarum (HG) is a complication mainly of the first trimester of pregnancy, which sometimes leads to metabolic disorders such as hypovolemia and acute kidney injury (AKI). Herein, we present the case of a 25-year-old woman at week 10 of gestation who exhibited a constellation ofsevere abnormalities, namely AKI (serum creatinine 6.15 mg/dl), transaminasemia (serum aminotransferases >1,000 IU/l), alkalemia (arterial pH7.667), hyponatremia (serum sodium 117 mEq/l), hypochloremia (serum chloride 54 mEq/l),hypokalemia (serum potassium 2.2 mEq/l) and hyperuricemia (serum uric acid 20 mg/dl). Despite a thorough work-up, no other disorder was found apart from HG. All symptoms and metabolic abnormalities resolved with targeted administration of intravenous fluids. The differential diagnosis of these disorders and therapeutic challenges are discussed.
References
- Erick M, Cox JT, Mogensen KM.ACOG Practice Bulletin No. 189: nausea and vomiting of pregnancy. Obstet Gynecol 2018;131(5):935.
- London V, Grube S, Sherer DM, Abulafia O.Hyperemesis gravidarum: a review of recent literature. Pharmacology 2017;100(3–4):161–171.
- Korman JD, Volenberg I, Balko J, Webster J, Schiodt FV, Squires RH, et al.Screening for Wilson disease in acute liver failure: a comparison of currently available diagnostic tests. Hepatology 2008;48(4):1167–1174.
- Lee NM,Brady CW.Liver disease in pregnancy. World J Gastroenterol 2009;15(8):897–906.
- Conchillo JM, Koek GH. Hyperemesis gravidarum and severe liver enzyme elevation. J Hepatol 2002;37(1):162–163.