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Acute Fatty Liver of Pregnancy With Disseminated Intravascular Coagulation

From the Department of Medicine, Saint Luke's Hospital, Cleveland, Ohio, and Department of Medicine, School of Medicine, Case Western Reserve University, Cleveland, Ohio.
Address reprint request to R. Thomas Holzbach, MD Department of Gastroenterlogy Cleveland Clinic Foundation 9500 Euclid Avenue Cleveland, OH 44106

Acute fatty liver of pregnancy is a rare, clinically distinct cause of jaundice occurring during the third trimester of pregnancy, with maternal death as the usual outcome. Clinical features characteristically involve disturbance in many organ systems with almost invariable gastrointestinal bleeding. The intent of the present report is to document a unique case with an associated disseminated intravascular coagulation (DIC) process. The hypothesis is advanced that DIC may be of pathophysiologic significance in this disorder. Prompt therapy for DIC, once identified, could substantially reduce the high mortality rate of acute fatty liver of pregnancy.