1987 Volume 28 Issue 12 Pages 1636-1643
An autopsy case of 36-year-old female patient with diabetic nephropathy placed under hemodialysis is described. The patient presented with a marked hepatomegaly, reaching a maximum of 7 fingers' breadth, associated with unstable blood glucose levels, fluctuating mostly between 100 and 1000mg/dl under insulin treatment, and with an anicteric hyper-alkaline phosphatasemia associated with serum transaminase elevations during the course of chronic hepatitis of non-A, non-B type following acute hepatic failure. The serum level of alkaline phosphatase (ALP) increased up to 77.8 K-AU with other lines of cholestatic evidence, such as the elevation of serum total cholesterol or the appearance of Slow-migrating HDL, although the serum level of bilirubin did not exceed 1.0mg/dl. The results of histopathological studies revealed that the present case had a hepatic glycogenosis due to the unstable diabetes mellitus and an anicteric biliary enzyme elevation as an unusual type of cholestasis overlapping with chronic hepatitis.
