Chronic Pericardial Constriction Induced Severe Ischemic Hepatitis Manifesting as Hypoglycemic Attack

Tetsuya Nomura; Natsuya Keira; Yota Urakabe; Daisuke Naito; Mayuka Nakayama; Atsumichi Kido; Hidetoshi Kanemasa; Hiroaki Matsubara; Tetsuya Tatsumi

doi:10.1253/circj.CJ-07-0881

Case Reports

Chronic Pericardial Constriction Induced Severe Ischemic Hepatitis Manifesting as Hypoglycemic Attack

Tetsuya Nomura, Natsuya Keira, Yota Urakabe, Daisuke Naito, Mayuka Nakayama, Atsumichi Kido, Hidetoshi Kanemasa, Hiroaki Matsubara, Tetsuya Tatsumi

Author information

Tetsuya Nomura
Department of Cardiovascular Medicine, Nantan General Hospital
Natsuya Keira
Department of Cardiovascular Medicine, Nantan General Hospital
Yota Urakabe
Department of Cardiovascular Medicine, Nantan General Hospital
Daisuke Naito
Department of Cardiovascular Medicine, Nantan General Hospital
Mayuka Nakayama
Department of Cardiovascular Medicine, Nantan General Hospital
Atsumichi Kido
Department of Cardiovascular Medicine, Nantan General Hospital
Hidetoshi Kanemasa
Department of Gastroenterology, Nantan General Hospital
Hiroaki Matsubara
Department of Cardiovascular Medicine, Kyoto Prefectural University School of Medicine
Tetsuya Tatsumi
Department of Cardiovascular Medicine, Nantan General Hospital

Keywords: Constrictive pericarditis, Heart failure, Hypoglycemia, Ischemic hepatitis

JOURNAL FREE ACCESS

2009 Volume 73 Issue 1 Pages 183-186

DOI https://doi.org/10.1253/circj.CJ-07-0881

View "Advance Publication" version (November 11, 2008).

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Abstract

Ischemic hepatitis, otherwise known as "shock liver", is characterized by a massive, but transient increase in serum transaminase levels, usually associated with cardiac failure. A patient who did not have a predisposition to hypoglycemia was discovered at home with disturbed consciousness caused by hypoglycemia. She had been diagnosed as having constrictive pericarditis several years earlier and had developed ischemic hepatitis. Though the high serum transaminase levels were rapidly normalized, severe jaundice gradually developed and the patient finally died of multiple organ failure. Hypoglycemia, which is considered secondary to reduced gluconeogenesis in the exhausted liver, is a rare complication of constrictive pericarditis. (Circ J 2009; 73: 183 - 186)

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