DOI: 10.36347/SJMCR.2019.v07i12.021

Pages: 795-799

Glycogenic hepatopathy (GH) is a disorder linked to inappropriate glycemic control attributable to insulin deficiency, intensive insulin therapy for diabetic ketoacidosis (DKA), or excessive glucose administration to control hypoglycemia. Our Case report describes a patient with unexplained persistent acidosis mimicking nonresolving DKA associated with glycogen hepatopathy in an adolescent female with T1DM. Clinical judgment for signs of hepatomegaly, early confirmation of lactic acidosis and a high index of suspicion in the context of uncontrolled T1DM, may be indicative and lead to a timely diagnosis. Additional research is required to develop a noninvasive, rapid diagnostic test to avoid the extensive investigations required to evaluate suspected cases of GH. Clinical probability criteria are required which would be easy to apply so that highly probable GH cases can be managed noninvasively and a liver biopsy should only be performed when the diagnosis is uncertain.