Non-alcoholic steatohepatitis in pregnancy: case report

Abstract Background: Dyslipidemia and non-alcoholic fatty liver disease (NAFLD) are well known diseases and are part of a very broad spectrum evolving towards non-alcoholic steatohepatitis (NASH). This entity has been very rarely described by pregnant women. Case presentation: A 26 years old woman with 28+5weeks of pregnancy presented with preterm labor. At admission, a significant hepatic cytolysis was detected (AST/ALT 265/485 U/L - GGT/alkaline phosphatase 60/164 U/L). She had normal blood pressure and negative 24-hour proteinuria. She didn’t have intrahepatic cholestasis of pregnancy (bile acid at 7) and also no organic hepatic etiology (negative serologies and imaging). This cytolysis worsened until a more detailed history revealed a potential etiology: a diet very rich in sugars and fatty acids corresponding to a NASH syndrome. Dietary rebalancing improved the cytolysis. Complications such as intrahepatic cholestasis of pregnancy and preterm birth favored by significant dyslipidemia could not be avoided. Conclusion: it is important to consider the lipid profile of our patients. This will allow for a more personalized follow-up given the multiple obstetrical repercussions that can arise from this pathology. It should also be considered in the differential diagnosis of liver test alterations during pregnancy. A healthy diet seems to help control the disease