SHM Converge Scientific Abstract ePoster Gallery-Embodied Inequity: Glycogenic Hepatopathy Due to Uncontrolled Type 1 Diabetes

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This case report describes glycogenic hepatopathy (GH) in an emerging adult with poorly controlled type 1 diabetes mellitus (T1DM). The patient’s diabetes control was likely shaped by biocultural factors, including significant trauma and multiple foster home placements, highlighting how social adversity can contribute to medical vulnerability during emerging adulthood.<br /><br />GH occurs when uncontrolled T1DM creates conditions that favor excessive hepatic glycogen accumulation. Clinically, this can cause abdominal pain, elevated liver function tests, and hepatomegaly, and it may mimic other liver diseases. In this case, the patient improved with inpatient glycemic control, along with a reduction in abdominal pain and liver enzyme abnormalities.<br /><br />A liver biopsy performed three months later showed sinusoidal congestion and perisinusoidal fibrosis, but did not reveal the classic glycogenated nuclei or positive PAS staining typically associated with GH. Despite the absence of definitive histologic findings, GH remained the most likely diagnosis because other testing was negative and symptoms remitted with better glucose control.<br /><br />The report emphasizes that the main treatment for GH is strict glycemic control, which can lead to rapid clinical and even histological improvement. It also notes broader disparities in diabetes outcomes among emerging adults, with only a minority meeting A1C targets and control varying by income and socioeconomic status.<br /><br />Overall, the case illustrates how uncontrolled T1DM in a socially vulnerable emerging adult can lead to GH, and how diagnosis may depend on the clinical picture even when biopsy findings are not classic.

Asset Subtitle

Reshma Sabnani

Meta Tag

Author List David Fish, Reshma Sabnani, Sanjay Chainani, Xunuo Shen

Category Clinical Vignettes

Concept Glycogenic Hepatopathy

Concept Type 1 Diabetes

Concept Poor Glycemic Control

Concept Glycemic Control

Concept Emerging Adult

Distinguished Non-Finalist

Presenter Organization UMass Memorial Medical Center - Children's Medical Center

Presenting Author Reshma Sabnani

Track Pediatric

Keywords

glycogenic hepatopathy

type 1 diabetes mellitus

poor glycemic control

emerging adulthood

hepatomegaly

elevated liver enzymes

abdominal pain

liver biopsy

glycemic control

social adversity

Glycogenic Hepatopathy

Type 1 Diabetes

Poor Glycemic Control

Glycemic Control

Emerging Adult