Casting a Wider NET: An Unusual Cause of Acute Liver Failure in a Pregnant Patient

Jasleen Grewal; Jihane Benhammou; Priyal V Patel; Sammy Saab; Gina Choi

doi:10.1007/s10620-020-06469-y

Casting a Wider NET: An Unusual Cause of Acute Liver Failure in a Pregnant Patient

Dig Dis Sci. 2020 Nov;65(11):3102-3105. doi: 10.1007/s10620-020-06469-y.

Authors

Jasleen Grewal¹, Jihane Benhammou^{1

2}, Priyal V Patel², Sammy Saab^{1

2

3}, Gina Choi^{4

5

6}

Affiliations

¹ Departments of Medicine, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA, USA.
² Departments of Surgery, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA, USA.
³ Pfleger Liver Institute, UCLA Medical Center, 200 Medical Plaza, Suite 214, Los Angeles, CA, 90095, USA.
⁴ Departments of Medicine, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA, USA. ginachoi@mednet.ucla.edu.
⁵ Departments of Surgery, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA, USA. ginachoi@mednet.ucla.edu.
⁶ Pfleger Liver Institute, UCLA Medical Center, 200 Medical Plaza, Suite 214, Los Angeles, CA, 90095, USA. ginachoi@mednet.ucla.edu.

PMID: 32671591
DOI: 10.1007/s10620-020-06469-y

Abstract

We present a case patient in her second trimester of pregnancy who developed acute liver failure from metastatic neuroendocrine tumor (NET). Although she underwent prompt induction of a non-viable fetus due to initial concerns of hemolysis, elevated liver enzymes, and low platelet count syndrome, her liver function continued to deteriorate postpartum. She was subsequently transferred to our institution in order to undergo further evaluation that included a transjugular liver biopsy and subsequent diagnosis of high-grade NET. She was given salvage carboplatin-based chemotherapy, as she was not a liver transplant candidate. Unfortunately, the patient expired from cardiovascular collapse as a component of multiorgan failure.

Keywords: Acute liver failure; Neuroendocrine tumor; Pregnancy.

Publication types

Case Reports

MeSH terms

Adult
Fatal Outcome
Female
Fetal Death
HELLP Syndrome / etiology*
Humans
Liver Failure, Acute / etiology*
Liver Neoplasms / complications*
Liver Neoplasms / pathology
Multiple Organ Failure
Neoplasm Grading
Neoplasms, Unknown Primary / complications
Neoplasms, Unknown Primary / pathology
Neuroendocrine Tumors / complications*
Neuroendocrine Tumors / pathology
Pregnancy
Pregnancy Complications, Neoplastic / pathology*
Pregnancy Trimester, Second