Hyperglycaemia as an indicator of concurrent acute pancreatitis in fulminant hepatic failure associated with hepatitis B infection

A Srinivasan, S Venkataraman, SG Hansdak, OC Abraham, D Mathai
Correspondence: Dr S Venkataraman, venkatcmc@rediffmail.com

ABSTRACT
Pancreatitis occurring concurrently with fulminant hepatic failure (FHF) is primarily detected on autopsy and is seldom clinically apparent. We report a fatal case of FHF in a 25-year-old woman which was related to acute hepatitis B infection. In this patient, hyperglycaemia needing insulin infusions led to the detection of acute pancreatitis. FHF complicated by acute pancreatitis has a poor prognosis. A high index of suspicion is necessary for its diagnosis. The role of orthotopic liver transplantation and use of antiviral therapies need further evaluation in this situation.

Keywords: fulminant hepatic failure, hepatitis B, hyperglycaemia, pancreatitis
Singapore Med J 2005; 46(5): 236-237