Hepatic Glycogenosis in a Type 1 Diabetes Mellitus Patient with Ketoacidosis

Hepatic glycogenosis, a rare disease characterized hepatomegaly and elevated liver enzyme levels, is observed in patients with type 1 diabetes mellitus. We present a case of 66-yeard-old woman with type 1 diabetes mellitus with poor glycemic control. She presented with impaired consciousness and findings of diabetic ketoacidosis (blood glucose level 1110 mg/dl; blood ketone bodies 10,926 μmol/l; pH 7.247). Hepatobiliary enzyme levels were elevated and CT showed hepatomegaly and elevated CT numbers in the hepatic parenchyma, from before and after hospitalization. A liver biopsy was performed and nuclear glycogen and ballooning in the hepatocytes were observed. Along with the stabilization of blood glucose levels, improvements in liver enzyme levels and hepatomegaly were observed. Appropriately adjusting the amount of insulin and continuing glycemic control should prevent future relapse of hepatic damag