We report the case of a 39-year-old woman with right hypochondrium pain, with a history of type I diabetes treated with insulin and poor metabolic control (HbA1c 10.6%).
Examination revealed painful hepatomegaly and short stature, and analytically AST/ALT of 7,500/2,150 U/l with no other abnormalities.
An abdominal ultrasound scan showed a white deposit liver with no lesions or involvement of the abdominal vessels.
Cholangio-MRI showed normal bile duct without stones and abdominal computed tomography (CT) showed hepatomegaly.
The etiological study of hepatitis was negative.
A liver biopsy was performed under suspicion of glycogen liver disease.
Histological study revealed minimal chronic inflammatory infiltrate in portal spaces, mild macromicrovascular steatosis and hepatocytes with abundant glycogenized nuclei without megamitochondria, compatible with hepatocyte glycogenosis.
The patient presented clinical improvement and normalization of the hepatic profile after optimization of the diabetes treatment.
In outpatient controls, he maintained good glycemic control without further alteration of liver biology.
