<abstract xmlns="http://www.w3.org/1999/xhtml"><sec><h3>Background</h3><p>Acute liver failure (ALF) is a rare condition during neonatal period.</p></sec><sec><h3>Objective</h3><p>To report a case of recipient twin with fulminant ALF secondary to hydrops fetalis caused by twin-to-twin transfusion syndrome (TTTS).</p></sec><sec><h3>Method</h3><p>The patient was admitted to the neonatal intensive care unit (NICU) for respiratory failure requiring mechanical ventilation and fulminant ALF with prolonged international normalized ratio (INR) and elevated liver enzymes with highest aspartate aminotransferase of 4,580 U/L.</p></sec><sec><h3>Results</h3><p>Laboratory investigation for secondary causes of liver failure was not revealing. Her liver enzymes and coagulation levels were dramatically normalized as the clinical symptoms of hypervolemia improved within 1 week.</p></sec><sec><h3>Conclusion</h3><p>TTTS can be a possible cause of neonatal ALF. Early detection with proper management of TTTS is important to avoid adverse outcomes. However, pathogenesis of hepatic dysfunction in TTTS is rarely described, and further studies are needed to help understanding the correlation between liver diseases and TTTS.</p></sec></abstract>

BackgroundAcute liver failure (ALF) is a rare condition during neonatal period.ObjectiveTo report a case of recipient twin with fulminant ALF secondary to hydrops fetalis caused by twin-to-twin transfusion syndrome (TTTS).MethodThe patient was admitted to the neonatal intensive care unit (NICU) for respiratory failure requiring mechanical ventilation and fulminant ALF with prolonged international normalized ratio (INR) and elevated liver enzymes with highest aspartate aminotransferase of 4,580 U/L.ResultsLaboratory investigation for secondary causes of liver failure was not revealing. Her liver enzymes and coagulation levels were dramatically normalized as the clinical symptoms of hypervolemia improved within 1 week.ConclusionTTTS can be a possible cause of neonatal ALF. Early detection with proper management of TTTS is important to avoid adverse outcomes. However, pathogenesis of hepatic dysfunction in TTTS is rarely described, and further studies are needed to help understanding the correlation between liver diseases and TTTS.

Twin-to-twin transfusion syndrome as a cause of neonatal acute liver failure

Department of Pediatrics, Faculty of Medicine, Vajira Hospital

Asian Biomedicine

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

{"article-title":"Twin-to-twin transfusion syndrome as a cause of neonatal acute liver failure"}

BackgroundAcute liver failure (ALF) is a rare condition during neonatal period.ObjectiveTo report a case of recipient twin with fulminant ALF secondary to...

Twin-to-twin transfusion syndrome as a cause of neonatal acute liver failure

Article Category: Clinical report

Published Online: Mar 31, 2020

Page range: 163 - 170

DOI: https://doi.org/10.1515/abm-2019-0055

Keywords
acute/therapy, fetofetal transfusion, hydrops fetalis, liver failure, newborn

© 2019 Chattip Prueksapraopong et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Twin-to-twin transfusion syndrome as a cause of neonatal acute liver failure

Article Category: Clinical report

Published Online: Mar 31, 2020

Page range: 163 - 170

DOI: https://doi.org/10.1515/abm-2019-0055

Keywordsacute/therapy, fetofetal transfusion, hydrops fetalis, liver failure, newborn

© 2019 Chattip Prueksapraopong et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Keywords
acute/therapy, fetofetal transfusion, hydrops fetalis, liver failure, newborn