RESUMO
Background Drug-induced liver injury is a common cause of transaminitis, occurring in up to 5% of patients who are hospitalized for liver failure. In pregnancy, transaminitis is seen in conditions which may require expedited delivery. Case A 39-year-old G2P0010 at 27 2/7 weeks' gestation with chronic hypertension on labetalol was found to have elevated transaminases. Evaluation for preeclampsia, acute fatty liver, nonalcoholic steatohepatitis, cholelithiasis, infections, and autoimmune conditions were all negative. Labetalol was then discontinued, and liver biopsy was performed. After discontinuation of labetalol, her hepatitis improved, and she was discharged on hospital day 12 and went on to deliver at term. Conclusion Labetalol-induced hepatitis should be considered in the differential for transaminitis during pregnancy to prevent iatrogenic preterm delivery.
RESUMO
Histoplasma capsulatum is a fungus that is endemic in many parts of the world and can present with a wide variety of symptoms. Here we present a case of a previously healthy 19-year-old female who presented with shortness of breath. She was found to have a right lung mass and coarctation of the aorta on computed tomography imaging. Pathology revealed granuloma caused by Histoplasma capsulatum. She later developed massive pericardial effusion, requiring emergent pericardiocentesis. She was treated with anti-fungal therapy and recovered well. This case illustrates an unusual presentation of newly diagnosed coarctation of the aorta complicated by Histoplasma pericardial effusion. Imaging and pathology slides are reviewed.
