21 April 2025
: Case report 
Diagnostic Challenges in Acute Fatty Liver of Pregnancy: Fever as a Key Symptom in Case Series from Indonesia
Unusual clinical course, Mistake in diagnosis, Unusual setting of medical care
Wahyudi Wirawan ABCDEFG 1*, Adhi Pribadi ABCDEF 1DOI: 10.12659/AJCR.946614
Am J Case Rep 2025; 26:e946614
Table 1. Laboratory and other findings.
| Main parameters | Admission Case 1 | Admission Case 2 | Admission Case 3 | Normal range |
|---|---|---|---|---|
| Hemoglobin | 12.2 | 12.4 | 17.1 | 12.3–15.3 g/dL |
| Hematocrit | 41.2 | 37.1 | 48.1 | 36.0–45.0% |
| Leukocytes | 28.470 | 24.120 | 4970 | 4.4–11.3×10/µL |
| Platelets | 30 000 | 22 000 | 5000 | 150–450 thousand/µL |
| PT | 28,4 | 15.2 | 14.3 | 12–16 seconds |
| APTT | 63.50 | 57.40 | 75.20 | 21–41 seconds |
| INR | 2.09 | 1.07 | 0.99 | 0.8–1.2 |
| Rapid glucose | 42 | 61 | 58 | <140 mg/dL |
| SGOT | 6020 | 1203 | 2485 | 15–17 U/L |
| SGPT | 892 | 578 | 874 | 0–55 U/L |
| Urea | 35.3 | 15.9 | 50.4 | 15–40 mg/dL |
| Creatinine | 0.80 | 1.24 | 2.44 | 0.57–1.11 mg/dL |
| Sodium (Na) | 120 | 137 | 126 | 135–145 mEq |
| Potassium (K) | 6.8 | 4.4 | 5.2 | 3.5–5.1 mEq |
| Fibrinogen | 161.8 | 274 | 508 | 228–498 |
| D-Dimer | 19.94 | 5.04 | – | <0.55 |
| NS-1 (for dengue diagnosis) | Reactive | – | Non reactive | Non reactive |
| Dengue IgM | Non reactive | Non reactive | Non reactive | Non reactive |
| Dengue IgG | Reactive | Non reactive | Non reactive | Non reactive |
| Cholesterol HDL | 136 | – | – | Borderline 170–199; High >200 |
| Cholesterol LDL | 15 | – | – | Normal >60; Low <40 |
| Triglyceride | 213 | – | – | Optimal <100; High 160–189; Very high >190 |
| LDH | 7480 | 962 | 1767 | 81–224 |
| Albumin | 2.66 | 2.48 | 1.72 | 3.5–5 g/dL |
| Bilirubin, total | 6.515 | 2.201 | 1.616 | 0.108–1080 |
| Bilirubin, direct | 4.803 | 1.221 | 1.182 | 0.108–1080 |
| Bilirubin, indirect | 1.712 | 0.980 | 0.434 | 0.108–1080 |
| Preceded by fever | Yes | Yes | Yes | – |
| Swansea criteria score | 8 | 6 | 4 | – |
| Method of delivery | Cesarian section | Cesarian section | Misoprostol ripening | – |
| Days until improvement | 34 days | 8 days | Deceased | – |
| APTT – activated partial thromboplastin time; INR – International Normalized Ratio; PT – prothrombin time; SGOT – serum glutamicoxaloacetic transaminase (also known as AST – aspartate aminotransferase); SGPT – serum glutamic-pyruvic transaminase (also known as ALT – alanine aminotransferase); NS-1 – non-structural protein 1 (commonly associated with the Dengue virus antigen test); HDL – high-density lipoprotein; LDL – low-density lipoprotein; LDH – lactate dehydrogenase. | ||||