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This is a case report of Hyperemesis Gravidarum (HG) with a distinctly abnormal elevated ALT and AST values, in association with intractable nausea and vomiting. A 26-year-old woman G2P1A0 with a 9-week gestational age and no significant past medical history, presented with intractable nausea and vomiting despite medication use for three weeks. Despite administration of Vitamin B6, the symptoms persisted. During this period, the patient was unable to tolerate solids or liquids, and experienced progressive weakness, fatigue, and non-radiating epigastric pain. The patient was admitted to the Brooklyn Hospital Center Family Medicine service and found to have notable electrolyte disturbances, and remarkable transaminitis, with alanine aminotransferase (ALT) and aspartate aminotransferase (AST) values of 3400 IU/L and 717 IU/L respectively. All alternative diagnoses were ruled out. Ultimately, transaminitis resolved and mother an baby are doing well. This case report describes the typical clinical presentation of HG with acute liver injury and positive feto-maternal outcome.

Hyperemesis gravidarum with acute liver injury and positive feto-maternal outcome