A case of severe preeclampsia leading to the diagnosis of de novo abnormal fatty acid metabolism and ACE gene deletion.

BACKGROUND

Enzymes involved in the metabolism of free fatty acids are essential for the proper use of caloric intake. Abnormal enzymes unable to degrade fatty acids will result in an accumulation of fatty acids in organs like the liver, impairing its function.

CASE: A 28-year-old primigravid woman underwent induction of labour because of severe preeclampsia. She was subsequently found to be a carrier for mutations in several fatty acid enzymes as well as the angiotensin converting enzyme.

CONCLUSION

During pregnancy, the increased need for fatty acid degradation will expose women who are carriers of mutations in these enzymes. The clinical manifestations in such women include acute fatty liver of pregnancy that may mimic severe preeclampsia. Strict metabolic control to avoid excess fatty acid degradation may allow for better pregnancy outcomes and newborn assessment.