Glycogenic hepatopathy is a rare condition that may be seen in patients with poorly controlled diabetes mellitus. This is a case presentation of a 15-year-old female with type 1 diabetes mellitus who was not fully adherent to her insulin regimen and presented in acute diabetic ketoacidosis. She had the associated symptom of two months of abdominal pain. The patient’s ketoacidosis resolved during her hospitalization with insulin and intravenous fluid management; however, her lactic acid and liver transaminases remained persistently elevated. Abdominal ultrasound was consistent with parenchymal liver disease and a clinical diagnosis of glycogenic hepatopathy was made. Management consisted of tight glucose control. After discharge, the patient was followed closely by pediatric endocrinology and pediatric gastroenterology, and once her glucose was optimized, her transaminitis and lactic acidosis resolved. Although an uncommon condition, it is important to consider glycogenic hepatopathy in diabetic patients with poor glucose control, abdominal pain, transaminitis and lactic acidosis.TopicsDiabetic ketoacidosis, hepatopathy, lactic acidosis, transaminitis, glycogen, diabetes mellitus. Brown D, et al. A Case Report of Glycogenic Hepatopathy. JETem 2021. 6(3):V1–3