We report a case of chronic hepatitis B carrier gravida who had acute exacerbation during pregnancy. She had been taking lamivudine 100 mg/qd for 17 months when hepatitis B virus (HBV) DNA in the YMDD region of the polymerase gene (YMDD motif) mutant was noted. After discontinuing lamivudine, she became ...

Although liver disease does not occur frequently during pregnancy, when it does, it can cause significant morbidity and mortality for both fetus and mother. Recent advances in molecular genetics have provided some insight into the pathogenesis of diseases such as intrahepatic cholestasis of pregnancy (IHCP) and acute fatty liver of ...

Pruritic urticarial papules and plaques of pregnancy (PUPPP) is among the most common dermatoses of pregnancy. Most reports of the effective treatment of PUPPP involve high potency topical corticosteroids or oral steroids. Many authorities have noted cases of PUPPP whose resolution followed parturition. A few have noted that PUPPP can ...

During pregnancy several alterations in the immune status allow mothers to tolerate the genetically different foetal tissues. We investigated the evolution of liver disease during and after pregnancy in chronic hepatitis B patients. Between 1998 and 2006 there were 38 pregnancies in 31 chronic hepatitis B 's' antigen-positive women at ...

BACKGROUND: Obstetric cholestasis (OC) is associated with increased maternal and perinatal complications. Nevertheless, data on pregnancy outcomes of women who experience pruritus on a transient basis, but have normal bile salts and liver function tests (LFT) is scarce. METHODS: The maternal and fetal outcomes of 144 women with pruritus but ...

CONTEXT: The dermatoses of pregnancy represent a group of pathologic skin disturbances that cause considerable distress to the gravid patient. It is important to understand the diagnosis, treatment, and implications of these disorders in order to avert unnecessary discomfort and complications. OBJECTIVES: To describe the specific dermatoses of pregnancy according ...

The skin changes in pregnancy can be either physiological (hormonal), changes in pre-existing skin diseases or development of new pregnancy specific dermatoses. Pregnancy-specific skin dermatoses include an ill-defined heterogeneous group of pruritic skin eruptions which are seen only in pregnancy. These include atopic eruption of pregnancy, polymorphic eruption of pregnancy, ...

OBJECTIVES: Neonatal respiratory distress syndrome is associated with intrahepatic cholestasis of pregnancy, and bile acids may play a major role in neonatal bile acid pneumonia. Our aim was to demonstrate the bile acid presence in the bronchoalveolar lavage fluid of neonates affected by respiratory distress syndrome who were born from ...

Intrahepatic cholestasis of pregnancy (ICP) occurs mainly in the third trimester and is characterised by pruritus and elevated serum bile acid levels. ICP is associated with an increased perinatal risk and higher rates of foetal morbidity and mortality. Although the pathogenesis of this disease is unknown, a genetic hypersensitivity to ...

BACKGROUND: Intrahepatic cholestasis of pregnancy is a multifactorial disorder of pregnancy associated with a genetic background. AIM: To evaluate the genetic contribution of ABCB4, MDR3 gene in the development of intrahepatic cholestasis of pregnancy in a large cohort of Italian subjects. METHODS: This study represents an extension of a previous ...

A 23-year-old woman presented to our polyclinic complaining of itching, generalized dermatitis, and jaundice. She was in her 31st gestational week and had developed pruritus and the dermatitis since the first month of pregnancy; her jaundice started about a month before presentation. Her history included similar complaints in a previous ...

Multiple sclerosis (MS) is an autoimmune disease of the central nervous system affecting predominantly women of childbearing age; therefore, issues of conception, pregnancy, and delivery become of significant importance to patients and treating physicians. This article discusses the immunological and clinical effects of pregnancy on the course of MS, clinical ...

In countries with a high prevalence of chronic hepatitis B, perinatal transmission from mother to infant accounts for the majority of cases of chronic hepatitis B. Passive-active immunoprophylaxis with hepatitis B immunoglobulin and hepatitis B vaccine at birth is 95% efficacious in reducing the risk of HBV transmission but is ...

BACKGROUND/AIMS: We hypothesized that common genetic variation at ABCC2 influences ICP susceptibility. Hence we studied the association of single nucleotide polymorphisms (SNPs) of promoter, coding and non-coding regions of ABCC2 and intrahepatic cholestasis of pregnancy (ICP). METHODS: 70 ICP patients and 112 healthy pregnant women in the third trimester of ...

Hemangioblastomas are low-grade, highly vascular tumors commonly associated with von Hippel-Lindau (VHL) syndrome and most often appearing in the cerebellum. They very rarely occur in the spinal nerve roots, and an origin in the filum terminale is exceptional with no instances of multiple hemangioblastomas of the filum terminale reported in ...

BACKGROUND: Spontaneous hepatic rupture in pregnancy is rare and carries a high maternal and perinatal mortality. CASE REPORT: We describe a case of hepatic rupture that occurred after emergency caesarean section performed in a pregnant woman at 38 weeks of gestation with Hemolysis, Elevated Liver enzymes and Low Platelet count ...

A 68-year-old healthy man presented with papulopustular rosacea (PPR) recalcitrant to multiple therapies, including permethrin cream 5%. Histologic examination detected the presence of chronic folliculitis and numerous Demodex organisms. A diagnosis of rosacealike demodicidosis was rendered, and the patient was treated with oral ivermectin and permethrin cream 5%, resulting in ...

OBJECTIVE: To provide an overview of the epidemiology, etiology, pathogenesis, diagnosis, and management of intrahepatic cholestasis of pregnancy. METHODS: We searched the Medline and PubMed database using the key words intrahepatic cholestasis of pregnancy, obstetric cholestasis, diagnosis, management, and complications. RESULTS: Intrahepatic cholestasis of pregnancy, or obstetric cholestasis, is a ...

Viral hepatitis is common in Nigeria and may present with jaundice in pregnancy. The objective of this study was to determine the contribution of viral hepatitis among other aetiological factors, to the development of jaundice during pregnancy. Data on viral hepatitis among gravidae with jaundice in pregnancy over a 10-year ...

BACKGROUND: Intrahepatic cholestasis of pregnancy (ICP) is a severely pruritic form of reversible cholestasis that is associated with significant fetal risks. Because precise diagnostic and therapeutic guidelines are lacking, we performed a retrospective investigation of dermatologic and biochemical features, treatment, and neonatal outcome in patients with ICP seen from 2000 ...

BACKGROUND AND AIMS: Intrahepatic cholestasis of pregnancy (ICP) is characterized by liver impairment, pruritus, and elevated maternal serum bile acids. It can cause premature delivery and intrauterine death. Bile acid synthesis, metabolism, and transport are regulated by the bile acid sensor FXR, and we hypothesized that genetic variation in FXR ...

PURPOSE OF REVIEW: This review focuses on the recent advances in cholestatic liver diseases. While there is an emphasis placed on translational and treatment-focused studies, basic science studies with the greatest impact on the field are also covered. RECENT FINDINGS: Highlights include new discoveries for the role of the farsenoid ...

Liver cirrhosis complications in pregnant women are frequent and death rate secondary to variceal bleeding is relevant. Both sclerotherapy and banding ligation seem to be safe procedures in pregnancy; when bleeding is not arrested endoscopically an emergency transjugular intrahepatic portosystemic shunt should be considered, but data regarding pregnant cirrhotic women ...

AIM: To study the clinicopathological characteristics of unsuspected gallbladder carcinoma (UGC). METHODS: We retrospectively studied 23 cases of UGC in Tongji Hospital, and compared their clinicopathological characteristics with 33 cases of preoperatively diagnosed gallbladder carcinoma (PDGC). RESULTS: The proportion of UGC coexisting with cholecystolithiasis was significantly higher than that of ...

Conjugal multiple sclerosis (MS) is a rare form of MS in which both spouses are affected, and at least one is affected after marriage. Among 1606 definite MS patients, 1076 were in marital relationship, among whom we identified six conjugal pairs, giving the conjugal rate of 0.5%. This rate is ...

Common skin conditions during pregnancy generally can be separated into three categories: hormone-related, preexisting, and pregnancy-specific. Normal hormone changes during pregnancy may cause benign skin conditions including striae gravidarum (stretch marks); hyperpigmentation (e.g., melasma); and hair, nail, and vascular changes. Preexisting skin conditions (e.g., atopic dermatitis, psoriasis, fungal infections, cutaneous ...

BACKGROUND: Acetaminophen overdose is the most common cause of acute liver failure (ALF). Our objective was to develop coding algorithms using administrative data for identifying patients with acetaminophen overdose and hepatic complications. METHODS: Patients hospitalized for acetaminophen overdose were identified using population-based administrative data (1995-2004). Coding algorithms for acetaminophen overdose, ...

Intrahepatic cholestasis of pregnancy (ICP) is a cholestatic disorder characterized by (i) pruritus with onset in the second or third trimester of pregnancy, (ii) elevated serum aminotransferases and bile acid levels, and (iii) spontaneous relief of signs and symptoms within two to three weeks after delivery. ICP is observed in ...

Intrahepatic cholestasis of pregnancy is the most common liver disorder in pregnancy that adversely affects maternal well being and fetal outcome. We present a case of eclampsia that followed intrahepatic cholestasis of pregnancy in a patient who has a sister with the same history in her two former pregnancies despite ...

Pruritic urticarial papules and plaques of pregnancy (PUPPP) are among the most common pruritic dermatoses observed in pregnant women. PUPPP appears most frequently in the third trimester, in primigravidas, and in multiple gestation pregnancies. The eruption of changes occurs initially on the abdomen and extends over the thighs, legs, back, ...

BACKGROUND: Quantification of HBsAg in serum may be of clinical importance in predicting HBsAg seroconversion and complete response to treatment. METHODS: Serum HBsAg was quantified by ADVIA Centaur in 63 patients with HBeAg-negative chronic hepatitis B (CHBe-). A total of 42 had received interferon-alpha2b (IFN-alpha2b) (median 12.1 months; 19 sustained ...

Pregnancy in women with advanced liver disease is rare. In this paper we described the case of a successful pregnancy in a young woman with advanced cirrhosis due to hepatitis B surface antigenemia, hepatitis delta super-infection and Hepatitis C co-infection. A brief review of the medical literature on pregnancy in ...

Intrahepatic cholestasis of pregnancy (ICP) is defined as pruritus and elevated bile acid serum concentrations in late pregnancy. Splicing mutations have been described in the multidrug resistance p-glycoprotein 3 (MDR3, ABCB4) gene in up to 20% of ICP women. Pedigrees studied were not large enough for linkage analysis. Ninety-seven family ...

The human endogenous retroviruses (HERV)-W family contains an extracellular particle detected in multiple sclerosis (MS) patients and designated as MS-associated retrovirus (MSRV). Through nested RT-PCR assays specific for pol MSRV gene, we preliminary reported that its presence in the cerebrospinal fluid (CSF) of early MS patients could be indicative of ...

BACKGROUND: Pemphigoid gestationis is a rare autoimmune blistering disease that occurs during pregnancy. OBJECTIVE: This study reviewed our clinical experience with pemphigoid gestationis. METHODS: We reviewed medical records of 10 patients with pemphigoid gestationis seen at Mayo Clinic, Rochester, Minnesota, between 1976 and 2004. RESULTS: Urticarial papules were the most ...

Gestational intrahepatic cholestasis, characterized by generalized pruritus and biochemical changes of cholestasis, usually occurs in the third trimester of pregnancy, persists until delivery and resolves spontaneously within the initial four weeks of the puerperium. The incidence is dependent on genetic basis, environmental factors and geographical location. We report the case ...

BACKGROUND: Lymphocytic myocarditis, an immune disorder of left ventricular dysfunction with sometimes confounding clinical presentations, occurs rarely during pregnancy. CASE: At 12 weeks gestation, a multigravid patient presented with a 2-month history of nausea and vomiting. Other symptomatology included postprandial epigastric pain, loose stools, and a 10-lb (4.5-kg) weight loss. ...

BACKGROUND: Intrahepatic cholestasis of pregnancy (ICP) is characterised by troublesome maternal pruritus, raised serum bile acid levels and increased fetal risk. Mutations of the ABCB4 gene encoding the hepatobiliary phospholipid transporter have been identified in a small proportion of patients with cholestasis of pregnancy. In a recent prospective study on ...

Intrahepatic cholestasis of pregnancy (ICP) is a cholestatic disorder that usually develops in the third trimester of pregnancy and persists until delivery. The cause of ICP remains elusive, but there is evidence that mutations in the canalicular ABC transporter phospholipid flippase (MDR3) and in the bile salt export pump (BSEP) ...

INTRODUCTION: Plaque and trapped debris that accumulate gingivally to orthodontic wire are difficult to remove. The triple-headed toothbrush (TH-TB) was designed to reach the gingival tooth margin. In this study, we examined its effectiveness in improving the oral health of orthodontic patients as compared with conventional and orthodontic toothbrushes. METHODS: ...

A 21-year-old woman of Romany origin, in the third trimester of her fourth pregnancy, was admitted to the hospital because of a generalized erythematous and pustular eruption and desquamation involving her face, neck, trunk, and extremities. The skin changes were accompanied by fever (100.4 degrees F [38 degrees C]) and ...

Intrahepatic cholestasis of pregnancy (ICP) is a pregnancy-specific disorders that occurs mainly in the third trimester of pregnancy and is characterized by pruritus and elevated bile acid levels. ICP is regarded as a benign disease with no meaningful consequences to the mother but associated to an increased perinatal risk with ...

The occurrence of cholestasis during pregnancy may be due to several disorders. These include pregnancyspecific diseases, like intrahepatic cholestasis of pregnancy(ICP), as well as to other causes such as oligosymptomatic choledocolitiasis, viral hepatitis and other underlying liver disorders like primary biliary cirrhosis. In recent years, the discovery of mutations in ...

Hepatic perforation is an unusual complication of woman pregnancy associated with a poor outcome. A comprehensive review of epidemiology, clinical spectrum, diagnostic methods and therapeutic options is presented in this short paper.

Autoimmune hepatitis is a rare condition that is more common among women than men. An association between pregnancy and autoimmune hepatitis is rare. This clinical scenario requires the gastroenterologist and hepatologist to have a profound knowledge of clinical course counseling and medical management. The prognosis in well-controlled and closely monitored ...

Women with viral chronic hepatitis generally do quite well during pregnancy, providing that they have not progressed to decompensated cirrhosis. As a general rule, a stable liver equals a safe pregnancy. However, concern is about how pre-existing chronic liver disease may affect the pregnancy and the unborn baby. This review ...

We prospectively investigated the short-term effects of intravenous methyl-prednisolone (IVMP) on cerebral volume in patients suffering a multiple sclerosis (MS) relapse. Ten patients underwent MRI brain studies immediately before and after IVMP treatment, and 4 and 8 weeks later. Whole brain volumes decreased significantly over the 8-week period. The greatest ...

BACKGROUND: The aetiology of intrahepatic cholestasis of pregnancy is unknown, but more than 10 different MDR3 gene mutations have recently been identified. AIM: To evaluate the genetic contribution of the MDR3 gene in the pathogenesis of intrahepatic cholestasis of pregnancy in Italian subjects. METHODS: We performed a multicentre prospective case-control ...

OBJECTIVE: Acute viral hepatitis C-induced jaundice in pregnancy is very rare and may be fatal. Here, we report a complicated case with acute hepatitis C-induced jaundice in pregnancy with successful management. CASE REPORT: A 27-year-old pregnant woman, gravida 2, para 1, with gestational age of 36 weeks and 5 days, ...

BACKGROUND: Severe liver dysfunction occurring during pregnancy is an unusual but dramatic event that poses special technical and ethical issues because it involves two lives. METHODS AND RESULTS: We report the case of a 35-year-old woman with cryptogenic fulminant hepatic failure who underwent successful orthotopic liver transplantation at 22 weeks ...