There may be a link between intrahepatic cholestasis of pregnancy and familial combined hyperlipidaemia: a case report
A 26-year-old gravida 3 para 1+1 was referred for antenatal care. In her last pregnancy she had a early spontaneous preterm delivery at 32 weeks and 2 days complicated by intra hepatic cholestasis of pregnancy. She had a strong family history of ischemic heart and combined hyperlipidaemia. In view o...
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Published in | Cases journal Vol. 2; no. 1; p. 8679 |
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Main Authors | , , , , |
Format | Journal Article |
Language | English |
Published |
BioMed Central
17.09.2009
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Abstract | A 26-year-old gravida 3 para 1+1 was referred for antenatal care. In her last pregnancy she had a early spontaneous preterm delivery at 32 weeks and 2 days complicated by intra hepatic cholestasis of pregnancy. She had a strong family history of ischemic heart and combined hyperlipidaemia. In view of her past obstetric history a baseline liver function test and fasting bile acid assay was carried out. Upto 21 week her Bile acids were normal but at 22 weeks her fasting bile acid assay increased to the upper limit of normal (9 µmol/L).
Ursodeoxycholic acid was started from 28 weeks gestation on a dosage of 500 mg b.i.d., which was subsequently increased to 500 mg t.d.s. at 32 weeks.
At 34 weeks she gave a history of occasional right upper quadrant abdominal pain and her biochemistry revealed raised serum aspartate transaminase ,alanine transaminase, fasting serum triglyceride and cholesterol levels 58 IU,79 IU/L,18.37 mmol/L and 25.7 mmol/L respectively. The triglyceride level was too high to calculate the low density lipoprotein cholesterol. A diagnosis of severe intrahepatic cholestasis of pregnancy in a patient with background familial combined hyperlipidaemia was made. Ultrasound abdomen and cardiotocography was normal. She had normal delivery. In cases of early onset cholestasis of pregnancy we suggest that lipid profiles are checked in these patients to rule out hyperlipidaemia and its attendant short term and long-term risks. More research will be required to ascertain if there is a link between these 2 disorders. |
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AbstractList | A 26-year-old gravida 3 para 1+1 was referred for antenatal care. In her last pregnancy she had a early spontaneous preterm delivery at 32 weeks and 2 days complicated by intra hepatic cholestasis of pregnancy. She had a strong family history of ischemic heart and combined hyperlipidaemia. In view of her past obstetric history a baseline liver function test and fasting bile acid assay was carried out. Upto 21 week her Bile acids were normal but at 22 weeks her fasting bile acid assay increased to the upper limit of normal (9 µmol/L).
Ursodeoxycholic acid was started from 28 weeks gestation on a dosage of 500 mg b.i.d., which was subsequently increased to 500 mg t.d.s. at 32 weeks.
At 34 weeks she gave a history of occasional right upper quadrant abdominal pain and her biochemistry revealed raised serum aspartate transaminase ,alanine transaminase, fasting serum triglyceride and cholesterol levels 58 IU,79 IU/L,18.37 mmol/L and 25.7 mmol/L respectively. The triglyceride level was too high to calculate the low density lipoprotein cholesterol. A diagnosis of severe intrahepatic cholestasis of pregnancy in a patient with background familial combined hyperlipidaemia was made. Ultrasound abdomen and cardiotocography was normal. She had normal delivery. In cases of early onset cholestasis of pregnancy we suggest that lipid profiles are checked in these patients to rule out hyperlipidaemia and its attendant short term and long-term risks. More research will be required to ascertain if there is a link between these 2 disorders. |
Author | Wray, Richard Zaidi, Jamal Whitehead, Mark William Rafi, Junaid Ajala, Tosin |
AuthorAffiliation | 1 Department Obstetrics and Gynaecology, Basingstoke & North Hampshire NHS Trust, Aldermaston Road, Basingstoke, RG24 9NA, UK 3 Department of Gastroenterology, Conquest Hospital, The Ridge St. Leonards on Sea, East Sussex, TN37 7RD, UK 4 Department Obstetrics and Gynaecology, Conquest Hospital, The Ridge St. Leonards on Sea, East Sussex, TN37 7RD, UK 2 Department of Cardiology, Conquest Hospital, The Ridge St. Leonards on Sea, East Sussex, TN37 7RD, UK |
AuthorAffiliation_xml | – name: 2 Department of Cardiology, Conquest Hospital, The Ridge St. Leonards on Sea, East Sussex, TN37 7RD, UK – name: 3 Department of Gastroenterology, Conquest Hospital, The Ridge St. Leonards on Sea, East Sussex, TN37 7RD, UK – name: 4 Department Obstetrics and Gynaecology, Conquest Hospital, The Ridge St. Leonards on Sea, East Sussex, TN37 7RD, UK – name: 1 Department Obstetrics and Gynaecology, Basingstoke & North Hampshire NHS Trust, Aldermaston Road, Basingstoke, RG24 9NA, UK |
Author_xml | – sequence: 1 givenname: Tosin surname: Ajala fullname: Ajala, Tosin – sequence: 2 givenname: Junaid surname: Rafi fullname: Rafi, Junaid – sequence: 3 givenname: Richard surname: Wray fullname: Wray, Richard – sequence: 4 givenname: Mark William surname: Whitehead fullname: Whitehead, Mark William – sequence: 5 givenname: Jamal surname: Zaidi fullname: Zaidi, Jamal |
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CitedBy_id | crossref_primary_10_1080_14767058_2017_1397124 crossref_primary_10_3390_life14010129 crossref_primary_10_3390_ijms140714575 crossref_primary_10_1111_tog_12373 |
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Title | There may be a link between intrahepatic cholestasis of pregnancy and familial combined hyperlipidaemia: a case report |
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