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Cholestasis of pregnancy

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https://www.readbyqxmd.com/read/29761167/phenotypic-spectrum-and-diagnostic-pitfalls-of-abcb4-deficiency-depending-on-age-of-onset
#1
Stephanie Barbara Schatz, Christoph Jüngst, Verena Keitel-Anselmo, Ralf Kubitz, Christina Becker, Patrick Gerner, Eva-Doreen Pfister, Imeke Goldschmidt, Norman Junge, Daniel Wenning, Stephan Gehring, Stefan Arens, Dirk Bretschneider, Dirk Grothues, Guido Engelmann, Frank Lammert, Ulrich Baumann
Genetic variants in the adenosine triphosphate-binding cassette subfamily B member 4 ( ABCB4 ) gene, which encodes hepatocanalicular phosphatidylcholine floppase, can lead to different phenotypes, such as progressive familial intrahepatic cholestasis (PFIC) type 3, low phospholipid-associated cholelithiasis, and intrahepatic cholestasis of pregnancy. The aim of this multicenter project was to collect information on onset and progression of this entity in different age groups and to assess the relevance of this disease for the differential diagnosis of chronic liver disease...
May 2018: Hepatology Communications
https://www.readbyqxmd.com/read/29740092/bile-acids-and-their-respective-conjugates-elicit-different-responses-in-neonatal-cardiomyocytes-role-of-gi-protein-muscarinic-receptors-and-tgr5
#2
Effendi Ibrahim, Ivan Diakonov, Dulasi Arunthavarajah, Teresa Swift, Mary Goodwin, Saraid McIlvride, Vanya Nikolova, Catherine Williamson, Julia Gorelik
Bile acids are recognised as bioactive signalling molecules. While they are known to influence arrhythmia susceptibility in cholestasis, there is limited knowledge about the underlying mechanisms. To delineate mechanisms underlying fetal heart rhythm disturbances in cholestatic pregnancy, we used FRET microscopy to monitor cAMP release and contraction measurements in isolated rodent neonatal cardiomyocytes. The unconjugated bile acids CDCA, DCA and UDCA and, to a lesser extent, CA were found to be relatively potent agonists for the GPBAR1 (TGR5) receptor and elicit cAMP release, whereas all glyco- and tauro- conjugated bile acids are weak agonists...
May 8, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29739259/role-of-ischemia-modified-albumin-in-the-evaluation-of-oxidative-stress-in-intrahepatic-cholestasis-of-pregnancy
#3
A T Tayyar, S Kozalı, G Y Yıldırım, R Karakus, I T Yuksel, O Erel, S Neselioglu, M Eroglu
OBJECTIVE: To investigate the ischemia-modified albumin (IMA) level, and the IMA/albumin ratio (IMAR) in healthy pregnant women, and pregnant women with intrahepatic cholestasis of pregnancy (ICP). MATERIAL AND METHOD: This cross-sectional study included 53 women with ICP and 52 healthy pregnant women. Their serum IMA and albumin levels were analyzed, and the women were followed up to delivery. RESULTS: No significant intergroup differences were identified in maternal age, body mass index, and gestational age at the time that the blood samples were taken...
May 8, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29709452/diagnostic-and-therapeutic-profiles-of-serum-bile-acids-in-women-with-intrahepatic-cholestasis-of-pregnancy-a-pseudo-targeted-metabolomics-study
#4
Yue Cui, Biao Xu, Xiaoqing Zhang, Yifan He, Yong Shao, Min Ding
BACKGROUND: Intrahepatic cholestasis of pregnancy (ICP), as a pregnancy-specific liver disorder, obtains increasing recognition due to a series of adverse outcomes. ICP is generally characterized by pruritus and jaundice, and closely related to abnormalities in the metabolism and disposition of bile acids composition. Because of its elusive pathogenesis, ICP has become an intractable issue to be diagnosed and managed for obstetricians. Analysis of metabolic profile could reveal the state of small-molecule metabolites systematically and provide comprehensively metabolic information for diseases...
April 27, 2018: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/29707880/risk-factors-for-adverse-maternal-and-perinatal-outcomes-in-women-with-preeclampsia-analysis-of-1396-cases
#5
Xun Li, Weishe Zhang, Jianhua Lin, Huai Liu, Zujing Yang, Yincheng Teng, Si Duan, Xinxiu Lin, Yingming Xie, Yuanqiu Li, Liangqun Xie, Qiaozhen Peng, Lu Xia
Preeclampsia is a major cause of adverse maternal and perinatal outcomes, but how to identify women and fetuses at increased risk for later adverse events is a challenge. This study aimed to investigate the risk factors for adverse maternal and perinatal outcomes in women with preeclampsia. Data from 1396 women with preeclampsia were retrospectively collected and analyzed. Eighteen candidate risk factors and 12 adverse outcomes were investigated. The following factors were found to be significantly associated with at least one adverse outcome: maternal age 35 years or older, multiple birth, the usage of assisted reproductive technology, living in a rural area, history of pregnancy-induced hypertension, male fetus, multigravida, or having polycystic ovary syndrome, hemolysis, elevated liver enzymes, and low platelet count syndrome, intrahepatic cholestasis of pregnancy, cardiovascular disease, gestational diabetes mellitus, systemic lupus erythematosus, thyroid disease, or liver disease...
April 30, 2018: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/29602694/-early-and-later-intrahepatic-cholestasis-of-pregnancy-icp-study-of-adverse-pregnancy-outcomes
#6
C Labbe, C Delesalle, C Creveuil, M Dreyfus
OBJECTIVE: To compare the risk for adverse pregnancy and fetal outcomes in early or late-onset intrahepatic cholestasis of pregnancy (ICP). METHODS: In a retrospective and unicentric analysis, data were collected for all women with ICP (serum bile acid level over 8mol/L) between June 1, 2008 and January 1, 2015. Patients were divided in early-onset ICP (pregnancy duration at diagnosis<33 weeks) and late-onset ICP (pregnancy duration at diagnosis≥33 weeks). The frequency of adverse pregnancy and fetal outcomes was assessed...
March 27, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
https://www.readbyqxmd.com/read/29563980/effect-of-yhhj-on-the-expression-of-the-hepatocellular-bile-acid-transporters-multidrug-resistance-associated-protein-2-and-bile-salt-export-pump-in-ethinylestradiol-induced-cholestasis
#7
Jia Liu, Li-Li Hou, Cui-Ying Zhao
The herbal medicine Yin Huang Mixture (YHHJ; patent no. 200910031240.7) is an aqueous extract composed from various herbs, including Artemisia capillaries Thunb, Hypericum japonicum Thunb, Eucommia ulmoides Oliver, Rheum officinale Baill, Gardenia jasminoides Ellis, Poria cocos Wolf and Dictamnus dasycarpus Turcz. Previous studies have indicated that YHHJ treatment has a beneficial effect on ameliorating itching and reducing serum bile acid levels in patients with intrahepatic cholestasis of pregnancy (ICP)...
April 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29560675/jaundice-in-a-pregnant-woman
#8
Sophiane Ibrahimi, Abbas Ali Mroué, Erik Francois, Robert Jagodzinski
A 34-year-old woman in the 22nd week of gestation presented with generalized pruritis and weight loss since the first trimester of pregnancy. Physical examination revealed cutaneous scratch lesions, jaundice, and hepatomegaly. Blood tests revealed cholestasis with elevated direct bilirubinemia. Auto-antibody and viral hepatitis tests were negative. Liver ultrasound was normal. The initial diagnosis was cholestasis of pregnancy. However despite treatment with ursodeoxycholic acid, the patient did not improve...
July 2017: Acta Gastro-enterologica Belgica
https://www.readbyqxmd.com/read/29513180/jaundice-in-a-pregnant-woman
#9
S Ibrahimi, A A Mroué, E Francois, R Jagodzinski
A 34-year-old woman in the 22nd week of gestation presented with generalized pruritis and weight loss since the first trimester of pregnancy. Physical examination revealed cutaneous scratch lesions, jaundice, and hepatomegaly. Blood tests revealed cholestasis with elevated direct bilirubinemia. Auto-antibody and viral hepatitis tests were negative. Liver ultrasound was normal. The initial diagnosis was cholestasis of pregnancy. However despite treatment with ursodeoxycholic acid, the patient did not improve...
July 2017: Acta Gastro-enterologica Belgica
https://www.readbyqxmd.com/read/29507303/impacts-of-different-methods-of-conception-on-the-perinatal-outcome-of-intrahepatic-cholestasis-of-pregnancy-in-twin-pregnancies
#10
Chun Feng, Wen-Juan Li, Rong-Huan He, Xi-Wen Sun, Guirong Wang, Li-Quan Wang
Twin pregnancies have a higher prevalence of intrahepatic cholestasis of pregnancy (ICP) than single pregnancies. It is unknown whether in vitro fertilization-embryo transfer (IVF-ET) influences the fetal outcomes in twin pregnancies complicated by ICP. This study aimed to explore the impact of IVF-ET on the perinatal outcomes of ICP in twin pregnancy. Clinical data from 142 twin pregnant women complicated with ICP were retrospectively analyzed, including 51 patients who conceived through IVF-ET (IVF group) and 91 patients with spontaneous conception (SC group)...
March 5, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29480924/intrahepatic-cholestasis-of-pregnancy-a-review-of-diagnosis-and-management
#11
Amber M Wood, Elizabeth G Livingston, Brenna L Hughes, Jeffrey A Kuller
Importance: Intrahepatic cholestasis of pregnancy (ICP) complicates approximately 0.2% to 2% of pregnancies and can lead to increased fetal risks in pregnancy. Objective: This review aims to increase the knowledge of women's health care providers regarding the diagnosis, management, and fetal risks associated with ICP. Results: The diagnosis of ICP is based on symptoms of pruritus that typically include the palms and soles, as well as elevated bile acid levels...
February 2018: Obstetrical & Gynecological Survey
https://www.readbyqxmd.com/read/29419378/does-ursodeoxycholic-acid-improve-perinatal-outcomes-in-women-with-intrahepatic-cholestasis-of-pregnancy
#12
Lucy C Chappell, Jenny Chambers, Jim G Thornton, Catherine Williamson
No abstract text is available yet for this article.
February 1, 2018: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29384912/intrahepatic-cholestasis-of-pregnancy-or-azithromycin-induced-intrahepatic-cholestasis-a-case-report
#13
Baoshi Han, Yan Sheng, Li Wang, Hao Feng, Xianzeng Hou, Yan Li
RATIONALE: Azithromycin-induced liver injury has been rarely reported in adult individuals, let alone in a pregnant woman. Here, we describe the clinical features and outcomes of azithromycin-induced liver injury in a pregnant woman. PATIENT CONCERNS: A 30-year-old pregnant woman presented with generalized pruritus and elevated serum bile acid level (123.6 μmol/L) on day 4 of azithromycin administration. A diagnosis of intrahepatic cholestasis of pregnancy was made, and cesarean section was performed immediately...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29366351/histomorphometric-changes-in-the-placenta-and-umbilical-cord-during-complications-of-pregnancy
#14
D Güven, B Z Altunkaynak, G Altun, I Alkan, I Kocak
Pregnancy complications may cause morphological changes and circulation defects in the placenta, which may lead to morbidity and mortality in fetuses and newborns. We investigated structural changes in the placenta and umbilical cord under various abnormal maternal conditions. Placenta and umbilical cord specimens were obtained from pregnant women during labor at 37 - 42 weeks gestation. Volumetric measurements were made for each placenta and umbilical cord using the Cavalieri method. Significant differences were observed for volumetric densities of total villi, syncytial knots, intervillous vessels and perivillous fibrin deposition...
January 25, 2018: Biotechnic & Histochemistry: Official Publication of the Biological Stain Commission
https://www.readbyqxmd.com/read/29355600/mechanisms-of-canalicular-transporter-endocytosis-in-the-cholestatic-rat-liver
#15
Gisel S Miszczuk, Ismael R Barosso, María Cecilia Larocca, Julieta Marrone, Raúl A Marinelli, Andrea C Boaglio, Enrique J Sánchez Pozzi, Marcelo G Roma, Fernando A Crocenzi
Impaired canalicular secretion due to increased endocytosis and intracellular retention of canalicular transporters such as BSEP and MRP2 is a main, common pathomechanism of cholestasis. Nevertheless, the mechanisms governing this process are unknown. We characterized this process in estradiol 17 β-d-glucuronide (E17G)-induced cholestasis, an experimental model which partially mimics pregnancy-induced cholestasis. Inhibitors of clathrin-mediated endocytosis (CME) such as monodansylcadaverine (MDC) or K+ depletion, but not the caveolin-mediated endocytosis inhibitors filipin and genistein, prevented E17G-induced endocytosis of BSEP and MRP2, and the associated impairment of activity of these transporters in isolated rat hepatocyte couplets (IRHC)...
April 2018: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/29350689/safety-of-intravitreal-injection-of-ranibizumab-in-early-pregnancy-a-series-of-three-cases
#16
P Fossum, C Couret, B Briend, M Weber, L Lagarce
PurposeRanibizumab is used in the treatment of choroidal neovascularization (CNV). Although systemic exposure to ranibizumab is low after ocular administration, its mechanism of action must be regarded as potentially teratogenic and embryo-fetotoxic. Women are advised to wait 3 months after the last dose of treatment with ranibizumab before conceiving. Little is known about the fetal side-effects of this drug.MethodsThree pregnant women were treated with ranibizumab. One patient had idiopathic CNV.ResultsAfter receiving injections at 10 and 21 weeks after her last menstrual period (LMP), she gave birth to a healthy child...
April 2018: Eye
https://www.readbyqxmd.com/read/29317337/heart-and-bile-acids-clinical-consequences-of-altered-bile-acid-metabolism
#17
REVIEW
Tharni Vasavan, Elisa Ferraro, Effendi Ibrahim, Peter Dixon, Julia Gorelik, Catherine Williamson
Cardiac dysfunction has an increased prevalence in diseases complicated by liver cirrhosis such as primary biliary cholangitis and primary sclerosing cholangitis. This observation has led to research into the association between abnormalities in bile acid metabolism and cardiac pathology. Approximately 50% of liver cirrhosis cases develop cirrhotic cardiomyopathy. Bile acids are directly implicated in this, causing QT interval prolongation, cardiac hypertrophy, cardiomyocyte apoptosis and abnormal haemodynamics of the heart...
April 2018: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/29304564/unexplained-cholestasis-in-adults-and-adolescents-diagnostic-benefit-of-genetic-examination
#18
Luise Aamann, Nikolaj Ørntoft, Ida Vogel, Henning Grønbaek, Naja Becher, Hendrik Vilstrup, Peter Ott, Dorte Launholt Lildballe
OBJECTIVES: A few adult and adolescent patients with even severe cholestatic liver disease remain unexplained after standard diagnostic work-up. We studied the value of genetic examination in such patients and developed a panel of eight genes with known cholestatic associations. MATERIALS AND METHODS: Thirty-three patients with unexplained cholestasis despite a thorough clinical work-up were examined for sequence variations in the coding regions of the ABCB4, ABCB11, ABCC2, ABCG5, ATP8B1, JAG1, NOTCH2, and UGT1A1 genes and the promoter region of UGT1A1 by massive parallel sequencing of DNA extracted from whole blood...
March 2018: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/29287028/hbv-or-hcv-coinfection-in-hiv-1-infected-pregnant-women-in-france-prevalence-and-pregnancy-outcomes
#19
Valérie Benhammou, Roland Tubiana, Sophie Matheron, Pierre Sellier, Laurent Mandelbrot, Jérôme Le Chenadec, Emmanuelle Marel, Babak Khoshnood, Josiane Warszawski
BACKGROUND: Chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infection is frequent in HIV-infected persons but their impact on pregnant HIV-infected women is understudied. We explored whether these coinfections are associated with adverse pregnancy outcomes and lower response to antiretroviral therapy (ART). METHODS: Pregnancies in HIV-1-infected women included in the ANRS French Perinatal Cohort between 2005 and 2013 were analyzed if HBV and HCV infection statuses were available...
April 15, 2018: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/29250459/intrahepatic-cholestasis-of-pregnancy-refractory-to-multiple-medical-therapies-and-plasmapheresis
#20
Adam John Covach, William Nicholas Rose
Objectives  We report on a patient suffering from intractable itching secondary to intrahepatic cholestasis of pregnancy (ICP) unresponsive to conventional medical therapies. She was started on a regimen of therapeutic plasma exchange (TPE), which is often efficacious in relieving patient's itching from all causes of cholestasis, including ICP. Methods  We performed a retrospective review of a patient's medical record. Results  Following initial TPE, the patient reported dramatic relief of her itching and consequent insomnia...
October 2017: American Journal of Perinatology Reports
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