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Liver disease in pregnancy

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https://www.readbyqxmd.com/read/28549143/bile-acids-and-tryptophan-metabolism-are-novel-pathways-involved-in-metabolic-abnormalities-in-bpa-exposed-pregnant-mice-and-male-offspring
#1
Martha Susiarjo, Frances Xin, Martha Stefaniak, Clementina Mesaros, Rebecca A Simmons, Marisa S Bartolomei
Increasing evidence has demonstrated that exposure to endocrine disrupting chemicals (EDCs) impacts maternal and fetal health, but the underlying mechanisms are still unclear. We have previously shown that dietary exposure to 10 µg/kg bw/day and 10 mg/kg bw/day bisphenol A (BPA) during pregnancy induced metabolic abnormalities in F1 male offspring and gestational glucose intolerance in F0 pregnant mice. The aim of this study is to elucidate the underlying etiologies of BPA exposure-induced metabolic disease by analyzing male fetal liver metabolome...
May 25, 2017: Endocrinology
https://www.readbyqxmd.com/read/28544232/peripartum-cytokine-flares-in-a-multiethnic-cohort-of-chronic-hepatitis-b-carriers-does-not-correlate-with-hepatitis-b-virus-suppression-or-increased-risk-of-liver-disease
#2
Shivali S Joshi, Daniel Wong, Eliana Castillo, Mark G Swain, Carla S Coffin
PROBLEM: In chronic hepatitis B (CHB) carriers, alanine transaminase (ALT) flares are common in the peripartum period. There are limited data on immunological changes of pregnancy in CHB. We hypothesize that in pregnant CHB carriers, the Th1/Th2 cytokine ratio is altered resulting in changes in biochemical/virological and liver fibrosis markers. STUDY METHODS: Serum from 38 pregnant/post-partum CHB carriers (median age 32 years, 53% Asian, 8 HBeAg(+) ) was tested for HBV DNA, quantitative HBV surface antigen, ALT and liver fibrosis by transient elastography (TE)...
May 19, 2017: American Journal of Reproductive Immunology: AJRI
https://www.readbyqxmd.com/read/28521326/the-yield-of-abdominal-ultrasound-in-the-evaluation-of-elevated-liver-enzymes-during-the-second-and-the-third-trimester-of-pregnancy
#3
Aya Mohr-Sasson, Eyal Schiff, Ramy Rahamim Suday, Zehava Hayman, Yeruham Kleinbaum, Anat Kalter-Farber, Roy Mashiach, Yoav Yinon, Moti Dulitzki, Eyal Sivan, Shali Mazaki-Tovi
AIMS: To determine the clinical yield of abdominal ultrasound in the evaluation of elevated liver enzymes (ELEs) in the second and the third trimester of pregnancy. METHODS: A retrospective cohort study including all pregnant women admitted to a single tertiary care center was conducted between April 2011 and January 2015 with ELE. Inclusion criteria included gestational age above 24 weeks and ELEs, abdominal ultrasound report, and live fetus. Exclusion criteria included known maternal liver disease, structural or chromosomal fetal anomalies, and positive serology for viral hepatitis...
May 19, 2017: Gynecologic and Obstetric Investigation
https://www.readbyqxmd.com/read/28501283/assessment-of-annexin-a5-and-annexin-a2-levels-as-biomarkers-for-pre-eclampsia-a-pilot-study
#4
Marwa Abd El-Latif, Hanan Azzam, Maha Othman, Osama Warda, Solafa El-Sharawy, Hayam Ghoneim
Deficient anticoagulant activity of annexin A5 and deficient profibrinolytic activity of annexin A2 have been linked to increased risk of thrombotic events. Placental dysfunction due to fibrin deposition/microthrombi has been implicated in the pathogenesis of pre-eclampsia (PE). In this study, we aimed to assess serum levels of annexin A5 and annexin A2 in a cohort of PE patients and investigate their role as biomarkers for the development of the disease. We examined 80 women in total; 40 healthy pregnant women and 40 pregnant women with PE after 20weeks of pregnancy...
April 2017: Pregnancy Hypertension
https://www.readbyqxmd.com/read/28491877/nodular-regenerative-hyperplasia-a-case-of-rare-prognosis
#5
Mindy Lee, Manhal Izzy, Ashwin Akki, Kathryn Tanaka, Harmit Kalia
Introduction: Nodular regenerative hyperplasia (NRH) is a known etiology of noncirrhotic portal hypertension. Cases of biopsy-proven NRH in human immunodeficiency virus (HIV)-positive patients have been described. While these patients often have normal synthetic liver function, several reports described disease progression to liver failure. Case: We here present a 26-year-old woman with history of congenital HIV on antiretroviral therapy complicated by Pneumocystis carinii pneumonia at age 14. CD4 counts have been >300 with undetectable viral load...
January 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28486373/medical-and-obstetric-complications-among-pregnant-women-with-liver-cirrhosis
#6
Anna Palatnik, Mary E Rinella
OBJECTIVE: To evaluate clinical characteristics and obstetric outcomes in pregnant women with liver cirrhosis. METHODS: This was a retrospective matched cohort study of women with liver cirrhosis between January 2005 and January 2016 in a university hospital. Women in a case group were matched to women in a control group according to year of delivery, age, body mass index, and parity in a 1:4 ratio. Bivariable and multivariable analyses were performed to compare the prevalence of the primary composite outcome, which included any one of the following: fetal or neonatal demise, placental abruption, preeclampsia, preterm delivery at less than 37 weeks of gestation, and small-for-gestational age neonate between women in the case group and those in the control group...
June 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28456398/effect-of-circulating-exosomes-from-transition-cows-on-madin-darby-bovine-kidney-cell-function
#7
M A Crookenden, C G Walker, H Peiris, Y Koh, F Almughlliq, K Vaswani, S Reed, A Heiser, J J Loor, J K Kay, S Meier, S S Donkin, A Murray, V S R Dukkipati, J R Roche, M D Mitchell
The greatest risk of metabolic and infectious disease in dairy cows is during the transition from pregnancy to lactating (i.e., the transition period). The objective of this experiment was to determine the effects of extracellular vesicles (microvesicles involved in cell-to-cell signaling) isolated from transition cows on target cell function. We previously identified differences in the protein profiles of exosomes isolated from cows divergent in metabolic health status. Therefore, we hypothesized that these exosomes would affect target tissues differently...
April 26, 2017: Journal of Dairy Science
https://www.readbyqxmd.com/read/28441168/a-review-of-caffeine-use-as-a-risk-or-protective-factor-for-women-s-health-and-pregnancy
#8
Amy Peacock, Richard P Mattick, Raimondo Bruno
PURPOSE OF REVIEW: To provide a narrative synthesis of recently published studies on caffeine use as a risk or protective factor for health outcomes, with a focus on women's health and pregnancy. RECENT FINDINGS: Based on predominantly observational studies, moderate caffeine intake has been shown to be a protective factor for liver cancer, certain bowel conditions, colorectal cancer, skin cancer, and regular menstrual cycle function. However, heavy consumption is a risk factor for osteoporosis, urinary incontinence, and poorer birth and child developmental outcomes...
April 22, 2017: Current Opinion in Psychiatry
https://www.readbyqxmd.com/read/28440316/modest-and-severe-maternal-iron-deficiency-in-pregnancy-are-associated-with-fetal-anaemia-and-organ-specific-hypoxia-in-rats
#9
Andrew G Woodman, Alison S Care, Yael Mansour, Stephana J Cherak, Sareh Panahi, Ferrante S Gragasin, Stephane L Bourque
Prenatal iron-deficiency (ID) is known to alter fetal developmental trajectories, which predisposes the offspring to chronic disease in later life, although the underlying mechanisms remain unclear. Here, we sought to determine whether varying degrees of maternal anaemia could induce organ-specific patterns of hypoxia in the fetuses. Pregnant female Sprague Dawley rats were fed iron-restricted or iron-replete diets to induce a state of moderate (M-ID) or severe ID (S-ID) alongside respective controls. Ultrasound biomicroscopy was performed on gestational day (GD)20 to assess uterine and umbilical artery blood flow patterns...
April 25, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28437442/relationship-between-early-onset-severe-intrahepatic-cholestasis-of-pregnancy-and-higher-risk-of-meconium-stained-fluid
#10
Maria C Estiú, Maria A Frailuna, Carla Otero, Marcela Dericco, Catherine Williamson, Jose J G Marin, Rocio I R Macias
BACKGROUND: Intrahepatic cholestasis of pregnancy (ICP) is the commonest gestational liver disease. The risk of adverse fetal outcome has been associated with the severity of maternal hypercholanemia after diagnosis. OBJECTIVE: To investigate whether there is a relationship between the severity and timing of onset of hypercholanemia and the risk of meconium-stained amniotic fluid (MSAF) and adverse neonatal events. STUDY DESIGN: The study included 382 pregnancies complicated by ICP managed at a referral hospital in Buenos Aires (Argentina) between June 2009 and December 2013...
2017: PloS One
https://www.readbyqxmd.com/read/28434090/a-best-practice-position-statement-on-the-role-of-the-nephrologist-in-the-prevention-and-follow-up-of-preeclampsia-the-italian-study-group-on-kidney-and-pregnancy
#11
Giorgina Barbara Piccoli, Gianfranca Cabiddu, Santina Castellino, Giuseppe Gernone, Domenico Santoro, Gabriella Moroni, Donatella Spotti, Franca Giacchino, Rossella Attini, Monica Limardo, Stefania Maxia, Antioco Fois, Linda Gammaro, Tullia Todros
Preeclampsia (PE) is a protean syndrome causing a transitory kidney disease, characterised by hypertension and proteinuria, ultimately reversible after delivery. Its prevalence is variously estimated, from 3 to 5% to 10% if all the related disorders, including also pregnancy-induced hypertension (PIH) and HELLP syndrome (haemolysis, increase in liver enzyme, low platelets) are included. Both nephrologists and obstetricians are involved in the management of the disease, according to different protocols, and the clinical management, as well as the role for each specialty, differs worldwide...
April 22, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28399088/-the-forensic-medical-evaluation-of-traumatic-and-spontaneous-ruptures-of-the-organs-affected-by-the-tumours
#12
Yu I Pigolkin, O V Dolzhansky, E M Pal'tseva, M A Shilova, D N Fedorov, S E Boeva
The present article was designed to report the results of the analysis of the cases of traumatic and spontaneous ruptures of the organs affected by the tumours based on the original observations and the literature data. It is shown that the probability of the tumour rupture depends on its histological type, localization, the size, and the distance from the capsule of the affected organ, the degree of involvement of the major blood vessels, the severity of the necrotic changes, the presence of cysts in the neoplasm, and the regimens of radio- and chemotherapy...
2017: Sudebno-meditsinskaia Ekspertiza
https://www.readbyqxmd.com/read/28397655/-liver-failure-in-neonatal-children-is-a-diagnostic-challenge
#13
Heidi Smedegaard, Vibeke Brix Christensen, Morten Hanefeld Dziegiel, Marianne Hørby Jørgensen
This case report presents a newborn boy with hypoglycaemia, anaemia, jaundice and severe coagulopathy during the first day of his life, imitating sepsis and disseminated intravascular coagulation. One week after the birth he was diagnosed with acute liver failure due to gestational alloimmune liver disease (GALD). Despite the fact that GALD is rare, it must be suspected in all unexplained stillborn children and infants with severe liver disease. If diagnosed, it is possible to prevent death and severe liver failure in future newborns by treating the affected women with immunoglobulin during pregnancy...
March 27, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28395793/visceral-aneurysms-old-paradigms-new-insights
#14
REVIEW
M J E van Rijn, S Ten Raa, J M Hendriks, H J M Verhagen
True visceral artery aneurysms (VAAs) are a rare entity with an incidence of 0.01-2%. The risk of rupture varies amongst the different types of VAAs and is higher for pseudo aneurysms compared with true aneurysms. Size, growth, symptoms, underlying disease, pregnancy and liver transplantation have all been associated with increased risk of rupture. Mortality rates after rupture are around 25%. The splenic artery is most commonly affected and the etiology is predominantly atherosclerosis. Open repair can be done by simple ligation or reconstruction of the artery, while endovascular options include embolization or using a stent graft...
February 2017: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/28376740/maternal-27-hydroxycholesterol-concentrations-during-the-course-of-pregnancy-and-in-pregnancy-pathologies
#15
Brigitte Sophia Winkler, Ulrich Pecks, Laila Najjari, Nicola Kleine-Eggebrecht, Nicolai Maass, Markus Mohaupt, Geneviève Escher
BACKGROUND: The oxysterol 27-hydroxycholesterol (27-OHC) plays an important role in the regulation of cholesterol homeostasis. Pregnancy pathologies like preeclampsia (PE), HELLP-syndrome (HELLP), intrauterine growth restriction (IUGR) and intrahepatic cholestasis in pregnancy (ICP) are linked to disturbances in lipid metabolism. In the present study, we hypothesized a specific gestational regulation of 27-OHC and compromised 27-OHC levels due to placental and hepatic diseases in pregnancy resulting in a dysregulation of lipid metabolism...
April 4, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28372806/multiple-immune-disorders-after-natalizumab-discontinuation-after-the-ciris-the-siris
#16
E K Van Obberghen, M Cohen, F Rocher, C Lebrun-Frenay
Natalizumab (NTZ) is an effective treatment for patients with highly active relapsing remitting multiple sclerosis (MS). However, when the therapy must be interrupted, it is important to anticipate the withdrawal to avoid reactivation or disease rebound. Described here is the case of a 35-year-old woman, with a past history of beta thalassemia, bulimia and asthma, who was diagnosed with MS at age 26. She was treated initially with first-line subcutaneous (sc) immunomodulatory treatments. However, due to liver toxicity, interferon beta-1a sc was interrupted and replaced by glatiramer acetate treatment, which was well tolerated and used for several years...
March 31, 2017: Revue Neurologique
https://www.readbyqxmd.com/read/28352008/spectrum-of-renal-injury-in-pregnancy-induced-hypertension-experience-from-a-single-center-in-india
#17
Mahesh Eswarappa, Madhyastha Rakesh, Puri Sonika, K Snigdha, M Midhun, K Kaushik, Gurudev Konana Chennabasappa, Bande Sujeeth
Pregnancy-induced hypertension (PIH) is a known complication of late pregnancy and is an important cause of maternal and fetal morbidity and mortality. Data on clinical profile, especially renal profile of preeclampsia and eclampsia in Indian women are lacking. The aim of our study was to examine the renal profile and clinical outcomes of patients diagnosed with PIH in our institution with a focus on the spectrum of acute kidney injury (AKI). In this prospective, observational study, 347 patients with a diagnosis of preeclampsia-eclampsia, who were undergoing treatment at the M...
March 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28344965/tuberculous-peritonitis-in-the-first-trimester-of-pregnancy
#18
Sukyung Jung, Nae Ri Yun, Jeong Ok Kim, Jeong Hoon Lee, Ho Yeon Kim, Eunseop Song, Byoung Ick Lee, Sung Ook Hwang, Soo Ran Choi
Tuberculous peritonitis in pregnancy is a rare form of extrapulmonary tuberculosis that is not easily diagnosed. The clinical presentations of tuberculous peritonitis are usually non-specific and mimic those of other diseases, such as ovarian malignancy or chronic liver disease, and this non-specificity can cause diagnostic delays and complications. The authors report the case of a 31-year-old primigravida woman who presented with uncontrolled fever, dyspnea, elevated liver enzymes, and mild abdominal distension at 13+2 weeks of gestation...
March 2017: Obstetrics & Gynecology Science
https://www.readbyqxmd.com/read/28326516/elevated-red-blood-cell-distribution-width-is-associated-with-intrahepatic-cholestasis-of-pregnancy
#19
Zehra Vural Yilmaz, Gulenay Gencosmanoglu Turkmen, Korkut Daglar, Elif Yılmaz, Ozgur Kara, Dilek Uygur
OBJECTIVES: Intrahepatic cholestasis of pregnancy is the most common pregnancy specific liver disease and related with adverse maternal and perinatal outcome. Red blood cell distribution width, an anisocytosis marker in a complete blood count, has been used as an inflammation marker in various diseases. However the association of red blood cell distribution width with intrahepatic cholestasis of pregnancy is unknown. We aimed to evaluate the relationship between red blood cell distribution width and intrahepatic cholestasis of pregnancy...
2017: Ginekologia Polska
https://www.readbyqxmd.com/read/28317816/hemophagocytic-syndrome-secondary-to-tuberculosis-at-24-week-gestation
#20
Alexandra Arteaga Fernández, David Fernández de Velasco Pérez, M C Jiménez Fournier, J C Moreno Del Prado, B Paraíso Torras, M L Cañete Palomo
Hemophagocytic syndrome is a life-threatening disease characterized by the uncontrolled activation of macrophages, resulting in hemophagocytosis of blood cells in the bone marrow. A 20-year-old gravida at 23-week and 5-day gestation was admitted to hospital to evaluate fever up to 104°F of unknown origin, moderate cytopenia, and elevated levels of liver enzymes. Bone marrow biopsy confirmed hemophagocytic syndrome, and polymerase chain reaction came back positive for Mycobacterium tuberculosis. Supportive care and tuberculosis treatment resulted in clinical improvement...
January 2017: International Journal of Mycobacteriology
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