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Intrahepatic cholestasis of pregnancy:When should you look further? 被引量:22

Intrahepatic cholestasis of pregnancy:When should you look further?
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摘要 Pruritis with abnormal liver function tests is the classical presentation of intrahepatic cholestasis of pregnancy(ICP),a condition associated with significant fetal complications.Although the etiology of ICP is unclear in many cases,certain features of the clinical presentation should alert the practitioner to the possibility of an underlying metabolic defect, which may not only affect subsequent pregnancies, but may be an indicator of more serious subsequent liver disease.We report a kindred of Anglo-Celtic descent,among whom many members present with ICP,gallstones or cholestasis related to use of oral contraception.Genetic studies revealed a novel mutation in the ABCB4 gene,which codes for a phospholipid transport protein.The clinical significance of this mutation and the importance of identifying such patients are discussed. Pruritis with abnormal liver function tests is the classical presentation of intrahepatic cholestasis of pregnancy (ICP), a condition associated with significant fetal complications. Although the etiology of ICP is unclear in many cases, certain features of the clinical presentation should alert the practitioner to the possibility of an underlying metabolic defect, which may not only affect subsequent pregnancies, but may be an indicator of more serious subsequent liver disease. We report a kindred of Anglo-Celtic descent, among whom many members present with ICP, gallstones or cholestasis related to use of oral contraception. Genetic studies revealed a novel mutation in the ABCB4 gene, which codes for a phospholipid transport protein. The clinical significance of this mutation and the importance of identifying such patients are discussed.
出处 《World Journal of Gastroenterology》 SCIE CAS CSCD 2009年第9期1126-1129,共4页 世界胃肠病学杂志(英文版)
关键词 妊娠期肝内胆汁淤积症 妊娠肝内胆汁淤积症 磷脂转运蛋白 突变基因 肝功能试验 口服避孕药 代谢缺陷 临床表现 ABCB4 gene ABCB4 transporter Phospholipids Cholestasis of pregnancy Gallstones
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参考文献8

  • 1Hay JE.Liver disease in pregnancy.Hepatology 2008;47:1067-1076
  • 2Paus TC,Schneider G,Van De Vondel P,Sauerbruch T,Reichel C.Diagnosis and therapy of intrahepatic cholestasis of pregnancy.Z Gastroenterol 2004;42:623-628
  • 3Oude Elferink RP,Paulusma CC.Function and pathophysiological importance of ABCB4 (MDR3 P-glycoprotein).Pflugers Arch 2007;453:601-610
  • 4Rosmorduc O,Poupon R.Low phospholipid associated cholelithiasis:association with mutation in the MDR3/ ABCB4 gene.Orphanet J Rare Dis 2007;2:29
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  • 6Milkiewicz P,Gallagher R,Chambers J,Eggington E,Weaver J,Elias E.Obstetric cholestasis with elevated gamma glutamyl transpeptidase:incidence,presentation and treatment.J Gastroenterol Hepatol 2003;18:1283-1286
  • 7Floreani A,Carderi I,Paternoster D,Soardo G,Azzaroli F,Esposito W,Montagnani M,Marchesoni D,Variola A,Rosa Rizzotto E,Braghin C,Mazzella G.Hepatobiliary phospholipid transporter ABCB4,MDR3 gene variants in a large cohort of Italian women with intrahepatic cholestasis of pregnancy.Dig Liver Dis 2008;40:366-370
  • 8Pusl T,Beuers U.Intrahepatic cholestasis of pregnancy.Orphanet J Rare Dis 2007;2:26 Receiveddate:2008-11-18 Modifieddate:2009-01-29 Published:2009-03-07

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