Pregnancy-specific liver diseases
Publication date: Available online 7 April 2020Source: Best Practice &Research Clinical Obstetrics &GynaecologyAuthor(s): Dev Katarey, Rachel H. Westbrook
AbstractPurpose of ReviewDiabetic ketoacidosis is a life-threatening complication of diabetes characterized by hyperglycemia, acidosis, and ketosis. Ketoacidosis may occur with blood glucose level
We present the case of a 32-year-old (G2P0) that presented at 23 + 5 weeks` gestation with pruritus and a maculo-popular rash on all extremities and abdomen with worsening symptoms at night for 5 days before advocating medical assistance. The patient had Crohn`s disease, diagnosed at age 17, treated with 125 mg azathioprine daily, in remission a year and a half preceding pregnancy. She was otherwise healthy, with no known allergies or liver diseases. The patient received anti-histamines and various ointments for her symptoms based on dermatologist consults.
The ATP binding cassette subfamily B member 4 (ABCB4) gene on chromosome 7 encodes the ABCB4 protein (alias multi drug resistance 3 protein [MDR3]), a P-glycoprotein in the canalicular membrane of the hepatocytes that acts as a translocator of phospholipids into bile. Several variants in ABCB4 have been identified so far that lead to ABCB4 deficiency accounting for a disease spectrum ranging from progressive familial cholestasis type 3 (PFIC-3) to less severe forms presenting as low phospholipid associated cholelithiasis (LPAC), intrahepatic cholestasis of pregnancy (ICP) or drug-induced liver injury (DILI).
Conclusions: Multiple risk factors for rALDs were identified, such as colectomy before LT, cholangiocacinoma, multiple episodes of acute cellular rejection, model for end-stage liver disease score, and especially the use of mycophenolate mofetil, cyclosporin A and tacrolimus.
A 29-year-old woman (Gravida 0, Para 0) at 26 weeks with a history of appendectomy 25 years ago was admitted to our emergency room for abdominal pain without stool defecation. Esophagogastroduodenoscopy revealed fluid accumulation from stomach to small intestine. No obvious lesions were found (Fig. 1A).
One of the worst symptoms of any plague is uncertainty—who it will strike, when it will end, why it began. Merely understanding a pandemic does not stop it, but an informed public can help curb its impact and slow its spread. It can also provide a certain ease of mind in a decidedly uneasy time. Here are some of the most frequently asked questions about the COVID-19 pandemic from TIME’s readers, along with the best and most current answers science can provide. A note about our sourcing: While there are many, many studies underway investigating COVID-19 and SARS-CoV-19, the novel coronavirus that causes the illn...
CONCLUSIONS AND IMPLICATIONS FOR PUBLIC HEALTH PRACTICE: Increasing rates of acute hepatitis C among young adults, including reproductive-aged persons, have put multiple generations at risk for chronic hepatitis C. The number of newly reported chronic infections was approximately equal among younger and older adults in 2018. The new CDC hepatitis C testing recommendations advise screening all adults and pregnant women, not just persons born during 1945-1965, and those with risk factors. PMID: 32271725 [PubMed - as supplied by publisher]
Publication date: Available online 8 April 2020Source: Clinics and Research in Hepatology and GastroenterologyAuthor(s): Audrey Payancé, Pierre François Ceccaldi, Emmanuelle De Raucourt, Dominique Valla, Sophie Hillaire, Danielle Dutheil, Virginia Hernandez-Gea, Christophe Bureau, Aurélie Plessier
Semin Thromb Hemost DOI: 10.1055/s-0040-1708842The impact of thrombocytopenia varies widely depending on the underlying pathophysiology driving it. The biggest challenge in managing thrombocytopenia in pregnancy is accurately identifying the responsible pathophysiology—a task made difficult given the tremendous overlap in clinical and laboratory abnormalities associated with different thrombocytopenia processes. The most common etiologies of thrombocytopenia in pregnancy range from physiology deemed benign to those that are life-threatening to the mother and fetus. Even in cases in which the responsible etiology is d...
SOUTH SAN FRANCISCO, CA, April 3, 2020 – Actelion Pharmaceuticals US, Inc., a Janssen Pharmaceutical Company of Johnson &Johnson, today announced that CHEST, the official publication of the American College of Chest Physicians, published results from an expert Delphi consensus survey that help provide additional insights for physicians to advance the care of patients with pulmonary arterial hypertension (PAH).The Prostacyclin International Expert Panel developed the consensus opinions based on common clinical scenarios in which they considered adding oral prostacyclin pathway agents (PPAs), including UPTRAVI®...