Intrahepatic cholestasis of pregnancy resistant to both therapeutic plasma exchange and albumin dialysis

Intrahepatic cholestasis in pregnancy (ICP) represents, depending on its severity, a serious risk for the fetus. Those cases with unusually high bile acid levels may be resistant to pharmaceutical treatment and can be treated with plasma exchange or albumin dialysis. However, the success rate of the...

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Autores principales: Lia, Massimiliano, Berg, Thomas, Weydandt, Laura Christina, Stepan, Holger
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2022
Materias:
Case Reports: Learning from unexpected outcome (positive or negative)
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8830103/
https://www.ncbi.nlm.nih.gov/pubmed/35135789
http://dx.doi.org/10.1136/bcr-2021-246318
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author Lia, Massimiliano
Berg, Thomas
Weydandt, Laura Christina
Stepan, Holger
author_facet Lia, Massimiliano
Berg, Thomas
Weydandt, Laura Christina
Stepan, Holger
author_sort Lia, Massimiliano
collection PubMed
description Intrahepatic cholestasis in pregnancy (ICP) represents, depending on its severity, a serious risk for the fetus. Those cases with unusually high bile acid levels may be resistant to pharmaceutical treatment and can be treated with plasma exchange or albumin dialysis. However, the success rate of these therapeutic options and the factors influencing therapeutic response are unknown. Furthermore, if these options fail to improve ICP and serum bile acid levels are very high (>200 μm/L), there are no clear recommendations when delivery should be planned. Here, we report a patient with severe ICP resistant to both therapeutic plasma exchange and albumin dialysis. Caesarean section was performed at 32 weeks of gestation followed by rapid remission of ICP.
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spelling pubmed-88301032022-02-22 Intrahepatic cholestasis of pregnancy resistant to both therapeutic plasma exchange and albumin dialysis Lia, Massimiliano Berg, Thomas Weydandt, Laura Christina Stepan, Holger BMJ Case Rep Case Reports: Learning from unexpected outcome (positive or negative) Intrahepatic cholestasis in pregnancy (ICP) represents, depending on its severity, a serious risk for the fetus. Those cases with unusually high bile acid levels may be resistant to pharmaceutical treatment and can be treated with plasma exchange or albumin dialysis. However, the success rate of these therapeutic options and the factors influencing therapeutic response are unknown. Furthermore, if these options fail to improve ICP and serum bile acid levels are very high (>200 μm/L), there are no clear recommendations when delivery should be planned. Here, we report a patient with severe ICP resistant to both therapeutic plasma exchange and albumin dialysis. Caesarean section was performed at 32 weeks of gestation followed by rapid remission of ICP. BMJ Publishing Group 2022-02-08 /pmc/articles/PMC8830103/ /pubmed/35135789 http://dx.doi.org/10.1136/bcr-2021-246318 Text en © BMJ Publishing Group Limited 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Case Reports: Learning from unexpected outcome (positive or negative)
Lia, Massimiliano
Berg, Thomas
Weydandt, Laura Christina
Stepan, Holger
Intrahepatic cholestasis of pregnancy resistant to both therapeutic plasma exchange and albumin dialysis
title Intrahepatic cholestasis of pregnancy resistant to both therapeutic plasma exchange and albumin dialysis
title_full Intrahepatic cholestasis of pregnancy resistant to both therapeutic plasma exchange and albumin dialysis
title_fullStr Intrahepatic cholestasis of pregnancy resistant to both therapeutic plasma exchange and albumin dialysis
title_full_unstemmed Intrahepatic cholestasis of pregnancy resistant to both therapeutic plasma exchange and albumin dialysis
title_short Intrahepatic cholestasis of pregnancy resistant to both therapeutic plasma exchange and albumin dialysis
title_sort intrahepatic cholestasis of pregnancy resistant to both therapeutic plasma exchange and albumin dialysis
topic Case Reports: Learning from unexpected outcome (positive or negative)
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8830103/
https://www.ncbi.nlm.nih.gov/pubmed/35135789
http://dx.doi.org/10.1136/bcr-2021-246318
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