A190 POST-PARTUM PRIMARY BILIARY CHOLANGITIS (PBC) AFTER RESOLUTION OF INTRAHEPATIC CHOLESTASIS OF PREGNANCY (ICP) IN FIRST NATION’S PATIENTS OF BC: A CASE SERIES
BACKGROUND: PBC is a progressive cholestatic disease characterized by destruction of intrahepatic bile ducts, peri-portal inflammation and fibrosis. PBC is the leading indication for liver transplantation in First Nations of British Columbia. Diagnosis of PBC during pregnancy is difficult due to cli...
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ftpubmed:oai:pubmedcentral.nih.gov:7043575 2023-05-15T16:15:50+02:00 A190 POST-PARTUM PRIMARY BILIARY CHOLANGITIS (PBC) AFTER RESOLUTION OF INTRAHEPATIC CHOLESTASIS OF PREGNANCY (ICP) IN FIRST NATION’S PATIENTS OF BC: A CASE SERIES Chahal, D Yoshida, E M Arbour, L Wallach, J 2020-02 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7043575/ https://doi.org/10.1093/jcag/gwz047.189 en eng Oxford University Press http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7043575/ http://dx.doi.org/10.1093/jcag/gwz047.189 © The Author(s) 2020. Published by Oxford University Press on behalf of the Canadian Association of Gastroenterology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model) Poster of Distinction Text 2020 ftpubmed https://doi.org/10.1093/jcag/gwz047.189 2020-03-08T01:42:07Z BACKGROUND: PBC is a progressive cholestatic disease characterized by destruction of intrahepatic bile ducts, peri-portal inflammation and fibrosis. PBC is the leading indication for liver transplantation in First Nations of British Columbia. Diagnosis of PBC during pregnancy is difficult due to clinical overlap with ICP and pregnancy induced immune tolerance (4–6). We present 3 cases of clinically diagnosed ICP in First Nations women who were later diagnosed with PBC post-partum. AIMS: To investigate the potential relationship between ICP and PBC in the First Nations community of BC. METHODS: Retrospective review of relevant cases. RESULTS: Case 1: A 27-year-old woman with history of ICP at 31 weeks during her 3(rd) pregnancy and family history of PBC presented with ursodiol and cholestyramine responsive pruritis and jaundice 20 weeks into her 4(th) pregnancy. Bilirubin was 103 µmol/L, ALP 371 IU/L, ANA and AMA negative. Symptoms and biochemistry remained in remission after delivery at 33 weeks. Discontinuation of medications led to recurrent pruritis 4 months later. Bilirubin was 6 µmol/L, ALP 272 IU/L, GGT 153 IU/L and ALT 204 IU/L. Liver biopsy was consistent with PBC, F1. Pruritis has now been refractory to ursodiol, cholestyramine and rifampin. Case 2: A 30-year-old woman with history of ICP at 20 weeks during 2 prior pregnancies presented with ursodiol responsive pruritis 20 weeks into her 3(rd) pregnancy. Symptoms and biochemistry remained in remission after delivery at 35 weeks. Post-partum discontinuation of ursodiol led to recurrent pruritis 2 months later. ALP was 876 and AMA >1:640. Re-initiation of ursodiol improved symptoms and biochemical abnormalities. Case 3: A 30-year-old woman with family history of PBC (mother) presented with ursodiol responsive pruritis and jaundice 20 weeks into her 4(th) pregnancy. Symptoms and biochemistry remained in remission after delivery at 37 weeks. Post-partum discontinuation of ursodiol led to recurrence jaundice 4 months later. Bilirubin was 68, ALP 1279, ... Text First Nations PubMed Central (PMC) Journal of the Canadian Association of Gastroenterology 3 Supplement_1 61 62 |
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Poster of Distinction Chahal, D Yoshida, E M Arbour, L Wallach, J A190 POST-PARTUM PRIMARY BILIARY CHOLANGITIS (PBC) AFTER RESOLUTION OF INTRAHEPATIC CHOLESTASIS OF PREGNANCY (ICP) IN FIRST NATION’S PATIENTS OF BC: A CASE SERIES |
topic_facet |
Poster of Distinction |
description |
BACKGROUND: PBC is a progressive cholestatic disease characterized by destruction of intrahepatic bile ducts, peri-portal inflammation and fibrosis. PBC is the leading indication for liver transplantation in First Nations of British Columbia. Diagnosis of PBC during pregnancy is difficult due to clinical overlap with ICP and pregnancy induced immune tolerance (4–6). We present 3 cases of clinically diagnosed ICP in First Nations women who were later diagnosed with PBC post-partum. AIMS: To investigate the potential relationship between ICP and PBC in the First Nations community of BC. METHODS: Retrospective review of relevant cases. RESULTS: Case 1: A 27-year-old woman with history of ICP at 31 weeks during her 3(rd) pregnancy and family history of PBC presented with ursodiol and cholestyramine responsive pruritis and jaundice 20 weeks into her 4(th) pregnancy. Bilirubin was 103 µmol/L, ALP 371 IU/L, ANA and AMA negative. Symptoms and biochemistry remained in remission after delivery at 33 weeks. Discontinuation of medications led to recurrent pruritis 4 months later. Bilirubin was 6 µmol/L, ALP 272 IU/L, GGT 153 IU/L and ALT 204 IU/L. Liver biopsy was consistent with PBC, F1. Pruritis has now been refractory to ursodiol, cholestyramine and rifampin. Case 2: A 30-year-old woman with history of ICP at 20 weeks during 2 prior pregnancies presented with ursodiol responsive pruritis 20 weeks into her 3(rd) pregnancy. Symptoms and biochemistry remained in remission after delivery at 35 weeks. Post-partum discontinuation of ursodiol led to recurrent pruritis 2 months later. ALP was 876 and AMA >1:640. Re-initiation of ursodiol improved symptoms and biochemical abnormalities. Case 3: A 30-year-old woman with family history of PBC (mother) presented with ursodiol responsive pruritis and jaundice 20 weeks into her 4(th) pregnancy. Symptoms and biochemistry remained in remission after delivery at 37 weeks. Post-partum discontinuation of ursodiol led to recurrence jaundice 4 months later. Bilirubin was 68, ALP 1279, ... |
format |
Text |
author |
Chahal, D Yoshida, E M Arbour, L Wallach, J |
author_facet |
Chahal, D Yoshida, E M Arbour, L Wallach, J |
author_sort |
Chahal, D |
title |
A190 POST-PARTUM PRIMARY BILIARY CHOLANGITIS (PBC) AFTER RESOLUTION OF INTRAHEPATIC CHOLESTASIS OF PREGNANCY (ICP) IN FIRST NATION’S PATIENTS OF BC: A CASE SERIES |
title_short |
A190 POST-PARTUM PRIMARY BILIARY CHOLANGITIS (PBC) AFTER RESOLUTION OF INTRAHEPATIC CHOLESTASIS OF PREGNANCY (ICP) IN FIRST NATION’S PATIENTS OF BC: A CASE SERIES |
title_full |
A190 POST-PARTUM PRIMARY BILIARY CHOLANGITIS (PBC) AFTER RESOLUTION OF INTRAHEPATIC CHOLESTASIS OF PREGNANCY (ICP) IN FIRST NATION’S PATIENTS OF BC: A CASE SERIES |
title_fullStr |
A190 POST-PARTUM PRIMARY BILIARY CHOLANGITIS (PBC) AFTER RESOLUTION OF INTRAHEPATIC CHOLESTASIS OF PREGNANCY (ICP) IN FIRST NATION’S PATIENTS OF BC: A CASE SERIES |
title_full_unstemmed |
A190 POST-PARTUM PRIMARY BILIARY CHOLANGITIS (PBC) AFTER RESOLUTION OF INTRAHEPATIC CHOLESTASIS OF PREGNANCY (ICP) IN FIRST NATION’S PATIENTS OF BC: A CASE SERIES |
title_sort |
a190 post-partum primary biliary cholangitis (pbc) after resolution of intrahepatic cholestasis of pregnancy (icp) in first nation’s patients of bc: a case series |
publisher |
Oxford University Press |
publishDate |
2020 |
url |
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7043575/ https://doi.org/10.1093/jcag/gwz047.189 |
genre |
First Nations |
genre_facet |
First Nations |
op_relation |
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7043575/ http://dx.doi.org/10.1093/jcag/gwz047.189 |
op_rights |
© The Author(s) 2020. Published by Oxford University Press on behalf of the Canadian Association of Gastroenterology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model) |
op_doi |
https://doi.org/10.1093/jcag/gwz047.189 |
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Journal of the Canadian Association of Gastroenterology |
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3 |
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Supplement_1 |
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61 |
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62 |
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1766001693112139776 |