Article ; Online: Acute liver injury in pregnancy.
BMJ case reports
2024 Volume 17, Issue 2
Abstract: A woman in her fifth month of pregnancy presented to the outpatient department with vomiting, generalised itching and yellowish discolouration of the skin for 1 week. No history of rashes, fever, pain abdomen or altered stools. In view of four pregnancy ... ...
| Abstract | A woman in her fifth month of pregnancy presented to the outpatient department with vomiting, generalised itching and yellowish discolouration of the skin for 1 week. No history of rashes, fever, pain abdomen or altered stools. In view of four pregnancy losses previously, she was evaluated to have antiphospholipid antibody syndrome and was advised low molecular weight heparin. She was a known type-II diabetic on insulin. Prophylactic oral dydrogesterone and natural micronised progesterone were started at a local hospital 2 months prior, in view of threatened abortion. Investigations revealed grossly elevated serum bilirubin and liver enzymes. Other blood investigations were unremarkable and abdominal ultrasonography was normal. The most likely diagnosis in this case, is drug-induced liver injury due to oral progestin consumption. Causality assessment by Roussel Uclaf Causality Assessment Model was used to establish the diagnosis. High doses of progestin over a prolonged period resulted in acute hepatic toxicity causing itching, jaundice and transaminitis. Cautious use of progestins in appropriate dosage is recommended during pregnancy. |
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| MeSH term(s) | Pregnancy ; Female ; Humans ; Progestins ; Liver ; Progesterone ; Jaundice/chemically induced ; Pruritus |
| Chemical Substances | Progestins ; Progesterone (4G7DS2Q64Y) |
| Language | English |
| Publishing date | 2024-02-21 |
| Publishing country | England |
| Document type | Case Reports ; Journal Article |
| ISSN | 1757-790X |
| ISSN (online) | 1757-790X |
| DOI | 10.1136/bcr-2023-257138 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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