Intrahepatic cholestasis of pregnancy plus reactivation of hepatitis B: Case report

Yıl 2014, Cilt: 13 Sayı: 2, 66 - 69, 01.08.2014

Mustafa Yalçın Mesut Akarsu

Öz

Intrahepatic cholestasis of pregnancy with reactivation of hepatitis B is a rare condition. In this manuscript, we present a case with concomitant presentation of these two pathologies. A 30-year–old, 30-week pregnant woman presented with the complaint of itching. The patient had been followed for inactive hepatitis B for four years. Laboratory tests and abdominal ultrasonography suggested reactivation of hepatitis B in addition to İntrahepatic cholestasis of pregnancy. Treatment with lamivudine and ursodeoxycholic acid was initiated. The transaminases levels and complaint of itching improved with treatment. A healthy delivery was performed by cesarean section at 37 weeks of gestation. The ursodeoxycholic acid and lamivudine therapies were discontinued post-partum. Concomitant use of ursodeoxycholic acid and lamivudine was effective in this case. The time needed for the maturation of the infant and the risk of fulminant hepatitis were the important points considered in this case.

Anahtar Kelimeler

Pregnancy, cholestasis, hepatitis B virus

Gebeliğin intrahepatik kolestazı ve hepatit B reaktivasyonu: Olgu sunumu

Öz

Gebeliğin intrahepatik kolestazı ve hepatit B reaktivasyonu birlikteliği literatürde bildirilmemiş, nadir görülebilecek bir durumdur. Burada her iki durumun eşzamanlı görüldüğü bir olgu sunulmuştur. 30 yaşında 30 haftalık gebe kaşıntı nedeniyle başvurdu. 4 yıldır inaktif hepatit B nedeniyle izlemde olan hastanın laboratuvar ve ultrasonografisi incelemesinde hepatit b reaktivasyonu ile birlikte gebeliğin intrahepatik kolestazı düşünüldü. Lamivudin ve ursodeoksikolik asit başlandı. Tedavi ile hastanın transaminazları geriledi. Kaşıntısı düzeldi. Gebeliğin 37. haftasında sezeryanla sağlıklı bir doğum geçekleşti. Hastanın doğum sonrası ursodeoksikolikasit ve lamivudin tedavisi kesildi. Bu hastada ursodeoksikolikasit ve lamivudinin birlikte kullanımı etkili olmuştur. Burada bebeğin matürasyonunun oluşması için geçecek süre ve bu süre içinde annede fulminan hepatit gelişme riski önem taşımaktadır.

Anahtar Kelimeler

Gebelik, kolestaz, hepatit B virüsü

Kaynakça

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