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Transient cholestatic hepatitis in a neonate associated with carbamazepine exposure during pregnancy and
B Frey1, G Schubiger, J P Musy
1Children's Hospital, Lucerne, Switzerland.
Insights
Carbamazepine exposure during pregnancy and breastfeeding may cause cholestatic hepatitis in newborns. This condition resolved after the infant stopped breastfeeding, suggesting a link to maternal drug use.
Area of Science:
- Neonatal cholestasis
- Drug-induced liver injury
- Pharmacovigilance
Background:
- Cholestatic hepatitis is a serious liver condition that can affect newborns.
- Carbamazepine is an anticonvulsant medication with known potential side effects.
- Drug-induced liver injury (DILI) is a significant concern in pediatric populations.
Observation:
- A 3-week-old infant presented with symptoms of cholestatic hepatitis.
- The infant had been exposed to carbamazepine in utero and through breastfeeding.
- Clinical presentation and liver biopsy findings were consistent with drug-induced hepatitis.
Findings:
- Cholestasis resolved completely after cessation of breastfeeding.
- Exclusion of other potential causes of hepatitis was confirmed.
- This case represents the first reported instance of carbamazepine-induced hepatitis linked to prenatal and/or breastfeeding exposure.
Implications:
- Highlights the potential risk of carbamazepine in pregnant and breastfeeding mothers.
- Underscores the importance of considering maternal medication use in neonatal cholestasis.
- Suggests the need for increased awareness and monitoring of carbamazepine exposure in neonates.
Abstract:
We report a 3-week-old boy with cholestatic hepatitis, most likely due to carbamazepine exposure during pregnancy and breastfeeding. Cholestasis resolved after cessation of nursing. Liver function test results and histological findings were compatible with a drug-induced hepatitis. Other causes were excluded. While carbamazepine-induced hepatitis is well known in children and adults, it has never been described in association with prenatal exposure and/or breast-feeding.