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Primary biliary cholangitis first demonstrated in pregnancy: a case report
Daniela Melo1, Ana Luísa Areia2,3, Paulo Moura2,3
1Obstetrics A Unit, Hospitais da Universidade de Coimbra, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal. dmelo_8@hotmail.com.
Journal of Medical Case Reports
|January 31, 2022
Summary
Diagnosing primary biliary cholangitis during pregnancy is rare. Careful clinical evaluation is crucial, as symptoms can mimic obstetric cholestasis, impacting both mother and child.
Area of Science:
- Hepatology
- Obstetrics
- Internal Medicine
Background:
- Primary biliary cholangitis (PBC) diagnosis during pregnancy is uncommon.
- Physiological changes in pregnancy can mask or mimic chronic liver diseases.
- Early and accurate diagnosis is vital for maternal and fetal well-being.
Observation:
- A 37-year-old pregnant patient presented with pruritus and cholestatic liver function tests.
- Initial diagnosis considered intrahepatic cholestasis of pregnancy, with partial response to ursodeoxycholic acid.
- Pregnancy was complicated by placental issues, necessitating an emergency cesarean section.
Findings:
- Postpartum evaluation, detailed clinical history, and laboratory analysis confirmed primary biliary cholangitis.
- The case highlights the diagnostic challenge of PBC presenting during gestation.
- Multidisciplinary collaboration was key to achieving the correct diagnosis.
Implications:
- Pregnancy can unmask underlying chronic liver conditions like PBC.
- Timely diagnosis and management of PBC in pregnancy are essential.
- This condition affects not only the pregnancy but also the woman's long-term health.
