IDIOPATHIC JAUNDICE OF PREGNANCY. REPORT OF A CASE.

Abstract

A case of idiopathic jaundice of pregnancy of short duration is reported in detail. This syndrome occurs in the last trimester of pregnancy, frequently is (but was not in this instance) preceded by pruritus, and is relieved by delivery. Liver function tests support biliary obstruction and militate against hepatocellular disease as the cause. The negative thymol turbidity, normal cephalin flocculation, and minimal elevation of SGPT seen in the condition quite well rule out hepatitis. A normal cholecystogram just as definitely rules out calculus disease of the biliary tree. In previous reports, mention has not been made of two pigment findings noted in histologic sections of the liver biopsy in this case. There was a mild increase in iron stain. In addition and separately in the cells was a definite increase in a golden brown or “lipochrome-like” pigment. Serum bile acid determination should be made in future cases. More than usual biliary stasis of pregnancy has been considered the etiological factor, but recent studies on the inhibition of glucuronosyl transferase by steroids seems worthy of consideration.