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Intrahepatic cholestasis of pregnancy (ICP), also known as obstetric cholestasis, cholestasis of pregnancy, jaundice of pregnancy, and prurigo gravidarum, [1] is a medical condition in which cholestasis occurs during pregnancy. [2] It typically presents with itching and can lead to complications for both mother and fetus. [2]
Cholestasis is a condition where the flow of bile from the liver to the duodenum is impaired. [1] The two basic distinctions are: [1] obstructive type of cholestasis, where there is a mechanical blockage in the duct system that can occur from a gallstone or malignancy, and
Most children will also require a liver transplant in the future because they will progress to having cirrhosis, hepatocellular carcinoma, and/or chronic liver disease. [13] Generally, treatment of neonatal cholestasis involves treating the underlying disease. Prognosis of neonatal cholestasis also varies based on the underlying pathologic process.
Progressive familial intrahepatic cholestasis (PFIC) is a group of familial cholestatic conditions caused by defects in biliary epithelial transporters. The clinical presentation usually occurs first in childhood with progressive cholestasis. This usually leads to failure to thrive, cirrhosis, and the need for liver transplantation. [citation ...
Cholestatic pruritus is the sensation of itch due to nearly any liver disease, but the most commonly associated entities are primary biliary cholangitis, primary sclerosing cholangitis, obstructive choledocholithiasis, carcinoma of the bile duct, cholestasis (also see drug-induced pruritus), and chronic hepatitis C viral infection and other forms of viral hepatitis.
In children, CPSS may present as neonatal cholestasis. These complications are generally induced by long term portosystemic derivations and are more commonly observed in children than in adults. [9] Unexplained neurocognitive dysfunction and other behavioural issues linked to hepatic encephalopathy occur in 17% to 30% of cases. [7]
Unlike other forms of jaundice, however, biliary-atresia-related cholestasis mostly does not result in kernicterus, a form of brain damage resulting from liver dysfunction. This is because in biliary atresia, the liver, although diseased, is still able to conjugate bilirubin, and conjugated bilirubin is unable to cross the blood–brain barrier.
It usually begins during the last three months of pregnancy or shortly after childbirth. [1] Symptoms may include feeling tired, retaining fluid, headache, nausea, upper right abdominal pain, blurry vision, nosebleeds, and seizures. [1] Complications may include disseminated intravascular coagulation, placental abruption, and kidney failure. [1]
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