Leftwich Heidi, Fang Yu Ming Victor, Borgida Adam, Crombleholme William
Department of Obstetrics and Gynecology, University of Connecticut School of Medicine, Farmington, Connecticut, USA.
J Reprod Med. 2010 Nov-Dec;55(11-12):517-9.
Primary sclerosing cholangitis (PSC) is a chronic cholestatic liver disease associated with fibrosis and inflammation of the bile ducts. Its complications include symptoms from pruritis and fatigue to dominant strictures, cholangiocarcinoma and liver failure necessitating liver transplant. Due to its predominance in young males, little is reported regarding PSC and pregnancy.
We report a case of a pregnant woman with PSC whose symptoms were initially unresponsive to the traditional treatment of ursodeoxycholic acid (UDCA) early in her pregnancy but subsequently did well using high dose steroids for the duration of her pregnancy.
With close management, successful pregnancy outcomes seem possible with patients with PSC, even when diagnosed multiple years prior to pregnancy, if not with UDCA, then possibly with steroid treatment.
原发性硬化性胆管炎（PSC）是一种慢性胆汁淤积性肝病，与胆管纤维化和炎症相关。其并发症包括从瘙痒、疲劳到显性狭窄、胆管癌和肝衰竭等症状，肝衰竭时需要进行肝移植。由于该病在年轻男性中更为常见，关于PSC与妊娠的报道较少。
我们报告一例患有PSC的孕妇，其症状在妊娠早期对传统的熊去氧胆酸（UDCA）治疗无反应，但在孕期使用高剂量类固醇后情况良好。
通过密切管理，即使在妊娠前多年就被诊断出患有PSC的患者，也有可能获得成功的妊娠结局。如果UDCA治疗无效，那么使用类固醇治疗可能有效。
