Azathioprine associated with intrahepatic cholestasis in a patient with twin pregnancy after a second kidney transplant
Introduction: Most pregnancies in women after a kidney transplant result in a live birth, but kidney functions should be stable for one year before conception. For immunosuppression modification occurring before pregnancy, azathioprine is used because it is considered safe for major congenital malfo...
| Main Authors: | , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SMC MEDIA SRL
2024-03-01
|
| Series: | European Journal of Case Reports in Internal Medicine |
| Subjects: | |
| Online Access: | https://www.ejcrim.com/index.php/EJCRIM/article/view/4385 |
| _version_ | 1797224795282079744 |
|---|---|
| author | Lamis Khedr Mohamed Ekram |
| author_facet | Lamis Khedr Mohamed Ekram |
| author_sort | Lamis Khedr |
| collection | DOAJ |
| description | Introduction: Most pregnancies in women after a kidney transplant result in a live birth, but kidney functions should be stable for one year before conception. For immunosuppression modification occurring before pregnancy, azathioprine is used because it is considered safe for major congenital malformations during pregnancy. However, there may be an association between exposure to azathioprine during pregnancy and the onset of an unusual, early and severe form of intrahepatic cholestasis.
Case description: A young patient with a twin pregnancy after a second kidney transplant experienced intrahepatic cholestasis. There was a wide range of differential diagnosis. A battery of tests was requested including autoimmune markers, virology, and imaging. The conclusion that azathioprine was contributing to intrahepatic cholestasis with pregnancy was reached after exclusion of all other differentials.
Conclusions: Complications of pregnancy after a kidney transplant include hypertension, pre-eclampsia, deterioration of graft function up to rejection, but also unusual side effects of immunosuppression medication. |
| first_indexed | 2024-04-24T13:58:48Z |
| format | Article |
| id | doaj.art-4841928d70ab458a8d8309c31f11ded5 |
| institution | Directory Open Access Journal |
| issn | 2284-2594 |
| language | English |
| last_indexed | 2024-04-24T13:58:48Z |
| publishDate | 2024-03-01 |
| publisher | SMC MEDIA SRL |
| record_format | Article |
| series | European Journal of Case Reports in Internal Medicine |
| spelling | doaj.art-4841928d70ab458a8d8309c31f11ded52024-04-03T13:10:13ZengSMC MEDIA SRLEuropean Journal of Case Reports in Internal Medicine2284-25942024-03-0110.12890/2024_0043853920Azathioprine associated with intrahepatic cholestasis in a patient with twin pregnancy after a second kidney transplantLamis Khedr0Mohamed Ekram1Nephrology Department, Ain Shams University, Cairo, EgyptInternal Medicine Department, New Giza University, Cairo, EgyptIntroduction: Most pregnancies in women after a kidney transplant result in a live birth, but kidney functions should be stable for one year before conception. For immunosuppression modification occurring before pregnancy, azathioprine is used because it is considered safe for major congenital malformations during pregnancy. However, there may be an association between exposure to azathioprine during pregnancy and the onset of an unusual, early and severe form of intrahepatic cholestasis. Case description: A young patient with a twin pregnancy after a second kidney transplant experienced intrahepatic cholestasis. There was a wide range of differential diagnosis. A battery of tests was requested including autoimmune markers, virology, and imaging. The conclusion that azathioprine was contributing to intrahepatic cholestasis with pregnancy was reached after exclusion of all other differentials. Conclusions: Complications of pregnancy after a kidney transplant include hypertension, pre-eclampsia, deterioration of graft function up to rejection, but also unusual side effects of immunosuppression medication.https://www.ejcrim.com/index.php/EJCRIM/article/view/4385kidney transplantazathioprinepregnancyintrahepatic cholestasis |
| spellingShingle | Lamis Khedr Mohamed Ekram Azathioprine associated with intrahepatic cholestasis in a patient with twin pregnancy after a second kidney transplant European Journal of Case Reports in Internal Medicine kidney transplant azathioprine pregnancy intrahepatic cholestasis |
| title | Azathioprine associated with intrahepatic cholestasis in a patient with twin pregnancy after a second kidney transplant |
| title_full | Azathioprine associated with intrahepatic cholestasis in a patient with twin pregnancy after a second kidney transplant |
| title_fullStr | Azathioprine associated with intrahepatic cholestasis in a patient with twin pregnancy after a second kidney transplant |
| title_full_unstemmed | Azathioprine associated with intrahepatic cholestasis in a patient with twin pregnancy after a second kidney transplant |
| title_short | Azathioprine associated with intrahepatic cholestasis in a patient with twin pregnancy after a second kidney transplant |
| title_sort | azathioprine associated with intrahepatic cholestasis in a patient with twin pregnancy after a second kidney transplant |
| topic | kidney transplant azathioprine pregnancy intrahepatic cholestasis |
| url | https://www.ejcrim.com/index.php/EJCRIM/article/view/4385 |
| work_keys_str_mv | AT lamiskhedr azathioprineassociatedwithintrahepaticcholestasisinapatientwithtwinpregnancyafterasecondkidneytransplant AT mohamedekram azathioprineassociatedwithintrahepaticcholestasisinapatientwithtwinpregnancyafterasecondkidneytransplant |