Peer-reviewedCC BY-NC-NDInternal Medicine
Marked Hyperbilirubinemia in a Patient with Intrahepatic Cholestasis of Pregnancy and a UGT1A1 Polymorphism: A Case Report
Abstract
A 36-year-old pregnant woman at 34 weeks of gestation, who had been receiving tocilizumab for Takayasu arteritis, presented with pruritus and hyperbilirubinemia. She delivered a healthy infant the day after admission. However, her bilirubin level increased to 32.2 mg/dL. Genetic testing revealed heterozygosity for a uridine diphosphate glucuronosyltransferase 1A1 (UGT1A1) polymorphism, and a liver biopsy revealed canalicular cholestasis. The patient was diagnosed with intrahepatic cholestasis of pregnancy (ICP) with UGT1A1 polymorphism, and tocilizumab therapy might have contributed to the marked and prolonged hyperbilirubinemia. Liver histology was useful for the diagnosis of ICP in this case.
Related
- Case Report: Severe persistent transaminitis during pregnancy: a complex differential diagnosis involving suspected toxoplasmosis, possible drug-induced liver injury, and intrahepatic cholestasis
- Severe intrahepatic cholestasis of pregnancy associated with thiopurines: Case report and review of the literature.
- Peak Total Bile Acids and Adverse Perinatal Outcomes in Intrahepatic Cholestasis of Pregnancy: A Retrospective Cohort Study with Threshold Analysis
- MOTS-c attenuates placental vascular endothelial cell apoptosis in intrahepatic cholestasis of pregnancy by inhibiting K33-linked deubiquitination of BACH1
- Cerebral venous thrombosis during pregnancy and the puerperium in the setting of hyperhomocysteinemia and methylenetetrahydrofolate reductase c.677 C > T polymorphism.
BibTeX
@article{ishizaki2026marked,
title = {{Marked Hyperbilirubinemia in a Patient with Intrahepatic Cholestasis of Pregnancy and a UGT1A1 Polymorphism: A Case Report}},
author = {Natsuki Ishizaki and Manabu Hayashi and Tatsuro Sugaya and Yosuke Takahata and Masashi Fujita and Kazumichi Abe and Yasuyuki Kobayashi and Erina Suzuki and Yuki Sato and Toma Fukuda and Shun Yasuda and Yuko Hashimoto and Hiromasa Ohira},
journal = {Internal Medicine},
year = {2026},
month = jul,
doi = {10.2169/internalmedicine.7587-26},
url = {https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_7587-26/_article},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Marked Hyperbilirubinemia in a Patient with Intrahepatic Cholestasis of Pregnancy and a UGT1A1 Polymorphism: A Case Report
AU - Natsuki Ishizaki
AU - Manabu Hayashi
AU - Tatsuro Sugaya
AU - Yosuke Takahata
AU - Masashi Fujita
AU - Kazumichi Abe
AU - Yasuyuki Kobayashi
AU - Erina Suzuki
AU - Yuki Sato
AU - Toma Fukuda
AU - Shun Yasuda
AU - Yuko Hashimoto
AU - Hiromasa Ohira
PY - 2026
DA - 2026/07/04
JO - Internal Medicine
DO - 10.2169/internalmedicine.7587-26
UR - https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_7587-26/_article
AB - A 36-year-old pregnant woman at 34 weeks of gestation, who had been receiving tocilizumab for Takayasu arteritis, presented with pruritus and hyperbilirubinemia. She delivered a healthy infant the day after admission. However, her bilirubin level increased to 32.2 mg/dL. Genetic testing revealed heterozygosity for a uridine diphosphate glucuronosyltransferase 1A1 (UGT1A1) polymorphism, and a liver biopsy revealed canalicular cholestasis. The patient was diagnosed with intrahepatic cholestasis of pregnancy (ICP) with UGT1A1 polymorphism, and tocilizumab therapy might have contributed to the marked and prolonged hyperbilirubinemia. Liver histology was useful for the diagnosis of ICP in this case.
SN - 1349-7235
SN - 0918-2918
ER -