Idiopathic Intrahepatic Cholestasis of Pregnancy

An atypical case of idiopathic cholestasis of pregnancy occurring in the 16th week of gestation in a 24-year old Pakistani female is presented. The case is unusual both in the duration of the jaundice as well as in the high levels of bilirubin found in the presence of normal renal function. A review of the recent literature emphasizes that this disorder is not entirely benign for the mother and the fetus. It also discusses some of the alterations in estrogen and lipid metabolism that are seen, as well as the possible mechanisms responsible for the increased incidence of gallstone formation found in these patients.