PDF(Pubmed)
Abstract：
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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.
CONCLUSIONS: A twin pregnancy after a second kidney transplant is rare.In addition to bone marrow suppression and elevation of liver enzymes, azathioprine can contribute to intrahepatic cholestasis of pregnancy.Complications of pregnancy after kidney transplant include hypertension, pre-eclampsia, deterioration of graft function up to rejection, but also unusual side effects of immunosuppression medication.
UNASSIGNED: 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.
UNASSIGNED: 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.
CONCLUSIONS: A twin pregnancy after a second kidney transplant is rare.In addition to bone marrow suppression and elevation of liver enzymes, azathioprine can contribute to intrahepatic cholestasis of pregnancy.Complications of pregnancy after kidney transplant include hypertension, pre-eclampsia, deterioration of graft function up to rejection, but also unusual side effects of immunosuppression medication.
摘要：
■大多数妇女在接受肾脏移植后怀孕会导致活产，但受孕前肾功能应稳定一年。对于怀孕前发生的免疫抑制修饰，使用硫唑嘌呤是因为它被认为对怀孕期间的主要先天性畸形是安全的。然而,在怀孕期间接触硫唑嘌呤和不寻常的发病之间可能存在关联，早期和严重形式的肝内胆汁淤积。
■一名年轻的双胎妊娠患者在第二次肾移植后出现肝内胆汁淤积。有广泛的鉴别诊断。要求进行一系列测试，包括自身免疫标志物，病毒学,和成像。在排除所有其他差异后，得出了硫唑嘌呤导致妊娠肝内胆汁淤积的结论。
■肾移植后妊娠的并发症包括高血压，先兆子痫,移植物功能恶化直至排斥反应，还有免疫抑制药物的不寻常副作用。
结论：第二次肾移植后双胎妊娠是罕见的。除了骨髓抑制和肝酶升高，硫唑嘌呤可导致妊娠期肝内胆汁淤积症。肾移植后妊娠的并发症包括高血压，先兆子痫,移植物功能恶化直至排斥反应，还有免疫抑制药物的不寻常副作用。
■一名年轻的双胎妊娠患者在第二次肾移植后出现肝内胆汁淤积。有广泛的鉴别诊断。要求进行一系列测试，包括自身免疫标志物，病毒学,和成像。在排除所有其他差异后，得出了硫唑嘌呤导致妊娠肝内胆汁淤积的结论。
■肾移植后妊娠的并发症包括高血压，先兆子痫,移植物功能恶化直至排斥反应，还有免疫抑制药物的不寻常副作用。
结论：第二次肾移植后双胎妊娠是罕见的。除了骨髓抑制和肝酶升高，硫唑嘌呤可导致妊娠期肝内胆汁淤积症。肾移植后妊娠的并发症包括高血压，先兆子痫,移植物功能恶化直至排斥反应，还有免疫抑制药物的不寻常副作用。
