title: Serum copper in intrahepatic cholestasis of pregnancy.
abstract: Intrahepatic cholestasis of pregnancy is characterised by clinical and biochemical fluctuations and further diagnostic tools are required. The aim of this study was to investigate serum copper and copper oxidase during the course of intrahepatic cholestasis of pregnancy (ICP). Twenty eight ICP patients and twenty healty pregnant women were included. Routine liver tests, fasting serum bile acids (FSBA), serum copper and serum copper oxidase were measured. In ICP, serum copper was significantly higher than in controls (274 +/- 49 micrograms/dl vs 176 +/- 34 micrograms/dl, p less than 0.001). Copper oxidase rose in ICP (78 +/- 15 mg/dl) different than healthy pregnant women (64 +/- 8 mg/dl); p less than 0.02. In contrast to marked oscillations in FSBA, serum copper remained elevated during the follow-up with only minor fluctuations and no correlation was demonstrated between changes in FSBA and those noted in serum copper (r:0.17, NS). At labor, a significant rise in serum copper was demonstrated in ICP (from 251 +/- 50 micrograms/dl to 297 +/- 55 micrograms/dl, p less than 0.01) and in controls (from 168 +/- 34 to 192 +/- 42 micrograms/dl, p less than 0.01). This increment in serum copper was associated with a peak in serum copper oxidase activity. Serum copper and copper oxidase are elevated in ICP and may be considered as adjuvant diagnostic tests. Disturbances in copper metabolism reported in this study are consistent with the hypothesis that normal pregnancy is associated with a mild cholestasis effect and ICP represent a form of improperly controlled response.
authors.affiliation: Department of Medicine, University Hospital, Santiago, Chile.
authors.forename: J
authors.initials: J
authors.lastname: Chesta
authors.forename: R
authors.initials: R
authors.lastname: Palma
authors.forename: C
authors.initials: C
authors.lastname: Antezana
authors.forename: J P
authors.initials: JP
authors.lastname: Aldunate
authors.forename: O
authors.initials: O
authors.lastname: Molina
mesh_terms: D000293:Adolescent; D000328:Adult; D000469:Alkaline Phosphatase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D001647:Bile Acids and Salts / Q000097:blood*; D001663:Bilirubin / Q000097:blood; D002780:Cholestasis, Intrahepatic / Q000097:blood*; D003300:Copper / Q000097:blood*; D005260:Female; D006801:Humans; D008111:Liver Function Tests; D010088:Oxidoreductases / Q000097:blood; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood*; D011263:Pregnancy Trimester, Third; D012016:Reference Values
chemical_list: D001647:Bile Acids and Salts; D003300:Copper; D010088:Oxidoreductases; C024748:copper oxidase; D001219:Aspartate Aminotransferases; D000469:Alkaline Phosphatase; D001663:Bilirubin