Acute reactive hepatitis in pregnancy induced by alpha-methyldopa.
BACKGROUND
Alpha-methyldopa is an antihypertensive medication used commonly in pregnancy. Reactive hepatitis is a severe, uncommon reported side effect of this medication. To our knowledge, there has been only one other reported case of alpha-methyldopa-induced hepatitis associated with pregnancy in the United States.


METHODS
A patient at 17 weeks' estimated gestational age was evaluated for elevated maternal serum alpha-fetoprotein, which is used generally as a screening test for birth defects. A thorough history, physical examination, and laboratory evaluation were performed, and alpha-methyldopa-induced maternal hepatitis was diagnosed.


CONCLUSIONS
The astute clinician should include maternal hepatic dysfunction in the differential diagnosis of an elevated maternal serum alpha-fetoprotein and should consider obtaining aminotransferase levels after initiation of alpha-methyldopa therapy during pregnancy.
Thomas
L A
LA
Riverside Hospital, Department of Maternal Fetal Medicine, Toledo, Ohio 43604, USA.
Cardwell
M S
MS
D000328:Adult; D000959:Antihypertensive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D056486:Chemical and Drug Induced Liver Injury / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008750:Methyldopa / Q000009:adverse effects* / Q000627:therapeutic use; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000188:drug therapy*; D000509:alpha-Fetoproteins / Q000032:analysis
D000959:Antihypertensive Agents; D000509:alpha-Fetoproteins; D008750:Methyldopa