title: Primary sclerosing cholangitis in pregnancy refractory to ursodeoxycholic acid treatment: a case report.
abstract: BACKGROUND
  Primary sclerosing cholangitis (PSC) is a chronic cholestatic liver disease associated with fibrosis and inflammation of the bile ducts. Its complications include symptoms from pruritis and fatigue to dominant strictures, cholangiocarcinoma and liver failure necessitating liver transplant. Due to its predominance in young males, little is reported regarding PSC and pregnancy.
  
  
  METHODS
  We report a case of a pregnant woman with PSC whose symptoms were initially unresponsive to the traditional treatment of ursodeoxycholic acid (UDCA) early in her pregnancy but subsequently did well using high dose steroids for the duration of her pregnancy.
  
  
  CONCLUSIONS
  With close management, successful pregnancy outcomes seem possible with patients with PSC, even when diagnosed multiple years prior to pregnancy, if not with UDCA, then possibly with steroid treatment.
authors.affiliation: Department of Obstetrics and Gynecology, University of Connecticut School of Medicine, Farmington, Connecticut, USA. hleftwich@resident.uchc.edu
authors.forename: Heidi
authors.initials: H
authors.lastname: Leftwich
authors.forename: Yu Ming Victor
authors.initials: YM
authors.lastname: Fang
authors.forename: Adam
authors.initials: A
authors.lastname: Borgida
authors.forename: William
authors.initials: W
authors.lastname: Crombleholme
mesh_terms: D000328:Adult; D002756:Cholagogues and Choleretics / Q000627:therapeutic use*; D015209:Cholangitis, Sclerosing / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D011241:Prednisone / Q000627:therapeutic use*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D014580:Ursodeoxycholic Acid / Q000627:therapeutic use*
chemical_list: D002756:Cholagogues and Choleretics; D005938:Glucocorticoids; D014580:Ursodeoxycholic Acid; D011241:Prednisone