Intrahepatic Cholestasis in a Pregnant Patient With Sickle Cell Disease: A Case Report

TL;DR

A pregnant woman with sickle cell disease developed a rare liver condition requiring early delivery, but was successfully treated.

Contribution

This case report highlights the rare occurrence of intrahepatic cholestasis in a pregnant patient with homozygous sickle cell disease.

Findings

Intrahepatic cholestasis occurred in a pregnant patient with homozygous SCD at 25 weeks gestation.

The patient required delivery at 30 weeks due to very high bile acid and liver enzyme levels.

Successful management of the condition was achieved in this rare case.

Abstract

Sickle cell intrahepatic cholestasis (SCIC) is a potentially fatal complication of sickle cell disease (SCD) with a high mortality rate, observed mainly in patients with homozygous SCD. Intrahepatic cholestasis of pregnancy is a known complication in pregnancy and usually presents in the late second or third trimester with itching, elevated bile acids, and elevated liver enzymes. Intrahepatic cholestasis in a pregnant patient with homozygous SCD is a rare occurrence. We present the case of a patient who was diagnosed with homozygous SCD during her second pregnancy and developed cholestasis with abnormal levels of liver enzymes at 25 weeks gestation, requiring delivery at 30 weeks gestation due to very high bile acid and liver enzyme levels. The patient was successfully managed.