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Sir, Hypertransaminasemia of the 3^rd trimester of pregnancy may be an early finding of some disorders: acute fatty liver (AFLP), haemolysis, elevated liver enzymes, low platelets (HELLP), intrahepatic cholestasis of pregnancy (ICP) and pre-eclampsia. These conditions differ for the frequency (AFLP 1:13000, HELLP 1:1000-6000, ICP 2-7: 1000), clinical course, prognosis and hepatic damage. AFLP is a genetic disorder in the course of an underlying failing in fatty acid oxidation due to mithocondrial trifunctional protein gene defect which results in long chain 3-ketoacyl CoA thiolase (LCHAD) deficiency, whilst recently ICP has been associated to a mutation of a gene codifying for xenobiotic receptors. An increased release of tumour necrosis factor-alpha (TNF-alpha) in HELLP syndrome has been shown thus suggesting that inflammatory mechanisms may participate in the pathophysiology of this disorder. Finally, an isolated hypertransaminasaemia (i. e. a significant elevation of transaminases specifically oc curring in the 3^rd trimester of pregnancy in the absence of known liver disorders) may be seen in pregnancy. In order to elucidate a possible mechanism sustaining this rare and vague condition, we correlated serum TNF-alpha levels and isolated hypertransaminasemia of the 3^rd trimester of pregnancy in a prospective study.

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2010-06-01   |   757 visitas   |   Evalua este artículo 0 valoraciones

Vol. 9 Núm.2. Abril-Junio 2010 Pags. 211-212 Ann Hepatol 2010; 9(2)