{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T00:32:09Z","timestamp":1793147529685,"version":"4.5.0"},"reference-count":0,"publisher":"Kare Publishing","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Hepatol Forum"],"abstract":"<jats:p>A 36-year-old patient presented with severe early-onset obstetric cholestasis on a background of having pre-term induction of labor at 33 weeks during her only previous pregnancy. The patient had significantly abnormal liver biochemistry with a bilirubin of 78 \u00b5mol\/L, ALP of 318 u\/L, ALT of 280 \u00b5mol\/L, and bile acid levels of 420 \u00b5mol\/L. The patient received ursode-oxycholic acid 750 mg 3 times a day, rifampicin 500 mg twice a day, aspirin 150 mg once a day, and metformin 500 mg 3 times a day. However, despite this, the patient still suffered from intractable pruritus and her bile acid level was still above the 100 \u00b5mol\/L target that the obstetrics team was aiming for to avoid early delivery at 32 weeks. Due to the nature and severity of her cholestasis, the patient had a number of investigations done postnatally in-cluding genetic analysis, which confirmed that the patient was heterozygous for a pathogenic variant of the ATP-binding cassette subfamily B member 4 gene (c.959C&gt;T [p.Ser320Phe]) and also a variant of unknown significance (c.1679C&gt;T [p.Thr560Met]).<\/jats:p>","DOI":"10.14744\/hf.2023.2023.0008","type":"journal-article","created":{"date-parts":[[2023,10,5]],"date-time":"2023-10-05T02:56:46Z","timestamp":1696474606000},"page":"142-144","source":"Crossref","is-referenced-by-count":1,"title":["Recurrent Early Onset Severe Obstetric Cholestasis in a Patient With Two Variants in the ABCB4 Gene: A Case Report"],"prefix":"10.14744","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2282-3791","authenticated-orcid":false,"given":"Mohammad","family":"Fawad Khattak","sequence":"first","affiliation":[{"name":"Speciality Registrar in Gastroenterology, Worthing Hospital University Hospital Sussex NHS Foundation Trust, Sussex, England"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0179-0995","authenticated-orcid":false,"given":"Sam","family":"Thomson","sequence":"additional","affiliation":[{"name":"Consultant in Gastroenterology and Hepatology, Worthing HospitalnUniversity Hospital Sussex NHS Foundation Trust, Sussex, England"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"5966","published-online":{"date-parts":[[2023]]},"container-title":["Hepatology Forum"],"original-title":[],"link":[{"URL":"https:\/\/file.paplino.com\/hepatologyforum\/pdfs\/1695380450-en.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/hepatologyforum.org\/storage\/upload\/pdfs\/1695380450-en.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T23:33:08Z","timestamp":1793143988000},"score":1,"resource":{"primary":{"URL":"https:\/\/hepatologyforum.org\/articles\/HF-83593"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023]]},"references-count":0,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2023]]}},"URL":"https:\/\/doi.org\/10.14744\/hf.2023.2023.0008","relation":{},"ISSN":["1307-5888","2757-7392"],"issn-type":[{"value":"1307-5888","type":"print"},{"value":"2757-7392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023]]}}}