Recurrent cholestatic jaundice of pregnancy with demonstrated estrogen sensitivity

Described herein is a patient with cholestatic jaundice which recurred during each of eight (or nine) pregnancies. Similar episodes of jaundice were associated with abnormal menses (menorrhagia). Following delivery or with the onset of menstruation the patient became asymptomatic, and liver function returned to normal. Liver biopsies showed intrahepatic cholestasis during pregnancy, and a return to normal after pregnancy. An identical clinical picture with jaundice and abnormal liver function tests was induced when the patient was challenged with the synthetic estrogen, estinyl estradiol (1 mg. daily). This patient is presented as a case of idiopathic recurrent cholestatic jaundice of pregnancy. The evidence that this entity may have a hormonal basis is discussed.