creators_name: Shakuntala, PN creators_name: Poornima, M creators_name: Padmalatha, VV creators_name: Rao, SR creators_id: shakuntala_pn@yahoo.com editors_name: Kakkilaya, Srinivas editors_id: Kakkilaya BS type: journale datestamp: 2013-05-04 23:08:47 lastmod: 2013-05-04 23:08:47 metadata_visibility: show title: Successful Pregnancy Outcome In Maternal Crigler Najjar Syndrome Type II. ispublished: pub subjects: OJHAS full_text_status: public keywords: Crigler Najjer Syndrome type II; Unconjugated hyperbilurubinemia; Phenobarbitone; Phototherapy. abstract: Estimated incidence of Crigler-Najjar syndrome(CNS) is 1 case per 1,000,000 births(1 million). The overall prevalence of CN syndrome is unknown, with only several hundred people reported to have this disease. It is interestingly very rare to encounter a pregnant adult women with congenital jaundice. Pregnancy in CN type II patients is a diagnostic and a therapeutic challenge because of the high risk of bilirubin encephalopathy with serious neurological damage as life-threatening complications for the fetus. To date 8 pregnancy outcome have been reported from 5 women and we report the6 woman with a successful 9 th pregnancy outcome. We have discussed detail history, presentation and management during pregnancy and care of the new born. date: 2012-10-25 date_type: published publication: Online Journal of Health and Allied Sciences volume: 11 number: 3(12) publisher: Kakkilaya BS refereed: TRUE referencetext: 1. Tukey RH, Strassburg CP. Human UDP-glucuronosyltransferases: metabolism, expression, and disease. Annu Rev Pharmacol Toxicol 2000;40: 581–616. 2. Crigler JF Jr, Najjar VA: Congenital familial nonhemolytic jaundice with kernicterus; a new clinical entity. AMA Am J Dis Child 1952;83:259–260. 3. Arias M. Chronic unconjugated hyperbilirubinemia without overt signs of hemolysis in adolescents and adults. J Clin Invest (NY) 1962;41:2233–2245. 4. Gupta R, Parashar Y. Crigler-Najjar syndrome type II. Indian J Pediatr 2004;71:1043. 5. Trotman BW, Shaw L, Roy-Chowdhury J, Malet PF, Rosato EF. Effect of Phenobarbital on serum and biliary parameters in a patient with Crigler-Najjar syndrome, type II and acquired cholestasis. Dig Dis Sci 1983;28:753–762. 6. Costa E. Hematologically important mutations: bilirubin UDP-glucuronosyltransferase gene mutations in Gilbert and Crigler- Najjar syndromes. Blood Cells Mol Dis2006;36:77–80. 7. Seppen J, Bosma PJ, Goldhoorn BG, Bakker CT, Chowdhury JR, Chowdhury NR, Jansen PL, Oude Elferink RP. Discrimination between Crigler-Najjar type I and II by expression of mutant bilirubin uridine diphosphate-glucuronosyltransferase. J Clin Invest 1994;94:2385–2391. 8. Ritter JK, Yeatman MT, Ferreira P, Owens IS. Identification of a genetic alteration in the code for bilirubin UDP-glucuronosyltransferase in the UGT1 gene complex of a Crigler-Najjar type I patient. J Clin Invest 1992;90:150–155. 9. Taylor WG, Walkinshaw SA, Farquharson RG, Fisken RA, Gilmore IT: Pregnancy in Crigler-Najjar syndrome. Case report. Br J Obstet Gynaecol 1991;98:1290–1291. 10. Smith JF, Baker JM. Crigler-Najjar disease in pregnancy. Obstet Gynecol 1994;84:670–672. 11. Ito T, Katagiri C, Ikeno S, Takahashi H, Nagata N, Terakawa N. Phenobarbital following phototherapy for Crigler-Najjar syndrome type II with good fetal outcome: a case report. J Obstet Gynaecol Res 2001;27:33–35. 12. Holstein A, Plaschke A, Lohse P, et al. Successful photo- and phenobarbital ther- apy during pregnancy in a woman with Crigler–Najjar syndrome type II. Scand J Gastroenterol 2005;40:1124–1126. 13. Pinkee S, Renu A, Bharati M. Crigler-Najjar syndrome with pregnancy. J Obstet Gynecol India 2005;55:270–271. 14. Holstein A, Bryan CS. Three consecutive pregnancies in a woman with Crigler–Najjar syndrome type II with good maternal and neonatal outcomes. Dig Liver Dis. 2010, doi:10.1016/j.dld.2010.08.003 15. Passuello V, Puhl AG, Wirth S, Steiner E, Skala C, Koelbl H, Kohlschmidt N. Pregnancy Outcome in Maternal Crigler-Najjar Syndrome Type II: A Case Report and Systematic Review of the Literature. Fetal Diagn Ther 2009;26:121–126 DOI: 10.1159/000238122 16. Hannam S, Moriaty P, O’Reilly et al. Normal neurological outcome in two infants treated with exchange transfusions born to mothers with Crigler-Najjar Type 1 disorder.Eur J Pediatr 2009;168:427-429. 17. Wielsma S, Kerkmeijer L, Bekkers R, Pyman J, Tan J, Quinn M. Persistent trophoblast disease following partial molar pregnancy. Aust N Z J Obstet Gynaecol. April 2006;46(2):119–123. citation: Shakuntala, PN and Poornima, M and Padmalatha, VV and Rao, SR (2012) Successful Pregnancy Outcome In Maternal Crigler Najjar Syndrome Type II. [Journal (On-line/Unpaginated)] document_url: http://cogprints.org/8922/1/2012-3-12.pdf