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CME Credit Offered
CME Credit Offered
Abstract Award
Abstract Award
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Poster Session 4

(970) Detection of individual bile acids by sebum sampling in cholestasis of pregnancy

Friday, January 31, 2025
4:00 PM – 6:00 PM  
Objective: Intrahepatic cholestasis of pregnancy (ICP) is characterized by elevated bile acids and pruritis of palms as a disease unique to pregnancy. There is a paucity of information on the individual bile acids that contribute to palmar pruritis in ICP. We aimed to perform a feasibility study to utilize a novel methodology of extraction of steroids through sebum sampling in those undergoing evaluation for ICP.

Study Design: This was a prospective, observational cohort study of pregnant individuals evaluated for ICP from December 2023 to July 2024 a single academic center. Patients were characterized into pruritis of pregnancy (total BA < 10 mmol/L, referent), ICP (BA ≥10 mmol/L), using a quantitative enzymatic assay.  At the time of initial evaluation for ICP, sebum sampling was performed after preparation of the skin to be sampled with an alcohol wipe cleanse. Three-five strips of sebutape were placed for 15 minutes and removed. Extraction of bile acids were performed through liquid chromatography mass spectrometry methods.

Results: There were 5 patients with cholestasis of pregnancy and 2 patients with pruritis of pregnancy whose samples were analyzed. There were no significant demographic differences between those with and without cholestasis of pregnancy. Gestational age at sebum sampling did not differ between the groups 35.9±0.9 vs 36.0±2.4, P=0.97. The mean total bile acids of those with cholestasis were 52.6±19.1. Corresponding analysis of serum samples from these cholestasis patients detected taurocholic acid as the main analyte. Levels of taurocholic acid, glycolcholic acid, taurochenodeoxycholic acid, cholic acid, glycol-chenodeoxycholic acid, and glycol-deoxycholic acid were detected in both upper back and palmar samples.

Conclusion: Beyond serum sampling of total bile acids, we have demonstrated a novel methodology of detection of bile acid levels in sebum samples in patients with cholestasis of pregnancy. This may offer further insight into disease characteristics and symptomatology.