First reference to ICP?
Back in 2018, when I was searching for something on the itch in intrahepatic cholestasis of pregnancy (ICP), I came across a reference to a case study that was published in the British Medical Journal on 21 September 1872 and which mentioned itching in pregnancy (pruritis gravidarum). It stood out for me as possibly being the first UK mention of the condition.
The case was written up by a doctor called David Page and in it he documents the pregnancy of a woman with such severe itch that he writes:
...she was affected with the most distressing itching, without any outward manifestation whatever...
...the incessant irritation and loss of sleep... [meant] that the pernicious mental reaction produced by the patient brooding over her misery, and dreading its results, probably aggravated the intensity of the pruritus...
...pruritus had so prostrated both body and mind as to bring her to the verge of mania.
Whilst we can’t say that is definitely ICP, the itch described is something that doctors today would investigate and there are other clues, such as she’d had the itch before in a previous pregnancy and that each time her itch resolved once she had the baby. She also developed pruritus in her third trimester.
I’ve been intending to ask experts for their opinion but just ran out of time to do this and then a little thing called the Pandemic happened...
My hunch is that she had ICP but what do you think? Here’s the reference:
Page D. On the occurrence of an unusual form of pruritus during pregnancy. Br Med J 1872; 2(612): 323–4. https://doi.org/10.1136/bmj.2.612.323-a
And you can download the paper here.
Jenny Chambers, Founder & CEO, ICP Support
17 November 2021