This is a good overview of the condition. Remember – it is a diagnosis of exclusion.
- Pruritus without a rash (except excoriation). It is often worse at night and affects palms and soles too.
- Cholestatic symptoms (pale stool / dark urine / jaundice)
- Deranged LFT (transaminases / gamma-GT – bilirubin and bile acids may also be raised). Beware; LFT can take weeks to rise, so if the woman has persistent pruritus, measure LFT every 1 to 2 weeks.
- To exclude other causes of liver disease – Hep ABC screening, EBV, CMV, Liver autoimmune screen, Coagulation screen