Reviewer's report
Title:Successful Management of Severe Intrahepatic Cholestasis of Pregnancy:
Report of a First Japanese Case
Version:3Date:16 June 2014
Reviewer: Toru Takahashi
Reviewer's report:
The authors of this manuscript report a first Japanese case of severe intrahepatic
cholestasis of pregnancy that was successfully treated with ursodeoxycholic acid.
Genetic analysis disclosed SNPs in the ABCB11 and ABCB4 loci that were
informative for diagnosis.
Major comments:
1. Authors should describe or even speculate why intrahepatic cholestasis only
appears in the term of pregnancy as a phenotype while genetic polymorphism
(predisposition) exists or continues throughout her lifetime.
2. Authors should describe or even speculate why UDCA is so effective for this
disease condition. Is it effective only because a bad (cytotoxic) bile acid is
substituted by a good bile acid (cytoprotective) like UDCA?
Minor comments:
1. Page 5, line 15. Multidrug resistance protein (MDR3) should be multidrug
resistance protein 3 (MDR3).
2. Page 5, line 16. Bile salt export protein (BSEP) should be bile salt export pump
(BSEP).
3. Page 6, line 6. What is SBP? May be SNP.
4. Page 7, line 13. AFP should be spelled out to alpha-fetoprotein (AFP).
5. Page 7, line 14. Spell out LCA.
6. Page 7, line 15. Tumor markers other than AFP and AFP-L3 are not described
in Table 1. Describe other tumor markers in Table 1, if present. Otherwise,
authors should omit the sentence, “no increases in tumor markers were
detected.”
7. Page 9, line 14. Spell out ABC.
8. Page 10, line 11. Spell out HELLP.
All above-mentioned comments are included into Minor Essential Revisions.
Level of interest: An article of limited interest
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a statistician.
Declaration of competing interests:
I declare that I have no competing interests.
Reviewer's report
Title:Successful Management of Severe Intrahepatic Cholestasis of Pregnancy:
Report of a First Japanese Case
Version:3Date:16 June 2014
Reviewer: Toru Takahashi
Reviewer's report:
The authors of this manuscript report a first Japanese case of severe intrahepatic
cholestasis of pregnancy that was successfully treated with ursodeoxycholic acid.
Genetic analysis disclosed SNPs in the ABCB11 and ABCB4 loci that were
informative for diagnosis.
Major comments:
1. Authors should describe or even speculate why intrahepatic cholestasis only
appears in the term of pregnancy as a phenotype while genetic polymorphism
(predisposition) exists or continues throughout her lifetime.
2. Authors should describe or even speculate why UDCA is so effective for this
disease condition. Is it effective only because a bad (cytotoxic) bile acid is
substituted by a good bile acid (cytoprotective) like UDCA?
Minor comments:
1. Page 5, line 15. Multidrug resistance protein (MDR3) should be multidrug
resistance protein 3 (MDR3).
2. Page 5, line 16. Bile salt export protein (BSEP) should be bile salt export pump
(BSEP).
3. Page 6, line 6. What is SBP? May be SNP.
4. Page 7, line 13. AFP should be spelled out to alpha-fetoprotein (AFP).
5. Page 7, line 14. Spell out LCA.
6. Page 7, line 15. Tumor markers other than AFP and AFP-L3 are not described
in Table 1. Describe other tumor markers in Table 1, if present. Otherwise,
authors should omit the sentence, “no increases in tumor markers were
detected.”
7. Page 9, line 14. Spell out ABC.
8. Page 10, line 11. Spell out HELLP.
All above-mentioned comments are included into Minor Essential Revisions.
Level of interest: An article of limited interest
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a statistician.
Declaration of competing interests:
I declare that I have no competing interests.
Please review this paper.
user
Reviewer's report
Title:Successful Management of Severe Intrahepatic Cholestasis of Pregnancy:
Report of a First Japanese Case
Version:3Date:16 June 2014
Reviewer: Toru Takahashi
Reviewer's report:
The authors of this manuscript report a first Japanese case of severe intrahepatic
cholestasis of pregnancy that was successfully treated with ursodeoxycholic acid.
Genetic analysis disclosed SNPs in the ABCB11 and ABCB4 loci that were
informative for diagnosis.
Major comments:
1. Authors should describe or even speculate why intrahepatic cholestasis only
appears in the term of pregnancy as a phenotype while genetic polymorphism
(predisposition) exists or continues throughout her lifetime.
2. Authors should describe or even speculate why UDCA is so effective for this
disease condition. Is it effective only because a bad (cytotoxic) bile acid is
substituted by a good bile acid (cytoprotective) like UDCA?
Minor comments:
1. Page 5, line 15. Multidrug resistance protein (MDR3) should be multidrug
resistance protein 3 (MDR3).
2. Page 5, line 16. Bile salt export protein (BSEP) should be bile salt export pump
(BSEP).
3. Page 6, line 6. What is SBP? May be SNP.
4. Page 7, line 13. AFP should be spelled out to alpha-fetoprotein (AFP).
5. Page 7, line 14. Spell out LCA.
6. Page 7, line 15. Tumor markers other than AFP and AFP-L3 are not described
in Table 1. Describe other tumor markers in Table 1, if present. Otherwise,
authors should omit the sentence, “no increases in tumor markers were
detected.”
7. Page 9, line 14. Spell out ABC.
8. Page 10, line 11. Spell out HELLP.
All above-mentioned comments are included into Minor Essential Revisions.
Level of interest: An article of limited interest
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a statistician.
Declaration of competing interests:
I declare that I have no competing interests.
assistant