CASE 33
A 26-year-old female at 35 weeks gestation presents to the clinic with com-
plaints of generalized itching. Patient reports no rash or skin changes. She
denies any change in clothing detergent, soaps, or perfumes. She denies nau-
sea and vomiting and otherwise feels well. On physical exam, there are no
rashes apparent on her skin and only some excoriations from itching. Blood
work reveals slightly elevated serum transaminase and bilirubin levels.
What is the patient’s likely diagnosis?
What are treatment options?
What is the cause of the patient’s generalized itching?
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