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Drug-induced autoimmune hepatitis is an acute and potentially severe side effect, particularly often reported after the long-term use of minocycline. The condition's characteristic biochemical findings are highly elevated transaminase levels, only mildly increased markers of cholestasis and bilirubin levels, an elevated IgG concentration and a high antinuclear antibody (ANA) titre.A 14-year-old girl developed autoimmune hepatitis due to the long-term use of minocycline for acne vulgaris. She presented with icterus and very high transaminase levels. The patient made a full recovery after the medication was discontinued.This type of autoimmune hepatitis can be differentiated from 'classic' autoimmune hepatitis by the patient's quick recovery after stopping the inducing drug and no relapse of the condition after the discontinuation of glucocorticoid therapy.

To determine and compare the obstetrical results of teenage pregnancies among the main ethnic groups in the Netherlands.Retrospective cohort study.From the cohorts 1990-1993 of the Landelijke Verloskundige Registratie (LVR, National Obstetrical Registration) the data were analysed concerning primiparae aged 14-19 years with a single pregnancy.During the period 1990-1993, 14.9% of the women whose parturitions were recorded in the LVR were allochtonous, of the teenage pregnancies recorded 55.2% occurred in an allochtonous population group. The numbers (percentages) of teenage pregnancies (primiparae, singles) in the various ethnic groups were 4742 (2.2%) in the autochtonous group, 3974 (25.9%) in the (Muslim) mediterraneous, 340 (7.8%) in the non-Dutch European, 588 (14.9%) in the Afro-allochtonous, 316 (9.7%) in the Hindustani, 263 (5.5%) in the Asian (excluding Hindustani and Asian Turkish) and 360 (10.4%) in the remaining ethnic groups. Hindustani and orthodox Muslims regard teenage pregnancy positively. The perinatal mortality was higher among Afro-allochtonous than among autochtonous teenagers (odds ratio: 2.89 (95% confidence interval: 1.89-4.40)), and the same was true of premature and immature parturition. Both findings occurred significantly more often in the autochtonous, Afro-allochtonous and Asian population parts than among women of the same ethnic groups aged 20-24 years. In relation to autochtonous women aged 20-24, the odds ratios for perinatal mortality and premature and immature parturition among Afro-allochtonous women were 3.64 (2.50-5.30) and 2.02 (1.59-2.55), respectively; after correction for pre- and immature parturition the odds ratio for perinatal mortality decreased to 2.35 (1.51-3.66). Low birth weight was less frequent among the Mediterraneans and more frequent among the Afro-allochtonous and Hindustani than among the autochtonous. Induced vaginal deliveries were less frequent among allochtonous teenagers, the risk of caesarean section was lower among Mediterranean teenagers but higher among Afro-allochtonous, Hindustani and other ethnic teenagers than among autochtonous teenagers. All groups of teenagers had lower frequencies of induced delivery than women of the same ethnic groups aged 20-24 years.Teenage pregnancy in the Netherlands occurs much more often among allochtonous than among autochtonous women and is encountered most often among (Muslim) mediterranean and Afro-allochtonous groups. Obstetrical results vary greatly from one ethnic teenage group to another; they are poorest among the Afro-allochtonous, best among the Hindustani group. Among the mediterranean teenagers, they are similar to those among the autochtonous group.

To compare the course of teenage pregnancies and deliveries with that in women between the ages of 20 and 29.Observational.The Netherlands.Using data from the 1989 National Obstetric Database (LVR), 4500 teenage pregnancies were studied, to compare the risk of preterm birth, low birth weight and delivering a small for gestational age (SGA) baby between teenagers and older women.Women between the ages of 13 and 19 ran one and a half times as high a risk of having a preterm baby as women between the ages of 20 and 29 years (p0.0001). The risk of intrauterine death was 4 times as high for age 13-17 and 2 times as high for age 18-19 compared with older women (p0.0001). These results were found for teenage mothers of Dutch origin as well as for young mothers of foreign descent. Deliveries by teenagers were more often spontaneous, were of shorter duration and less often needed assistance than deliveries in older mothers (p0.001).Even in the Netherlands, with the lowest teenage pregnancy rate in the Western world and a prenatal care system generally considered of high quality, teenage pregnancies have less favourable outcomes than those in older women. Since we had no information on cultural background, socioeconomic status or life style, further research into determinants of outcomes of Dutch teenage pregnancies is indicated.The objective was to compare the course of teenage pregnancies and deliveries with those of women between the ages of 20 and 29, using data from the 1989 National Obstetric Database (LVR) when approximately 76% of cases conducted by obstetricians were registered. 4500 teenage pregnancies were studied to compare the risk of preterm birth, low birth weight and delivering a small for gestational age (SGA) baby between teenagers and older women. In the 13-17 year age group, 61.5% were of foreign origin. The 13-17 age group had the lowest percentage of delivery at home, with 10%. Women 13-19 years old ran 1.5 times as high a risk of having a preterm baby as women age 20-29 (p 0.0001). The likelihood of SGA delivery was increased only in the 18-19 age group (13.2%) compared to 11% in the 20-29 age group. The risk of death within 24 hours after delivery was also increased because of the risk of intrauterine death, which was 4 times as high for age 13-17 (1.6%) and 2 times as high for age 18-19 (0.7%) compared with women age 20-29 (0.4%) (p 0.0001). These results were found for teenage mothers of Dutch origin as well as for young mothers of foreign descent. Deliveries by teenagers were more often spontaneous, were of shorter duration and less often needed assistance than deliveries in older mothers (p 0.001). The incidence of home delivery was low in both age groups (8.5%), and it was the same for both Dutch and foreign origin groups. Even in the Netherlands, with the lowest teenage pregnancy rate in the Western world and a prenatal care system generally considered of high quality, teenage pregnancies have less favorable outcomes than those in older women. Since the study was conducted without information on cultural background, socioeconomic status or life style, further research into determinants of outcomes of Dutch teenage pregnancies is indicated.

Doel. Vergelijking van zwangerschappen en bevallingen tussen tieners en vrouwen van 20-29 jaar. Opzet. Observationeel. Plaats. Nederland. Methode. Met behulp van gegevens van de Landelijke Verloskunde Registratie (LVR) van 1989 werden 4500 tienerzwangerschappen bestudeerd. Onderzocht werd of zwangerschappen en bevallingen van tieners anders verlopen dan die van vrouwen van 20-29 jaar, alsmede of laag geboortegewicht, vroeggeboorte en groeivertraging meer of minder vaak voorkomen bij tieners in vergelijking met oudere vrouwen. Resultaten. Vrouwen van 13-19 jaar hadden een 1,5 maal grotere kans op vroeggeboorte dan vrouwen van 20-29 jaar (p < 0,0001), maar geen duidelijk vergroot risico voor groeivertraging. In de groep van 13-17 jarigen bestond een 4 maal vergroot risico voor intra-uterien overlijden van het kind en in de groep van 18-19 jarigen een 2 maal vergroot risico (p < 0,0001). Deze resultaten werden bij zowel allochtone als autochtone tieners gevonden. De bevalling bij tieners verliep vaker spontaan, sneller en met minder kunstgrepen dan bij vrouwen van 20-29 jaar (p < 0,001). Conclusie. Zelfs in Nederland, met het kleinste percentage tienerzwangerschappen in de westerse wereld en een prenatale zorg die in het algemeen als adequaat wordt beoordeeld, hebben zwangerschappen van tieners slechtere uitkomsten dan die van oudere vrouwen. Aangezien wij geen gegevens hadden over leefstijl, culturele achtergrond en socio-economische status is nader onderzoek naar de invloed van deze indicatoren op de uitkomsten van tienerzwangerschappen gewenst.