Pruritus in liver disease – pathenogenisis and treatment
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Student Scientific Association, Department of In ternal Medicine, Medical University, Lublin, Poland
Chair and Department of Internal Medicine, Medical University, Lublin, Poland
J Pre Clin Clin Res. 2011;5(2):47–49
Pruritus often constitutes a most irritating ailment in patients suffering from chronic liver diseases, especially when cholestasis plays a prominent role. The exact pathogenesis is not entirely recognized. Nevertheless, several mechanisms have been proposed: pruritus connected with a central/peripheral origin, itch caused by mast cells’ hyperactivity, or determined by the intrahepatic cholestasis of pregnancy. This article concentrates on the pruritus accompanying advanced liver disorders. Its pathogenesis and treatment are also discussed.
Andrzej Prystupa   
Chair and Department of Internal Medicine, Medical University, Lublin, Staszica 16, 20-081 Lublin, Poland.
1. Mela M, Mancuso A, Burroughs K. Review article: pruritus in cholestatic and other liver diseases. Aliment Pharmacol Th er 2003;17:857-870.
2. Levy C, Lindor KD. Management of primary biliary cirrhosis. Current Treatment Options in Gastroenterology 2003;6:493-498.
3. O’Keeff e C, Baird AW, Nolan N et al. Cholestasic pruritus – the role of cutaneous mast cells and nerves. Aliment Pharmacol Th er 2004;19:1293- 1300.
4. Biro T, Ko MC, Bromm B et al. How best to fi ght that nasty itch – from new insights into the neuroimmunological, neuroendocrine, and neurophysiological bases of pruritus to novel therapeutic approaches. Exp Dermatol 2005;14:225-240.
5. Krajnik M, Zylicz Z. Pruritus in advanced internal diseases. Pathogenesis and treatment. Neth J Med 2001;58:27-40.
6. Glasova H, Beuers U. Extrahepatic manifestation of cholestasis. J Gastroenterol Hepatol 2002;17:938-948.
7. Reuben A. Old scratch. Hepatology 2004;39:870-873.
8. Bergasa NV. Treatment of the pruritus of cholestasis. Current Treatment Options in Gastroenterology 2004;7:501-508.
9. Jones AE, Bergasa NV. Th e pruritus of cholestasis. Hepatology 1999;29:1003-1006.
10. Bergasa NV. Pruritus in chronic liver disease: mechanisms and treatment. Curr Gastroent Rep 2004;6:10-16.
11. Bergasa NV et al. Open-label of oral nalmefene therapy for the pruritus of cholestasis. Hepatology 1998;27:679-684.
12. Chazouilleres O. MARS: Th e ultimate warrior against pruritus of cholestasis. J Hepatol 2010;53:228-229.
13. Bacq Y, Sapey T, Brechot M, et al. Intrahepatic cholsetasis of pregnancy: a french prospective study. Hepatology 1997;26:358-362.
14. Dann AT, Kenyon AP, Seed PT et al. Glutathione s-transferase and liver function in intrahepatic cholestasis of pregnancy and pruritus gravidarum. Hepatology 2004;40:1406-1414.