Extracorporeal artificial liver support systems in the management of intractable cholestatic pruritus.

Abstract

Pruritus can occur as a severe complication of cholestasis. Several hypotheses suggest an important role for the accumulation of bile acids, endogenous opioids and - mire recently - lysophosphatidic acid. Bile acid sequestrants are the first-line therapeutic agents. In refractory cases, a stepwise approach using rifampicin, oral opiate antagonists and the selective serotonin reuptake inhibitor sertraline should be tested. Recent case series reported effective relief of pruritus using extracorporal liver support systems and plasmapheresis.

• Authors: Valentin Fuhrmann, Andreas Drolz, Michael Trauner
• Journal: Liver international : official journal of the International Association for the Study of the Liver (Liver Int) Vol. 31 Suppl 3 Pg. 31-3 (Sep 2011) ISSN: 1478-3231 [Electronic] United States
• PMID: 21824282 (Publication Type: Journal Article, Review)
• Copyright: © 2011 John Wiley & Sons A/S.

Chemical References

• Lysophospholipids
• Opioid Peptides
• Cholestyramine Resin
• Ursodeoxycholic Acid
• lysophosphatidic acid
• Sertraline
• Rifampin

Topics

• Cholestasis (complications)
• Cholestyramine Resin (therapeutic use)
• Humans
• Lysophospholipids (metabolism)
• Opioid Peptides (antagonists & inhibitors, metabolism)
• Plasmapheresis (methods)
• Pruritus (diagnosis, drug therapy, metabolism, physiopathology, therapy)
• Renal Dialysis (methods)
• Rifampin (therapeutic use)
• Sertraline (therapeutic use)
• Sorption Detoxification (methods)
• Ursodeoxycholic Acid (therapeutic use)