title: [Hydroxyethyl starch-(HES)-induced pruritus as secondary complication of an occupational accident].
abstract: A 29-year old employee (controller in the textile industry) had an occupational accident leading to a femoral fracture. After surgery, he developed acute respiratory distress syndrome (ARDS) necessitating intensive care treatment. Three weeks after the accident, he developed generalized severe itching on a daily basis unresponsive to systemic and topical treatments. After one year, the itching had decreased to approximately 50% of its initial intensity. Hydroxyethyl starch (HES)-induced pruritus was diagnosed, based on the typical history and clinical features, the proven administration of HES and its cutaneous tissue storage by electron microscopy. Drug-induced pruritus caused by the plasma expander hydroxyethyl starch can be a secondary consequence of an occupational accident and thus an issue in accident compensation claims.
authors.affiliation: Abteilung Klinische Sozialmedizin, Berufs- und Umweltdermatologie, Universitätsklinikum Heidelberg, Heidelberg. elke.Weisshaar@med.uni-heidelberg.de
authors.forename: E
authors.initials: E
authors.lastname: Weisshaar
authors.forename: S
authors.initials: S
authors.lastname: Ständer
authors.forename: D
authors.initials: D
authors.lastname: Metze
authors.forename: T L
authors.initials: TL
authors.lastname: Diepgen
mesh_terms: D000062:Accidents, Occupational; D000328:Adult; D005264:Femoral Fractures / Q000150:complications / Q000188:drug therapy / Q000209:etiology / Q000601:surgery*; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D010952:Plasma Substitutes / Q000009:adverse effects / Q000627:therapeutic use; D019106:Postoperative Hemorrhage / Q000188:drug therapy; D011537:Pruritus / Q000139:chemically induced* / Q000175:diagnosis / Q000473:pathology*; D016896:Treatment Outcome
chemical_list: D006895:Hydroxyethyl Starch Derivatives; D010952:Plasma Substitutes