Cholestasis of pregnancy, pruritus and 5-hydroxytryptamine 3 receptor antagonists.
Pruritus, an early symptom of intrahepatic cholestasis of pregnancy, may be severe. Conventional treatment includes ursodeoxycholic acid and cholestyramine. Ondansetron, a 5-hydroxytryptamine 3 receptor antagonist antiemetic, has been shown to reduce pruritus of different etiologies including cholestasis. We now report the successful preoperative use of ondansetron in a patient with pruritus from intrahepatic cholestasis of pregnancy. While the mechanism for our patient's response is poorly understood, 5-hydroxytryptamine 3 receptor antagonists should be further evaluated and possibly considered as a treatment option for intrahepatic cholestasis of pregnancy-related pruritus.
Department of Anesthesia, Tufts University School of Medicine, Tufts-New England Medical Center, Boston, MA 02111, USA. Rschumann@tufts-nemc.org
Roman
R
Schumann
Jana
J
Hudcova
D002585:Cesarean Section; D002780:Cholestasis, Intrahepatic / Q000175:diagnosis / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007275:Injections, Intravenous; D008423:Maternal Age; D017294:Ondansetron / Q000008:administration & dosage*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000188:drug therapy*; D011256:Pregnancy Outcome; D018566:Pregnancy, High-Risk; D011537:Pruritus / Q000175:diagnosis / Q000188:drug therapy*; D012702:Serotonin Antagonists / Q000008:administration & dosage*; D016896:Treatment Outcome
D012702:Serotonin Antagonists; D017294:Ondansetron