title: Pruritus in chronic cholestatic liver disease.
abstract: Pruritus is a troublesome complication in patients with cholestatic liver disease. Several links to its pathogenesis have been proposed, including the role of bile acids, endogenous opioid and serotonins, and lysophosphatidic acid. The management of pruritus in cholestasis is challenging. Medical treatment of the underlying cholestatic condition may provide benefit. Extracorporeal albumin dialysis can be pursued for those who have a poor quality of life and failed the various therapeutic interventions, while awaiting liver transplantation. Experimental interventions, and the management of pruritus in certain conditions such as intrahepatic cholestasis of pregnancy and benign recurrent intrahepatic cholestasis, are also briefly reviewed.
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Medicine, University of Pennsylvania, Philadelphia, USA.
authors.forename: Chalermrat
authors.initials: C
authors.lastname: Bunchorntavakul
authors.forename: K Rajender
authors.initials: KR
authors.lastname: Reddy
mesh_terms: D000465:Algorithms; D000837:Anion Exchange Resins / Q000627:therapeutic use; D000982:Antipruritics / Q000627:therapeutic use; D001647:Bile Acids and Salts / Q000378:metabolism; D002779:Cholestasis / Q000150:complications* / Q000628:therapy; D002908:Chronic Disease; D005260:Female; D006633:Histamine Antagonists / Q000627:therapeutic use; D006801:Humans; D008107:Liver Diseases / Q000150:complications* / Q000628:therapy; D016031:Liver Transplantation; D008246:Lysophospholipids / Q000378:metabolism; D009292:Narcotic Antagonists / Q000494:pharmacology / Q000627:therapeutic use; D018847:Opioid Peptides / Q000378:metabolism; D010727:Phosphoric Diester Hydrolases / Q000378:metabolism; D010956:Plasmapheresis; D011247:Pregnancy; D011248:Pregnancy Complications / Q000628:therapy*; D000077297:Pregnane X Receptor; D011537:Pruritus / Q000209:etiology* / Q000628:therapy*; D011987:Receptors, Steroid / Q000819:agonists; D012701:Serotonin / Q000378:metabolism; D012702:Serotonin Antagonists / Q000627:therapeutic use; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D015398:Signal Transduction / Q000187:drug effects; D000099189:Lysophospholipase D
chemical_list: D000837:Anion Exchange Resins; D000982:Antipruritics; D001647:Bile Acids and Salts; D006633:Histamine Antagonists; D008246:Lysophospholipids; D009292:Narcotic Antagonists; D018847:Opioid Peptides; D010727:Phosphoric Diester Hydrolases; D000077297:Pregnane X Receptor; D011987:Receptors, Steroid; D012701:Serotonin; D012702:Serotonin Antagonists; D017367:Selective Serotonin Reuptake Inhibitors; D000099189:Lysophospholipase D; C032881:lysophosphatidic acid