title: Aquagenic pruritus in polycythemia vera: characteristics and influence on quality of life in 441 patients.
abstract: Aquagenic pruritus (AP) is a symptom typical for polycythemia vera, but very little is known about its exact frequency, characteristics, influence on quality of life, and proper treatment. Therefore, we investigated these aspects in a large cohort of German patients with polycythemia vera using a patient directed questionnaire. Our analysis revealed that 301 of 441 analyzed patients suffered from AP. In 64.8%, AP occurred on average 2.9 years prior to diagnosis of polycythemia vera. Only in 15.4% did this lead to a hematological investigation. AP occurs primarily on the trunk and proximal parts of the extremities. Most patients complain about itching (71.8%), the remainder about tickling, stinging, or burning sensations. Forty-four patients (14.6%) classified the pruritus as "unbearable." Patients with AP reported reduced global health status and higher fatigue, pain, and dyspnea. Only 24% of patients received pruritus specific treatment for pruritus consisting mostly of histamine antagonists, which ameliorated symptoms in about half of the patients. In 5.6% of patients, polycythemia vera directed therapy (phlebotomy/cytoreduction) resolved the symptoms. In summary, AP is a serious symptom in patients with polycythemia vera, which until recently was difficult to treat. The advent of the novel JAK2 inhibitors, however, may open new ways for therapy.
authors: Department of Medical School, Hematology Oncology Center and Ludwig-Maximilians-University Medical School Munich, Germany.
authors: Fabian P
authors: FP
authors: Siegel
authors: Jan
authors: J
authors: Tauscher
authors: Petro E
authors: PE
authors: Petrides
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006633:Histamine Antagonists / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D018962:Phlebotomy / Q000379:methods; D011087:Polycythemia Vera / Q000150:complications / Q000473:pathology / Q000503:physiopathology / Q000628:therapy; D011537:Pruritus / Q000209:etiology / Q000473:pathology / Q000503:physiopathology / Q000628:therapy; D011788:Quality of Life; D011795:Surveys and Questionnaires
chemical_list: D006633:Histamine Antagonists