Disease relevance of Pruritus

• In 15 of 18 trials, disodium cromoglycate produced marked amelioration of the clinical manifestations of pruritus, whealing, flushing, diarrhea, abdominal pain and disorders of cognitive function [1].
• Erythropoietin therapy lowers plasma histamine concentrations in patients with uremia and can result in marked improvement of pruritus [2].
• A hydrocortisone preparation containing methylparaben and propylparaben provoked bronchospasm and pruritis when given intravenously to an asthmatic patient, whereas another hydrocortisone preparation without paraben preservative did not [3].
• To study the effect of bile-acid depletion on pruritus, 8 patients with chronic cholestasis and intractable pruritus which had not responded to cholestyramine and/or phenobarbitone underwent plasma perfusion through USP-charcoal-coated glass beads [4].
• Comparison of rifampicin with phenobarbitone for treatment of pruritus in biliary cirrhosis [5].

Psychiatry related information on Pruritus

• We describe a patient who presented with secondary hyperparathyroidism and symptoms of memory loss, pruritus, constipation, and bone and joint pain [6].
• Hyperactivity, polyphagia, lethargy, anorexia, increased pruritus, or ocular discharge were seen in three dogs treated with terfenadine [7].

High impact information on Pruritus

• Anal pruritus after cancer chemotherapy with gemcitabine [8].
• Relief of pruritus and decreases in plasma histamine concentrations during erythropoietin therapy in patients with uremia [2].
• After one year 17 of the 19 patients assigned to cyclosporine had improvement or stability in their degree of fatigue, and 18 in their degree of pruritus [9].
• Cimetidine for the treatment of pruritus [10].
• Pruritus in dialysis patients treated with parenteral lidocaine [11].

Chemical compound and disease context of Pruritus

• The severity of pruritus was scored weekly, and plasma histamine levels were measured at the beginning and end of each five-week period [2].
• Improvement of cholestatic pruritus by ondansetron [12].
• RESULTS: Pruritus was more effectively reduced by ursodeoxycholic acid than cholestyramine (66.6% vs 19.0%, respectively; P < .005) [13].
• In 27 patients, bilirubin declined to anicteric or subicteric levels and pruritus subsided [14].
• Propofol was recently shown to be efficient in relieving pruritus secondary to spinal morphine administration [15].
• A significant effect was noted within 48 h of treatment, with pruritus improving in 56% of pimecrolimus-treated patients and 34% of vehicle-treated patients (P = 0.003) [16].
• Sertraline seems to be an effective, well-tolerated treatment for pruritus due to chronic liver disease [17].

Biological context of Pruritus

• None of these indices correlated with levels of hemoglobin, PTH, alkaline phosphatase or albumin, or with nerve conduction velocity or any other subsequent clinical outcomes including death, technique failure, hospital days, peritonitis rate and subjective indices of fatigue, pruritus and insomnia [18].
• The main side effects of megestrol acetate included weight gain (20% or over), pruritus, elevation of blood pressure, weakness, and vaginal bleeding; they were only occasionally observed [19].
• Visual analog pain scores, sensory changes, blood pressure, heart rate, ephedrine requirements, motor blockade, sedation, pruritus, and nausea were also recorded [20].
• There was a statistically significant and positive correlation between the pruritus intensity (AUC 0, 72 h) and the malaria parasite load in the itching subjects, not receiving prednisolone (n = 9) (r = 0.73, P = 0.026 ANOVA) [21].
• Furthermore, with long-term use of mizolastine over 1 year, a reduction in pruritus and the number of urticarial episodes was maintained with no evidence of tachyphylaxis or tolerance [22].

Anatomical context of Pruritus

• The finding of raised histamine concentrations in chronic cholestatic liver disease suggests in vivo mast cell activation and a potential role for its mediators in the pruritus characteristic of these disorders [23].
• CONCLUSION: We provide evidence that IL-31 expression is associated with CLA(+) T cells and might contribute to the development of AD-induced skin inflammation and pruritus [24].
• Common side effects of intravenous miconazole include phlebitis, pruritus, anaemia, thrombocytosis, hyponatraemia, nausea, hyperlipidaemia, vomiting, central nervous system effects, and rashes [25].
• Transgenic mice expressing human stratum corneum chymotryptic enzyme in suprabasal epidermal keratinocytes were found to develop pathologic skin changes with increased epidermal thickness, hyperkeratosis, dermal inflammation, and severe pruritus [26].
• Activation of 5-hydroxytryptamine receptors on dermal sensory nerve-endings plays a role in the perception of pruritus [27].

Gene context of Pruritus

• Transgenic mice overexpressing IL-31 developed severe pruritis, alopecia and skin lesions [28].
• In two volunteers, an inflammatory papule with transient pruritus developed 12-18 h after applying IL-2 [29].
• HIV+ pruritus was significantly highest in TNF-alpha (P=0.0001) staining [30].
• ET-1, -2 and -3 all caused a dose-dependent area of pallor surrounded by a long-lasting flare which was accompanied by a short-lived burning pruritus [31].
• After 1.5 million units s.c. of IFN-alpha 2b every second day for 2 weeks, pruritus and serum IgE levels diminished markedly (48,000 IU/ml) [32].

Analytical, diagnostic and therapeutic context of Pruritus

• We undertook a 10-week placebo-controlled, double-blind, crossover study in a group of patients receiving hemodialysis who had severe pruritus, to investigate the effects of recombinant human erythropoietin on their pruritus and plasma histamine levels [2].
• The current report describes two cases of severe, prolonged cholestasis after treatment with trimethoprim sulfamethoxazole; intractable pruritus and abnormal liver test results lasted for 1-2 years after discontinuation of the drug [33].
• BACKGROUND AND AIMS: Progressive familial intrahepatic cholestasis (PFIC) is characterized by pruritus, intrahepatic cholestasis, low serum gamma-glutamyltransferase levels, and characteristic "Byler bile" on electron microscopy [34].
• However, with immunofluorescence, the reactivity strictly paralleled that of antimitochondrial antibodies in only one of these (1:640)--a sibling with mild pruritus and a liver biopsy specimen diagnostic of primary biliary cirrhosis despite normal levels of serum alkaline phosphatase [35].
• Pantoprazole appears to be well tolerated during short term oral administration, with diarrhoea (1.5%), headache (1.3%), dizziness (0.7%), pruritus (0.5%) and skin rash (0.4%) representing the most frequent adverse events [36].

References