Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0033774 (pruritus)
 14,546 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Fifteen patients with cholestatic disorders were treated for 1 to 5 months with phenobarbital. Primary biliary cirrhosis was diagnosed in seven, sclerosing cholangitis in two, intrahepatic biliary hypoplasia in three, and cholestatic hepatitis in three. Except for the patients with cholestatic hepatitis, in whom marked cholestasis was virtually the only abnormality in liver biopsy specimens, serum bilirubin and bile acid concentrations were diminished during therapy, the hepatic clearance of sulfobromophthalein and 131-I-rose bengal was variably enhanced, and there was relief from pruritus. Serum cholesterol concentrations and other measures of hepatic function were not significantly changed during therapy except for serum alkaline phosphatase activity, which rose in twelve patients. Parallel changes occurred in 5'-nucleotidase, suggesting a hepatic origin for the alkaline phosphatase activity. These studies indicate that phenobarbital therapy is associated with improvement in organic anion clearance in some patients with cholestatic disorders and may be beneficial to such patients.
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PMID:Phenobarbital effects in cholestatic liver diseases. 111 64

Problems of pregnancy in patients with liver disease are discussed. The effects of pregnancy on the disease course are generally limited to triggering of intensifiying icterus and pruritus; intrahepatic cholestasis may also occur. Increased incidences of miscarriage and prematurity have been reported in patients with liver cirrhosis, chronic hepatitis, cholestasis, and Dubin-Johnson syndrome, which is hereditary, and viral hepatitis in early pregnancy (increased incidence of chromosome abnormalities). Liver diseases constitute a relative indication for abortion, depending on the general state of the mother's health and her desire for the child. Problems of diagnosis and treatment are also considered.
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PMID:[Pregnancy in liver diseases]. 112 34

7 cases of pruritus in pregnancy are reported and their laboratory findings compared with a group of normal pregnant women; then pruritus is reviewed with respect to diagnosis, pathogenesis, therapy, and prognosis. The 7 women developed pruritus in 28-38 weeks of typically the 2nd pregnancy, although during oral contraception in 1 woman. The frequency was about 2/1000 pregnancies. Lab findings suggestive of cholestasis included normal prothrombin, elevated transaminaes, alkaline phosphatase, total bilirubin, total cholesterol, and slowed BSP clearance. None of these women had any history of hepatitis, medication, or positive Australia antigen. It is important in diagnosis to rule out infections, toxic or iatrogenic hepatitis, and especially herpes gestationis, which is teratogenic. Pruritus of pregnancy is identical to that seen during oral contraception, i.e., it is a less severe form of cholestatsis than jaundice. It can be treated with cholestyramine, or will regress spontaneously after delivery, but may cause prematurity.
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PMID:[Significance of pruritus during pregnancy. Relations with the hepatic disorders of gestation]. 113 31

The influence of cholestasis of pregnancy (CP) on liver lipid synthesis as reflected by the composition of serum phosphoglycerides was studied in 28 pregnant women in the last trimester by means of gas-liquid-chromatography (GLC). All patients complained of pruritus and had immunologically detectable lipoprotein-X (LP-X) in serum. Twenty women with uncomplicated pregnancies served as a control series. In lecithin, low palmitic acid (16:0) and high oleic acid (18:1 (n-9)) were found which appear to be characteristic for CP. The increased oleic acid suggests an enhanced liver lecithin synthesis through the cytidine-diphosphate diglyceride pathway. Measurement of the concentrations of lecithin from the gas-liquid-chromatograms was made possible by the use of an internal standard fatty acid added, which gave a linear relation to direct determination of lecithin. For further studies of influences of cholestasis of pregnancy on the relative fatty acid composition, lecithin was chosen because differences between lecithin (PC) and phosphoglycerides (GPL) were found, evidently due to mutual variations among the three components in GPL (lecithin, cephalin and lysolecithin).
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PMID:Studies in cholestasis of pregnancy. III. Fatty acid composition of serum phosphoglycerides. 116 16

The development of the syndrome of chronic intrahepatic cholestasis in five young, black men who had systemic granulomatous disease and clinical features consistent with those of sarcoidosis is described. Clinical and biochemical aspects, similar to those of primary biliary cirrhosis, included pruritus, jaundice, hepatomegaly and striking elevations of serum levels of alkaline phosphatase and cholesterol. (One patient had skin xanthomas.) Mitochondrial antibodies were not found; and survival of the patients (7 to 18 years) exceeded the usual survival of patients with primary biliary cirrhosis. The histologic abnormalities included noncaseating granulomas, chronic intrahepatic cholestasis, increased copper in hepatocytes, progressive diminution in number of interiobular bile ducts, periportal fibrosis and the eventual development of a micronodular "biliary" cirrhosis. The histologic evolution of the disease suggests a slow, progressive destruction of the bile ducts by granulomas. Although the end stage of this syndrome resembles primary biliary cirrhosis, the characteristic nonsuppurative, destructive cholangitis of primary biliary cirrhosis was not present.
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PMID:Chronic intrahepatic cholestasis of sarcoidosis. 116 46

Pregnant women with pruritus and with cholestasis of pregnancy verified from the medical history and by the presence of lipoprotein-X in serum have been studied. Thirty-nine patients were investigated for serum lipids (cholesterol, phospholipids, and triglycerides), serum lipoproteins (high-density-lipoproteins cholesterol and estimated low-density-lipoproteins cholesterol), and for hematological data (serum iron and serum iron binding capacity), in relation to duration of pruritus. In 28 patients the serum lecithin concentrations and fatty acid compositions were also analysed. Severity and duration of the disease appeared to influence the lipid/lipoprotein metabolism. The results support the hypothesis of an abnormal reaction of liver metabolism to estrogens in the initial stage of cholestasis of pregnancy.
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PMID:Studies in cholestasis of pregnancy. IV. Serum lipids and lipoproteins in relation to duration of symptoms and severity of the disease, and fatty acid composition of lecithin in relation to duration of symptoms. 119 99

Anion exchange resins form a non-absorbable complex with bile acids in the intestine, thus removing bile acids from the enterohepatic circulation and facilitating bile acid excretion in the faeces. A new bile acid sequestrant (PDX chloride, Secholex) was evaluated for the relief of pruritus in cholestasis of pregnancy (CP) in 31 women. CP was verified by the presence of the abnormal lipoprotein X in serum and the clinical series was divided into two degrees of severity, pruritus gravidarum (PG) and hepatosis of pregnancy (HP) based on liver function tests. Eleven of 31 women discontinued treatment because of gastro-intestinal side effects. Of the 20 women continuing the study for more than one week, all with a milder form of cholestasis, PG (n=8), experienced relief of pruritus, while some relief was obtained in 75% of the women with HP. After up to 4 weeks administration of Secholex, no obvious interference with fat absorption was evident judging from the serum lecithin content of linoleic and arachidonic acids. A reduction in serum folic acid might indicate an interaction in folic acid absorption. An expected reduction in serum cholesterol levels which are characteristically increased in CP, was not achieved by the administration of Secholex.
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PMID:Treatment of pruritus in cholestasis of pregnancy with a new anion exchange resin (Secholex). 119 2

Clinical and laboratory findings from 15 patients with icteric viral hepatitis during pregnancy (VHP) and from 22 patients with intrahepatic cholestasis during pregnancy (CJP) were evaluated statistically in order to find out which parameters might help in order to find out which parameters might help in differentiating the two diseases. Diagnosis was established by needle liver biopsy in all cases. The following data were considered: history, physical examination, erythrocyte sedimentation rate (ESR) serum cholesterol, prothrombin time, total serum bilirubin, SGOT, SGPT, serum alkaline phosphatase, serum protein, serum flocculation tests, BSP blood clearance and serum HB Ag. Vomiting, high GOT and GPT serum levels, and serum HB Ag positivity suggest VHP diagnosis. Otherwise a severe itching with scratching lesions, high ESR, elevated total cholesterol and serum alkaline phosphatase values mainly if occurring in the later stage of pregnancy are consistent with CJP diagnosis. When clinical and laboratory data from a jaundiced pregnant female do not allow diagnosis, this can be established only on the basis of needle liver biopsy.
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PMID:The differential diagnosis between intrahepatic cholestatic jaundice and viral hepatitis during pregnancy. 122 May 7

Report of a 10-year-old boy with congenital hypoplasia of the intrahepatic bile ducts, the socalled MacMahon-Thannhauser-Syndrome. The patient had been suffering from a varying degree of jaundice since his 2nd day of life and from pruritus since his 21st month of life. Furthermore, he had hepatomegaly, a systolic cardiac murmur, hypogenitalism, retarded growth, and finally hypertension. Transitory xanthomas existed between 1 3/4 and 2 3/4 years of age. Signs of persistent intrahepatic cholestasis was manifested by increased levels of bilirubin and bile acids in serum as well as raised activities of leucine aminopeptidase, gamma-glutamyl transpeptidase and alkaline phosphatase. Pathological values of serum glutamic dehydrogenase pointed to a persistent destruction of liver cells. Without treatment, the activities of vitamin K dependent clotting factors were decreased. Cholesterol, phosphatides and triglycerides in serum were increased and lipoprotein-X was detectable. Aortography revealed stenosis of both renal arteries. An exploratory laparotomy and 5 liver biopsies led to the diagnosis of hypoplasia of the intrahepatic bile ducts. Therapeutic trials with steroids and the anion exchange resin "cholestyramine" were ineffective. Phenobarbital relieved the pruritus. Parenteral administration of fat soluble vitamins restored the activity of vitamin K dependent clotting factors to normal. The high blood pressure fell significantly due to treatment with adelphan. The etiology of hypoplasia of the intrahepatic bile ducts is unknown. It may be a malformation or an obliteration secondary to inflammation. In our patient, narrowing of the renal arteries, increase of plasma-renin activity and hypertension were probably secondary to hyperlipidemia. It has been suggested that hyperlipemia secondary to cholestasis may be due to a disturbance of lipoprotein metabolism. A review of reports on 118 patients suffering from intrahepatic bile ducts hypoplasia is included.
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PMID:[Hypertension and bilateral stenosis of the renal artery associated with congenital hypoplasia of the intrahepatic bile ducts (author's transl)]. 124 84

In two patients intrahepatic cholestasis and cholestatic liver disease probably due to N-propyl ajmaline were observed. In both cases there was a four-week-interval between the first ingestion of the drug and the onset of jaundice. In one case with rigors there was a temporary rise in temperature and cholestasis. In the other there was a two to three week prodromal period of pruritus and gastro-intestinal symptoms. Both cases were characterised by blood and pronounced tissue eosinophilia in the periportal zones, a marked increase of cholestatic and hepatic cell enzymes, serum bilirubin and cholesterol, a moderate increase in erythrocyte sedimentation rate and absence of leucocytosis. Pathological laboratory findings returned to normal spontaneously within 5 weeks in one case and within two weeks under steroid therapy in the other.
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PMID:[Intrahepatic cholestasis due to N-propyl ajmaline]. 126 1


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