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)

The results of hemoperfusion through a suspension of cryoconserved hepatocytes in 21 patients with severe hepatic insufficiency are analysed. It is shown that the manipulation had a beneficial effect on the clinical and biochemical indices, which was manifested by diminished jaundice and skin pruritus, increased physical activity, improved appetite; reduced levels of bilirubin, transaminase, alkaline phosphatase, bile acids, and cholesterol. The information gained is evidence that the method can be included in the complex treatment of patients with severe hepatic insufficiency.
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PMID:[Treatment of severe hepatic insufficiency by perfusion of patients' blood through a suspension of cryopreserved hepatocytes]. 233 79

Primary biliary cirrhosis (PBC) or chronic non-suppurative destructive cholangiohepatitis is rare in southern Africa. Eight patients with this diagnosis were identified and fully investigated at Groote Schuur Hospital between 1980 and 1988. Seven patients were female, all were white or coloured, and their ages ranged from 49 years to 80 years. All patients presented with a history of malaise, fatigue, night sweats and pruritus, which had been present for 3 months--12 years before diagnosis of PBC. Initial misdiagnosis had resulted in unnecessary invasive investigations including laparotomies. Signs of chronic liver disease, such as xantholasmas, evidence of pruritus, the sicca syndrome or hepatomegaly, were invariably present. Marked elevation of serum alkaline phosphatase level and IgM were present in all cases. Antimitochondrial antibodies were positive in significant titre in 7 of the 8 patients. Liver biopsies demonstrated stage II-III disease in all patients. Therapy was chiefly supportive and symptomatic although most patients received immunosuppressive agents. Despite the late presentation, the subsequent course was similar to that seen elsewhere where patients are recognised earlier.
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PMID:Primary biliary cirrhosis. A retrospective survey at Groote Schuur Hospital, Cape Town. 236 77

We report four cases of severe delayed cholestatic hepatitis induced by flucloxacillin. All patients presented with deep jaundice and pruritus which developed soon after ceasing flucloxacillin. Liver function tests were abnormal in all patients with markedly elevated serum bilirubin concentration, alkaline phosphatase and aspartate transaminase levels. Extrahepatic biliary obstruction and infective hepatitis were excluded in all cases. Liver biopsies showed centrilobular cholestasis with portal and lobular inflammation and eosinophil infiltration. Although symptoms resolved within six weeks in all patients, cholestatic liver function tests have persisted in two patients for more than six months. With the increasing usage of this drug and the delayed presentation of cholestasis, flucloxacillin needs to be considered in the differential diagnosis of all patients presenting with cholestatic jaundice.
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PMID:Flucloxacillin induced delayed cholestatic hepatitis. 237 76

Fourteen patients with sclerosing cholangitis underwent percutaneous cholangioplasty and stent placement with balloon-angioplasty and biliary-drainage catheters. There was initial clinical improvement in 13 of the 14 patients; one patient did not improve and died 1 month after the procedure. One of the 13 survivors developed encephalopathy and received a liver transplant 9 months after cholangioplasty; during the 9 months before transplantation, serum bilirubin and alkaline phosphatase levels returned to normal, and pruritus decreased. Restenosis of a duct following stent removal prompted repeat cholangioplasty in five of the 13 patients. Four of these five patients benefited from repeat cholangioplasty, and the fifth underwent liver transplantation 10 months after the second cholangioplasty. The other seven of the 13 survivors became either asymptomatic (n = 3) or less symptomatic than before cholangioplasty (n = 4) and did not require repeat cholangioplasty or liver transplantation during 10-42 months of follow-up.
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PMID:Sclerosing cholangitis: palliation with percutaneous cholangioplasty. 246 61

Dimetindene (active principle of Fenistil) belongs to the group of H1-antihistamines which are used in the treatment of allergic disorders. An experimental approach was made to clarify the risk of dimetindene application during the conditions of an impaired liver function as a consequence of extrahepatic cholestasis (bile-duct ligation). Acute and subchronic treatment with dimetindene (1 and 10 mg/kg p.o., respectively) did not enhance the effect of cholestasis on the parameters of liver function (plasma bile acids, glutamate pyruvate transaminase (GPT), alkaline phosphatase) or kidney function (creatinine, urea retention in plasma). It is concluded that the use of dimetindene in the treatment of pruritus during cholestasis is without notable risk.
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PMID:[The effect of dimetindene on liver and kidney function in the cholestatic rat]. 261 78

Altogether 108 patients with acute alcoholic hepatitis (AAH) were examined. Of these, 14 patients (13%) presented with the cholestatic pattern of AAH, 45 with extrahepatic cholestasis, and 45 were healthy. As compared with the total patients' group with AAH, the patients with the cholestatic form consumed alcohol in greater amounts. Due to intensive jaundice, 50% of the patients were admitted by error to the infectious clinic and 32% to the surgical one. The disease runs a comparatively grave course, the general conditions gets deteriorated, the body temperature rises, the patient senses pains in the right hypochondrium, skin pruritus is lacking. As compared with other patterns of cholestasis, cholestatic AAH is characterized by a higher thymol test, higher levels of cholesterol, low density lipoproteins, activation of gamma-glutamyl transpeptidase and aspartate aminotransferase and by a lower level of leukocytes, bilirubin, free fatty acids and alkaline phosphatase. Verification of the diagnosis demands the use of certain up-to-date instrumental methods. To identify the cause of cholestasis, great diagnostic significance is attached to echography.
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PMID:[Clinico-laboratory characteristics of the cholestatic form of acute alcoholic hepatitis]. 263 92

The study includes 108 patients with acute alcohol hepatitis, 45 patients with cholestasis and 124 healthy controls. In 14 patients (13%) cholestatic acute alcohol hepatitis was found. The patients with cholestatic acute alcohol hepatitis consumed considerably more alcohol than the other patients with acute alcohol hepatitis. The intensive jaundice led half of the patients with cholestatic acute alcohol hepatitis to the infectious diseases clinic and 32% of them to the surgical clinic. The course of the disease was heavy, with disturbed general condition, high temperature, pain in the right subcostal region but without itching. The patients showed higher levels of timol test, cholesterol, LDL-cholesterol, coefficient LDL/HDL-cholesterol, beta-lipoproteins, total lipids, gamma-GTP, ASAT and lower levels of leucocytes, bilirubin, SMC, alkaline phosphatase and LAP than the other patients with cholestasis. The patients with cholestatic acute alcohol hepatitis showed a higher level of total lipids and gamma-GTP than the other patients examined. The confirmation of the diagnosis implies the application of contemporary instrumental and invasive methods. The ultrasound examination is of special importance.
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PMID:[The clinico-laboratory characteristics of the cholestatic form of acute alcoholic hepatitis]. 263 77

Cholestatic syndromes present symptomatically with pruritus and biochemically either with elevated levels of serum bile acid as an early manifestation of hepatocellular disease or with elevated levels of serum alkaline phosphatase if the disease originates in the biliary tree. Slow progression to cirrhosis occurs, with recurrent cholangitis and/or pancreatitis as the major problems if the obstruction is in the larger duct system. Maintenance of nutrition and relief of pruritus are important supportive measures. Colchicine and ursodeoxycholic acid administered orally have been proposed as useful therapies for delaying the progression to cirrhosis. Liver transplantation has proven successful in those patients in whom spontaneous remission does not occur.
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PMID:Cholestatic liver disease and its management. 265 62

Primary biliary cirrhosis is a chronic liver disease of unknown etiology characterized by slowly progressive intrahepatic cholestasis due to an inflammatory destruction of small intrahepatic bile ducts. The clinical course of PBC is variable ranging from a few years in rapidly progressive cases to a normal life-expectancy in a proportion of asymptomatic cases. The typical patient is a middle-aged woman who may present with pruritus, increasing pigmentation of the skin, and eventually jaundice. The level of serum alkaline phosphatase is almost invariably elevated, serum mitochondrial antibodies are present in more than 90 per cent, and an elevated serum IgM is usually present. PBC is associated with many immunologic abnormalities and appears to be a classic autoimmune disease. Some of the immune defects may be epiphenomena; others such as a marked defect in suppressor T cell function seem to be related to the pathogenesis of the disease. All drug therapy that is aimed at slowing the disease process is experimental. A place for immunosuppressive drugs in the management of PBC would be anticipated. However, no drug has to date been definitively shown to have a beneficial effect on the disease. Currently, the main treatments used are aimed at preventing or correcting the complications of intractable cholestasis. Patients with PBC and evidence of hepatic decompensation and/or poor quality of life make good candidates for liver transplantation. The current aim of therapy is to find an effective regime of immunosuppression that will make hepatic transplantation redundant for this disease.
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PMID:Primary biliary cirrhosis. 265 67

Twenty three patients with primary biliary cirrhosis surviving for greater than 1 yr after liver transplantation were studied. All reported marked symptomatic improvement, and had significant falls in serum bilirubin, alkaline phosphatase (p less than 0.0001), immunoglobulin M, and antimitochondrial antibody levels (p less than 0.005). Beyond 1 yr, liver biopsies showed features compatible with disease recurrence in 9 of 10 patients, and a further 4 patients developed pruritus or associated abnormalities. Immunoglobulin M levels were raised in 80%, with elevated antimitochondrial antibody titers in all those tested. Cyclosporine treatment in some patients initially given prednisone and azathioprine was followed by regression of histologic abnormalities. Of 102 patients with nonprimary biliary cirrhosis followed similarly, 50 underwent biopsy, and although 12 showed features of bile duct damage, all had additional histologic and clinical changes supporting an alternative diagnosis. These findings are consistent with previous reports that primary biliary cirrhosis can recur after transplantation, possibly modified by the use of cyclosporine.
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PMID:Evidence for disease recurrence after liver transplantation for primary biliary cirrhosis. Clinical and histologic follow-up studies. 266 53


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