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)

Thirty-five patients with advanced cancers were treated with estramustine phosphate tablets (Estracyt). Doses ranged between 420 mg and 700 mg daily. One partial response was documented in a hormone resistant prostatic cancer patient. Four minor responses (less than 50% responses, or less than one month more than 50% response) were obtained; one in a hormone resistant prostatic cancer, two in metastatic colorectal cancers; and another in a malignant melanoma. Toxicity phenomena included nausea (9/35 - 25%), water retention (4/35 - 11.5%) and mild elevation of alkaline phosphatase (2/35 - 6%). Other toxicity effects were vaginal bleeding in two women, acne in one woman and mild pruritus in another patient. Myelosuppression and immune suppression were not significantly detected.
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PMID:Oral estramustine phosphate (Estracyt): a broad phase II study. 659 4

Parathyroidectomy was carried out in 26 patients over a 14-year period. Excellent results were obtained in patients with severe hyperparathyroidism. Vascular calcification, hypercalcaemia and pruritus did not justify surgery unless associated with unequivocal hyperparathyroidism. 13 patients required intravenous calcium infusion for up to 2 weeks to control post-operative hypocalcaemia. Calcium requirements could be predicted from the pre-operative plasma alkaline phosphatase level. Following operation continued treatment with vitamin D was necessary to prevent hypocalcaemia. Hyperparathyroidism recurred in 1 patient after 8 years and 4 patients developed osteomalacia. Since parathyroid hormone may have toxic effects other than those on bone, maintenance of normal levels should be a long-term objective in the treatment of patients with chronic renal failure. Where large parathyroid glands are present, surgical reduction in gland mass is a logical prelude to long-term suppression of parathyroid hormone with vitamin D and phosphate-binding agents.
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PMID:Parathyroidectomy in chronic renal failure. 668 30

This is a retrospective review of 233 patients who had surgical exploration for proven or suspected malignant lesions of the exocrine pancreas and periampullary structures. There were 24 patients with carcinoma of the ampulla or duodenum, 12 with carcinoma of the bile duct, and 197 with lesions of the pancreas. Among the latter group, 128 patients had carcinoma diagnosed at initial operation (31 by duodenopancreatectomy, 33 by liver, and 64 by other biopsies), and 69 patients had suspected carcinoma of the pancreas without histological proof. History of jaundice, pruritus, nausea/vomiting, total weight loss, duration of pain, and values of blood urea nitrogen, bilirubin, alkaline phosphatase, and albumin were significantly different among the various groups. Patients who had resection of carcinoma of the duodenum or ampulla had the best 5-year survival rate (39 +/- 12%). Among patients with resectable or nonresectable carcinoma of the pancreas, some of the symptoms and laboratory tests studied had prognostic significance.
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PMID:Clinical and laboratory findings of carcinoma of the pancreas and periampullary structures. 669 85

This paper presents a case of a patient who developed a severe illness with marked jaundice after 1 cycle of oral contraceptives (OCs). Although effects on liver physiology are a frequent but clinically insiginificant consequence of OC use, major hepatic dysfunction with clinically apparent jaundice occurs rarely. This patient's illness was manifest initially by pruritus and later was characterized by marked jaundice with mild to moderate transaminase and alkaline phosphatase elevations. Serologic studies for hepatitis and primary biliary cirrhosis were negative, and extrahepatic biliary obstruction was excluded by cholangiography. Liver biopsy revealed cholestasis without features of hepatitis. The patient, 22 years of age, has shown gradual resolution of jaundice and pruritus and normalization of liver tests over a 12-month period. OC-induced cholestasis appears to be associated primarily with the estrogen component of OCs, although the progeston component may enhance the cholestatic effects of the estrogen. This case demonstrates that, although typically benign, OC jaundice may occasionally be manifest by a severe and lengthy clinical illness. Since patients with prior jaundice of pregnancy often experience a recurrence of cholestatic symptoms if OC use is resumed, OC use should be avoided in such cases.
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PMID:Severe and prolonged oral contraceptive jaundice. 671 53

Primary biliary cirrhosis is a disease where small intra-hepatic bile ducts are destroyed as a result of an immunological reaction, presumably by cytotoxic T-lymphocytes on biliary epithelium. Analogies can be made to the graft-versus-host reaction. Hepatic copper retention is secondary to cholestasis. A circulating mitochondrial antibody is virtually constant. A mitochondrial antibody, specific for primary biliary cirrhosis, has been identified. Liver biopsy appearances have been staged but there are difficulties because of the varying rte of evolution in different parts of the liver, the focal nature of the changes and the lack of correlation with the clinical picture. Other diagnostic criteria include female sex, raised serum alkaline phosphatase values and various associated diseases. Many patients are now diagnosed when presymptomatic and such patients, particularly with granulomas in the liver, may have a normal life expectancy. General therapeutic measures include control of pruritus and prevention of fat soluble vitamin and calcium deficiencies. There is no specific treatment but D-penicillamine is useful in the later stages and prolongs survival. The prognosis in those with progressive jaundice is very poor.
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PMID:Primary biliary cirrhosis: critical evaluation and treatment policies. 675 Aug 30

From 1975 to 1981 total parathyroidectomy and parathyroid autotransplantation were carried out in 62 patients for renal (secondary) hyperparathyroidism. The paper reports on 46 patients followed for one to six years (mean 2.2 +/- 1.2 years). Forty-one were on chronic hemodialysis, three were predialytic, two had a functioning renal graft. There have been two different groups of indications: one in which hypercalcemia was the main reason for surgery (59%), the other in which severe renal osteopathy (bone pain, radiologic and histologic signs, elevation of alkaline phosphatase, and parathyroid hormone) was observed. Among 45 patients not previously operated on for hyperparathyroidism, five parathyroid glands were removed in three patients, four glands were removed in 36 patients, and three glands were removed in five patients. In one patient previously operated (thyroid surgery), two glands were removed. Tissue was immediately autografted into a forearm muscle. One patient (two glands removed) received a cryopreserved tissue six months after neck exploration. An improvement of bone pain, pruritus, and radiologic signs of renal osteopathy was noted in about 80% of patients. At one to six years no patient was hypercalcemic, in 44 patients the grafted tissue was functioning normally after an average time of 5.8 +/- 1.4 months. One patient is still on low-dose, supplemental therapy for slight hypocalcemia 14 months after autotransplantation. In another patient a part of the grafted tissue was removed for increasing parathyroid hormone levels. Serum concentration of alkaline phosphatase and serum parathyroid hormone decreased after surgery. One- to six-year results after total parathyroidectomy and autotransplantation for renal hyperparathyroidism are considered to be extremely satisfactory.
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PMID:Total parathyroidectomy and autotransplantation of parathyroid tissue for renal hyperparathyroidism. A one- to six-year follow-up. 684 57

Studies of 14 North American Indian children with a familial type of severe neonatal cholestasis are described. Jaundice occurred during the neonatal period in 9 children, but disappeared before the end of the 1st yr. Progressive liver damage was documented by the persistence of high levels of alkaline phosphatase, moderate elevation of transaminases, and severe pruritus. Serum bile acids were constantly elevated (3.0-119.5 microgram/ml). Early portal hypertension and variceal bleeding necessitated portal-systemic shunts in 7 children. By light microscopy, the early stage was characterized by hepatitis with giant-cell transformation and biliary stasis. Later on, portal fibrosis became evident and was followed by cirrhosis. By electron microscopy bile canaliculi appeared slightly dilated with preservation or only partial loss of microvilli. They were surrounded by a prominent pericanalicular filamentous web. Immunofluorescence studies indicated the presence of action-containing microfilaments. This group of children might represent a human model of microfilament dysfunction-induced cholestasis.
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PMID:Severe familial cholestasis in North American Indian children: a clinical model of microfilament dysfunction? 689 6

Nineteen patients suffering from the intrahepatic cholestasis (IHC) of pregnancy were studied. Twelve of them were treated with phenobarbital (100 mg/day) and seven with cholestyramine (18 g/day). The overnight fasting levels of serum cholic acid (CA), chenodeoxycholic acid (CDCA) and deoxycholic acid (DCA) were measured by radioimmunoassay. The activities of serum transaminases, gamma-glutamyltranspeptidase, alkaline phosphatase and total and conjugated bilirubins were also analyzed. It was found that there was no correlation between the itching symptom and the serum bile acid levels. During phenobarbital treatment serum bile acid concentrations did not change. Also, the other measured parameters as well as the CA/CDCA ratio did not change significantly. Transaminases had, however, a slight tendency to decrease. The therapy successfully relieved itching in half of the cases. There was no relationship between the relief of the itching and the change in the bile acid concentrations. Cholestyramine treatment did not decrease the CA level significantly, but that of the CDCA decreased (P less than 0.05) and the ratio of CA/CDCA increased (P less than 0.05). In the other analyzed liver function test results, an increase (P less than 0.05) occurred only in the concentrations of conjugated bilirubin. The itching was relieved in five of the seven cases during the first week of treatment, but after that the symptom tended to reappear. There was a slight correlation between the decrease in the CDCA level and in the relief of the itching. The two drugs did not cause any particular side effects.
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PMID:Serum bile acid levels in intrahepatic cholestasis of pregnancy during treatment with phenobarbital or cholestyramine. 716 May 24

The authors report the cases of 4 patients with jaundice following the administration of ajmaline. The disease had a pseudo- angiocholitic onset with fever, chills and pruritus in the 4 patients and abdominal pains in 2 patients. Serum transaminase activity and serum alkaline phosphatase activity were increased in the 4 patients. Blood eosinophilia was found in 3 patients. Liver lesions included predominantly centrilobular cholestasis, mild hepatocytic lesions, and portal inflammation. After the interruption of the drug administration, recovery occurred in the 4 patients. Two patients resumed the intake of ajmaline; transient hepatitis recurred in these 2 patients.
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PMID:[Hepatitis due to ajmaline. Report of cases and review of the literature]. 718 70

Four cases of chronic active hepatitis with cholestasis resembling primary biliary cirrhosis are reported. Two patients were women and two were men; their age ranged from 18 to 52 years. They had recurrent jaundice with pruritus, and, in two cases, xanthelasma or xanthomas. All patients had hyperbilirubinemia, a moderate increase in serum aspartate aminotransferase activity, an increase in serum alkaline phosphatase activity and immunoglobulins G levels. Hepatitis B surface antigen was present in one patient. Histological examination of the liver revealed active chronic hepatitis with cholestasis. Moderate doses of prednisone had no effect on clinical or biochemical signs in any of the patients.
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PMID:[Ineffectiveness of corticosteroids in cholestatic forms of chronic active hepatitis]. 718 71


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