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Extracorporeal artificial liver support systems in the management of intractable cholestatic pruritus
Author(s) -
Fuhrmann Valentin,
Drolz Andreas,
Trauner Michael
Publication year - 2011
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/j.1478-3231.2011.02584.x
Subject(s) - cholestasis , bile acid , medicine , serotonin reuptake inhibitor , sertraline , extracorporeal , fluoxetine , plasmapheresis , gastroenterology , pharmacology , serotonin , antidepressant , receptor , antibody , hippocampus , immunology
Pruritus can occur as a severe complication of cholestasis. Several hypotheses suggest an important role for the accumulation of bile acids, endogenous opioids and – mire recently – lysophosphatidic acid. Bile acid sequestrants are the first‐line therapeutic agents. In refractory cases, a stepwise approach using rifampicin, oral opiate antagonists and the selective serotonine reuptake inhibitor sertraline should be tested. Recent case series reported effective relief of pruritus using extracorporal liver support systems and plasmapheresis.