Relief of pruritus and decreases in plasma histamine concentrations during erythropoietin therapy in patients with uremia
Article Abstract:
Treatment with recombinant (genetically engineered) human erythropoietin may decrease pruritus, or itching, and blood histamine levels in patients with end-stage kidney disease. Of 20 patients with end-stage kidney disease who were undergoing kidney dialysis, 10 had severe pruritus and 10 did not have pruritus. These patients were treated with 36 units per kilogram of body weight of erythropoietin three times per week for five weeks, and with a placebo, an inactive substance, for five weeks. Eight of the 10 patients with pruritus had a marked decrease in pruritus during treatment with erythropoietin, but their pruritus returned within one week after finishing their treatment. Patients with pruritus had higher blood levels of histamines than patients without pruritus or healthy individuals. Treatment with erythropoietin decreased blood levels of histamines in both patients with pruritus and those who did not have pruritus. In patients who had pruritus, recurrence of pruritus was accompanied by an increase in blood levels of histamines. Elevated blood levels of histamines may cause pruritus in patients with end-stage renal disease.
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 1992
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The pruritus of cholestasis and the opioid system
Article Abstract:
Opiate antagonists may be an effective treatment for severe pruritus, or itching, caused by cholestasis. Cholestasis is a condition characterized by obstruction of the bile ducts and the accumulation of bile in the liver. Pruritus is a common symptom of different liver diseases, especially those caused by cholestasis. It may be caused by increased activity of the opioid system, a physiological system that mediates the body's sensitivity to pain. A 52-year-old women developed severe and intractable pruritus after being diagnosed with liver disease one year earlier. The patient experienced relief from itching during short term treatment with intravenous naloxone and long-term treatment with oral nalmefene, two opiate antagonists. Side effects of treatment with nalmefene included psychological symptoms characteristic of opiate withdrawal.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1992
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Uremia
Article Abstract:
The pathogenesis and course of uremia, the illness accompanying kidney failure caused by unidentified accumulation of organic waste products is reviewed. Further research is required to understand the uremic solutes and their toxic effects better that would provide an effective treatment therapy other than dialysis and kidney replacement.
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 2007
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