Hepatic pruritis

Ugeskr Læger 2006;168(8):776-9

Pruritus is a key symptom of hepatic disease. In severe cases, this symptom ruins the patient's quality of life. Most likely it is caused by a protein-bound bile acid (metabolite) that stimulates opioid receptors in the brain. Symptomatic treatments that can reduce pruritus in selected patients include opioid receptor antagonists, biliary diversion, cholestyramine, ursodeoxycholic acid, rifampicin and phenobarbitone. Plasmapheresis or albumin dialysis may be useful when other treatment fails.