- 作者：Sofie Decock ; Rik Roel ; ts ; Werner Van Steenbergen ; Wim Laleman ; David Cassiman ; Chris Verslype ; Johan Fevery ; Jos Van Pelt ; Frederik Nevens
- 关键词：Pruritus ; Cholestasis ; UVB ; Phototherapy ; Autotoxin
- 刊名：Journal of Hepatology
- 出版年：2012
- 出版时间：September, 2012
- 年：2012
- 卷：57
- 期：3
- 页码：637-641
- 全文大小：569 K
Background & Aims
Pruritus is a disabling complication of cholestatic liver disorders. Its management remains challenging. Ultraviolet B (UVB) phototherapy has been successfully used to treat pruritus in other indications.Methods
This is an observational case series. The study population consists of 13 patients (10 females, mean age 52 years) with pruritus due to different cholestatic liver disorders: PBC (n = 4), PSC (n = 2), drug-induced (n = 3) and persistent cholestasis after liver transplantation (LT) (n = 4). Serum alkaline phosphatase levels were: 686 ¡À 363 ¦Ì/L and serum bile acids levels: 147 ¡À 15 ¦Ìmol/L. In all patients, conventional medical treatment had failed to control pruritus. Perception of pruritus was recorded by the visual analogue scale (VAS).
Results
The mean follow-up was 3 years. Ten patients (77 % ) had more than 60 % reduction in perceived pruritus of which 4 had more than an 80 % reduction. Median [25-75 % percentiles] VAS score before and after treatment decreased from 8.0 [8.0-10] to 2.0 [1.5-2.1] (p <0.001). The mean number of irradiations required to obtain this effect was 26 ¡À 17 (average duration of phototherapy: 8 weeks). No significant changes in cholestatic serum markers were observed. Four patients (30 % ) needed an additional phototherapy course because of recurrent pruritus and in all of them again a marked improvement of pruritus was observed. The therapy was well tolerated, except in two patients who developed, during retreatment, pronounced erythema in one case and paresthesia in the other case.
Conclusions
UVB phototherapy appears to be a promising and well tolerated treatment also for cholestasis-associated pruritus.