Histamine Metabolism in Polycythaemia Vera

Abstract

Histamine metabolism was studied in 35 patients with polycythaemia Vera (PV) at different stages of their disease and compared with controls and patients with secondary polycythaemia. In addition to blood and urinary histamine the main urinary metabolites of histamine, methylhistamine (MeHi) and 1-methyl-4-imidazoleacetic acid (MeImAA) were measured. In patients with active PV the excretion of MeHi and MeImAA was significantly higher than in controls and secondary polycythaemia, indicating an increased histamine formation. The MeImAA excretion was correlated to the blood histamine level, the degree of blood basophilia, the total white blood count and the spleen volume. The blood histamine level was significantly higher in PV patients compared with controls and secondary polycythaemia. No patients with secondary polycythaemia had an increased blood histamine level. With the bio-assay technique used in this study the urinary excretion of histamine in the PV patients was within the normal range. There was no correlation between the increased hstamine formation and 'histaminerelated symptoms'. Pruritus and duodenal ulcer occurred with a similar frequency in patients with and without increased MeImAA excretion. The similarity between the disturbance of the histamine metabolism in PV and that found by other authors in chronic myeloid leukaemia is pointed out.

The JAK2V617 mutation induces constitutive activation and agonist hypersensitivity in basophils from patients with polycythemia vera

“…32 This symptom can antedate diagnosis or appear during the course of the disease; it is poorly responsive to phlebotomy or myelosuppressive therapy, while interferon-α, 33.34 or selective serotonin reuptake inhibitors 35 can be successful. Pruritus has been associated with iron deficiency, 36 high leukocyte count, 36 platelet activation, 35 histamine release, 37,38 infiltration of the derma by mononuclear cells and eosinophils, 39 and degranulation of dermal mast cells, 39,40 but the underlying mechanisms remain substantially obscure. Furthermore, we, like others, found that pruritus was more common among patients harboring a greater than 50% V617F allele burden; 26,27,41 accordingly, we found that the number of circulating activated basophils, measured by their expression of CD63, was significantly increased in this category of patients.…”

Polycythemia vera‐associated pruritus and its management

“…Pruritus (Latin prurire , to itch) has long been recognized as an important clinical feature of PV [4,5]. PV‐associated pruritus is often triggered by contact with water at any temperature, and is a subtype of a broader grouping termed as ‘aquagenic pruritus’ (AP) [6–8]. Pruritus has been noted in 5–69% of PV patients.…”

“…PV-associated pruritus is often triggered by contact with water at any temperature, and is a subtype of a broader grouping termed as 'aquagenic pruritus' (AP) [6][7][8]. Pruritus has been noted in 5-69% of PV patients.…”

Peptic Ulcer Disease with Gastrointestinal Bleeding in Father and Son with Primary Polycythemia Vera

“…Increasedhistamine release has been touted as a potential risk factor for the peptic ulcer disease [24]. PV patients have been proven to have higher serum and urinary histamine level [26]. Increased histamine release has been associated with increases in gastric acid secretion, mucosal blood flow and mucosal permeability, hence predisposing to peptic ulcer disease [27].…”