Ileal exclusion for pruritus treatment in children with progressive familial intrahepatic cholestasis and other cholestatic diseases

Vaisberg, Victor Van; Tannuri, Ana Cristina Aoun; Lima, Fábio; Tannuri, Uenis

doi:10.1016/j.jpedsurg.2019.09.018

Cited by 14 publications

(13 citation statements)

References 46 publications

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“…The efficacy was persistent at 6 months. Van Vaisberg et al ( 24 ) analysed 11 children who were treated with ileocaecal bypass in a retrospective study. For 8 patients, pruritus remained clinically controlled postoperatively (72.7%).…”

Section: Resultsmentioning

confidence: 99%

Efficacy of Treatments for Cholestatic Pruritus: A Systemic Review and Meta-analysis

Dervout¹,

Boulais²,

Nousbaum³

et al. 2022

Acta Derm Venereol

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Cholestatic itch is a disabling symptom that may be secondary to liver or biliary diseases. Management of cholestatic pruritus is complex. A systematic review and meta-analysis on the efficacy of treatments for cholestatic pruritus were performed. PubMed and Cochrane Library were searched using the algorithm “(hepatitis OR cholestatic OR liver) AND (pruritus OR itch) AND (management OR treatment OR treatments)” for 1975–2019. Of the 2,264 articles identified, 93 were included in a systematic review and 15 in a meta-analysis (studies evaluating pruritus with a visual analogue scale). Some treatments act by reducing levels of pruritogens in the enterohepatic cycle, others modify the metabolism or secretion of these pruritogens, or act on pruritus pathways. A further possible treatment is albumin dialysis. However, due to many heterogeneities in the reviewed studies it is difficult to identify and recommend an optimum treatment. Only 15 studies were included in the meta-analysis, due to the small number of randomized studies using a visual analogue scale.

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Section: Resultsmentioning

confidence: 99%

Efficacy of Treatments for Cholestatic Pruritus: A Systemic Review and Meta-analysis

Dervout¹,

Boulais²,

Nousbaum³

et al. 2022

Acta Derm Venereol

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“…GGT is a routinely requested serum parameter, and GGT data are available in many other studies that focused on cholestatic itch [3,5,8,[17][18][19][20][21][22]. However, in these studies, an association between cholestatic itch and GGT has not been reported.…”

Section: Discussionmentioning

confidence: 99%

Gamma-Glutamyl Transferase: A Friend against Cholestatic Itch? A Retrospective Observational Data Analysis in Patients with Extrahepatic Cholestasis

Haijer

Vliet

Brusse-Keizer

et al. 2023

International Journal of Hepatology

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Background and Aim of This Study. Itch frequently occurs in patients with chronic cholestasis. However, it remains unclear why some patients do and others do not develop pruritus. In addition, drug treatment is frequently ineffective. We repeatedly observed that cholestatic patients without itch had a relatively high serum gamma-glutamyl transpeptidase (GGT), relative to their serum bilirubin. The aim of this study was to validate this clinical observation. Methods. We included 235 patients with chronic extrahepatic cholestasis due to pancreatic cancer, cholangiocarcinoma, or papillary carcinoma. Results. GGT was significantly higher in patients without pruritus (median 967, IQR 587–1571) compared to patients with pruritus (median 561 IQR 266–1084 IU/l) ( p < 0.01 ). In contrast, median alkaline phosphatase (AP) was 491 U/L (IQR; 353–684) in patients with pruritus and was not significantly different from 518 U/L (IQR; 353–726) in patients without pruritus ( p = 0.524 ). Direct bilirubin was significantly higher in patients with pruritus compared to patients without pruritus (168 μmol/L (IQR; 95–256) vs. 120 μmol/L (IQR; 56.75–185.5)) ( p < 0.01 ). After correcting for the extent of cholestasis via direct bilirubin, the negative association between GGT and pruritus remained significant and became stronger ( p < 0.001 ). Conclusion. Serum GGT activity is inversely associated with the presence of cholestatic itch in patients with chronic extrahepatic cholestasis.

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“…Because the patient's sympathetic nerves are excited at night, the itching is increased, most the patient has insufficient sleep, auxin cannot be secreted normally, therefore most patients are short [7]. Nurse should closely observe the child's skin for skin damage and deal with it as soon as it occurs [8]; at the same time, attention should be paid to detect the patient's growth and development status, and calculate according to the "Standardization Curve of Height for Children and Adolescents 0-18 Years" height and weight Z value to assess the growth and development of PFIC patients [9]. Therefore, for the care of itch-related symptoms in PFIC patients, including changes in the severity of itching, skin condition, appetite, length, weight, and upper arm circumference should be dynamically observed.…”

Section: General Symptom Carementioning

confidence: 99%

“…The richness of long-chain fatty acids in breast milk can cause steatorrhea in patients with PFIC, while medium-chain fatty acids are not dependent on bile absorption [12]. Therefore, nurses should inform the parents of children with PFIC to special formula milk powder with enhanced medium-chain fatty acids on the basis of breastfeeding [8]. When supplementary food is added to the diets of children with PFIC, it is important to follow the principle of high carbohydrate, high protein and normal lipids, and supplement with the addition of medium chain fatty acid to meet the nutrients needed for growth and development [8].…”

Section: General Symptom Carementioning

confidence: 99%

Summary and Considerations in the Nursing Care of Patients with Progressive Familial Intrahepatic Cholestasis

Zhang¹,

Song²,

Chen³

et al. 2020

AJNS

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Ileal exclusion for pruritus treatment in children with progressive familial intrahepatic cholestasis and other cholestatic diseases

Cited by 14 publications

References 46 publications

Efficacy of Treatments for Cholestatic Pruritus: A Systemic Review and Meta-analysis

Efficacy of Treatments for Cholestatic Pruritus: A Systemic Review and Meta-analysis

Gamma-Glutamyl Transferase: A Friend against Cholestatic Itch? A Retrospective Observational Data Analysis in Patients with Extrahepatic Cholestasis

Summary and Considerations in the Nursing Care of Patients with Progressive Familial Intrahepatic Cholestasis

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