Uncontrollable pruritus in primary biliary cirrhosis is an indication for liver transplantation.
In this study, physicians from Spain assessed whether a new extracorporeal albumin dialysis (ECAD) procedure has any effect on pruritus of cholestasis.
The team treated 4 patients with primary biliary cirrhosis and resistant pruritus two 7-hour ECAD sessions 1 day apart.
They recorded pruritus using a visual analogue scale from 15 days before the first session, and before and after each session, as well as during the follow-up.
Standard liver tests as well as serum bile acid levels were also measured.
|1 patient was free of pruritus for 18 months.|
|American Journal of Gastroenterology|
The team found that there was a clear association between ECAD treatment and relief of itching. Itching disappeared in 2 patients, and decreased markedly in the other 2.
The physicians found that 1 patient was generally free of pruritus for 18 months.
Another patient experienced amelioration of itching.
In the remaining patients pruritus was alleviated markedly after ECAD but gradually recurred. These patients were treated again several months later with good results.
The team determined that the scratching skin lesions improved or disappeared in parallel with the alleviation of itching.
They found that the albumin dialysis procedure did not result in liver test changes except for circulating bile acids; these decreased in all the patients.
Dr Albert Parés and colleagues concluded, "The ECAD procedure seems to be an effective alternative for the treatment of patients with pruritus of cholestasis who do not respond to other therapeutic methods".