O Prurido da Colestase
DOI:
https://doi.org/10.34024/rnc.2002.v10.10309Palavras-chave:
Prurido, colestaseResumo
Prurido é um sintoma comum e complexo. Mais do que qualquer outra modalidade sensitiva ele é influenciado pelo estado emocional e por alterações ambientais. Prurido resulta de ativação direta dos nociceptores na pele em resposta à lesão tecidual e está associado à ativação dos receptores opióides no sistema nervoso central. Avanços recentes no entendimento dos mecanismos que levam à sensação de prurido têm permitido medidas terapêuticas mais efetivas, especialmente nos pacientes com colestase.
Referências
1. Teofoli P, Procacci P, Maresca M, Lotti T. Itch and pain. Int J Dermato, 35:159-66, 1996.
2. Gilchrest BA. Prutitus: pathogenisis, therapy, and significance in systemic disease states. Arch Intern Med, 142:101-5, 1982.
3. Bergasa NV, Jones EA. The pruritus of cholestasis. Evolving pathogenic concepts suggest new therapeutic options. Clinics Liver Dis, 2:391-405, 1998. 4. Bergasa NV, Sabol SL, Young III S et al . Cholestasis is associated with preproenkephalin mRNA expression in the adult rat liver. Am J Physio, 268:G346-G354, 1995.
5. Garden JM, Ostrow JD, Roenig HH. Pruritus in hepatic cholestasis. Arch Dermatalol, 121:1415-20, 1985.
6. Jones EA, Bergasa NV. Why do cholestatic patients itch? Gut, 38:644-5, 1996.
7. Long RG, Scheuer PJ, Sherlock S. Presentation and course of asymptomatic primary biliary cirrhosis. Gastroenterology, 72:1204-7, 1997.
8. Dantas W. Prurido da colestase fisiopatologia e tratamento. GED,16:151-3, 1997.
9 . Whitington PF, Balistreri WF. Liver transplantation in pediatrics: indications, counter indications, and pretransplant management. J Pediatrics, 118:169-77, 1991.
10. Bergasa NV, Jones EA. The pruritus of cholestais. Hepatology, 29:1003-6, 1999.
11. Basbaum AI, Jessell TM. The perception of pain. In: Kandel ER, Scwartz JH, Jessell TM (eds.). Principles of Neural Science. New York, McGraw-Hill, 2002, pp. 472-91.
12. Greaves MW, Wall PD. Pathophysiology of itching. Lancet, 348(5):938-40, 1996.
13. Greaves MW, Wall PD. Pathophysiology of itching. Lancet, 348:1513-4, 1996.
14. Price DD. Psychological and neural mechanismis of the affective dimension of pain. Scienc, 288:1769-72, 2000.
15. Woolf CJ, Salter MW. Neuronal plasticity: increasing the gain in pain. Scienc, 288:1765-8, 2000.
16. Bergasa N, Jones EA. The pruritus of cholestasis: potencial pathogenic and therapeutic implications of opioids. Gastroenterol, 108:1582-8, 1995. 17. Spivey JR, Jorgrnsen RA, Gores GJ, Lindor KE. Methionine-enkephalin concentrations correlate with stage of disease but not pruritus in patients with primary biliary cirrhosis. Am J Gastroenterol, 89:2028-2, 1994.
18. Thomas DA, Willians GW, Iwata K, Kenshalo DR Jr, Dubner R. Efects of central administration of opioid on facial scratching in monkeys. Brain Res, 585:315-7, 1992.
19. Ferreira AR, Roquete MLV. Prurido na colestase. In: Penna FJ, Mota JAC, Roquete MLV, Ottoni CMC. Série Gastroenterologia Pediátrica, 1999, pp. 331-52 .
20. Raiford DS. Pruritus of chronic cholestasis. Q J Med, 88:603-7, 1995.
21. Bergasa NV, Jones EA. The pruritus of cholestasis. Semin Liver Dis, 13:319-27, 1993.
22. Cançado ELR, Leitão RMC, Carrilho FJ et al . Unexpected clinical remission of cholestasis after rifampicin therapy in patients with normal or slightly increased levels of g-glutamyl transpeptidase. Am J Gastroenterol, 93:1510-7, 1998.
23. Airede A, Weerasinghe HD. Rifampicin and the relief of pruitus of hepatic cholestatic origin. Acta Paediatr, 85:8878, 1996.
24. Cynamon HA, Andres HM, Lafrate RP. Rifampicin relieves pruritus in children with cholestatic disease. Gastroenterology, 98:1013-6, 1990.
25. Gregorio GV, Ball CS, Mowat AP et al . Effect of rifampicin in the treatment of patient in hepatic cholestasis. Arch Dis Child, 69:141-3, 1993.
26. Yerushalmi B, Sokol RJ, Narkewicz MR, Smith D, Karrer FM. Use of rifampin for severe pruritus in children with chronic cholestasis. J Ped Gastroenterol Nutrition, 29:442-7, 1999.
27. Wietholtz H, Marchal HU, Sjovall J, Mater S. Stimulation of the bile acid 6α-hydroxylation by rifampin. J Hepatol, 24:713-8, 1996.
28. Grosset J, Leventis S. Adverse effects of rifampin. Rev Infec Dis, 5:S440-S446, 1983.
29. Degot C, Zafrani ES, Callard P et al . Histopatological study of primary biliary cirrhosis and the effect of ursodeoxycholic acid treatment on histology progression. Hepatology, 29:1007-12, 1999.
30. Souto EO, Jorgensen RA, Lindor KD. The natural history of pruritus in patients with PBC and effects of medical therapy. Hepatology, 32(pt 2): 133A, 2000.
31. Bergasa NV, Jones EA. Management of the pruritus of cholestasis: potencial role of opiate antagonists. Am J Gastroenterol, 86:1404-12, 1991.
32. Jones EA, Bergasa NV. The pruritus of cholestasis and the opioid system. JAMA, 268:3359-62, 1992.
33. Bergasa NV, Alling DW, Talbot TL et al . Effects of naloxone infusions in patients with the pruritus of cholestasis. Ann Int Med, 123:161-7, 1995.
34. Carson KI, Tran TT, Cotton P et al . Pilot study of the use of naltrexone to treat the severe pruritus of cholestatic liver disease. Am J Gastroenterol, 91:1022-3, 1996.
35. Jones EA, Dekker LRC. Florid opioid withdrawal-like reaction precipitated by naltrexone in a patient with chronic cholestais. Gastroenterology, 118:431-2, 2000.
36. Terg R, Coronel E. Oral naltrexone treatment for cholestatic pruritus: a randomized, double blind, crossover study. Hepatology, 32:167A, 2000.
37. Terra SG, Tsunoda DM. Opioid antagonists in the treatment of pruritus from cholestatic liver disease. The Annals of Pharmacotherapy, 33:1228-30, 1998.
38. Wolfhagen FHJ, Sternieri E, Hop WCJ, Vitale G, Bertolotti M, Buuren HRV. Oral naltrexone treatment for cholestatic pruritus: a double-blind, placebo-controlled study. Gastroenterology, 113:1264-69, 1997.
39. Bergasa NV, Alling DW, Talbot TL et al. Oral nalmefene therapy reduces scratching activty due to the pruritus of cholestasis: a controlled study. J Am Acad Dermatol, 431-4, 1999.
40. Bergasa NV, Schimitt JM, Talbot TL et al. Open-label trial of oral nalmefene therapy for the pruritus of cholestasis. Hepatology, 27(3):679-84, 1998.
41. Borgeat A, Wilder-Smith OHG, Mentha G. Subhypnotic doses of propofol relieve pruritus associated with liver disease. Gastroenterology, 104:244-7, 1993.
42. Raderer M, Müller C, Sheithauer W. Ondansetron for pruritus due to cholestasis. N Engl J Med, 330:1540, 1994.
43. Schwörer H, Ramadori G. Improvement of cholestatic pruritus by ondansetron. Lancet, 341:1277, 1993.
44. Schwörer H, Hartmann H, Ramadori G. Relief of cholestatic pruritus by a novel class of drugs – 5-hydroxytryptamine type 3(5-HT3) receptor antagonists: effectiveness of ondansetron. Pain, 61:33-7, 1995.
45. Trioche P, Samuel D, Odièvre M, Labrune P. Ondansetron for pruritus in child with chronic cholestasis. Eur J Pediatr, 155:990-6, 1996.
46. Cerio R, Murphy GM, Slanden GE e t al . A combination of phototherapy and cholestyramine for the relief of pruritus in patients with primary biliary cirrhosis. Brith J Dermatol, 116:265-7,1987.
47. Rosenthal E, Diamond E, Benderly A, Etzioni A . Cholestatic pruritus: effect of phototherapy on pruritus and excretion of bile acids in urine. Acta Paediatr, 83:888-91, 1994.
48. Villamil AG, Bandi JC, Galdame O, Gerona S, Chao S, Ciardullo M et al . Efficacy of lidocaine in the treatment of pruritus in patients with chronic cholestatic liver diseases. Hepatology, 32:168A, 2000.
49. Ng VL, Ryckman FC, Porta G, Miura IK, Carvalho E e t al . Long-term outcome after partial external biliary diversion for intractable pruritus in patients with intrahepatic cholestais. J Ped Gastroenterol Nutrition, 30:152-6, 2000.
50. Melter MI, Rodeck B, Kardorff R, Hoyer PF, Petersen C et al . Progressive familial intrahepatic cholestasis: partial biliary diversion normalizes serum lipids and improves growth in noncirrhotic patients. Am J Gastroenterol, 95:3522-8, 2000.
51. Rebhandl W, Felberbauer FX, Turnbull J, Paya K, Barcik U e t al . Biliary diversion by use of the appendix (cholecystoappendicostomy) in progressive familial intrahepatic cholestasis. J Ped Gastroenterol Nutrition, 28:217-9, 1999.
52. Hollands CM, Rivera-Pedrogo FJ. Gonzales-Vallina R e t al . Ileal Exclusion for Byler´s disease: an alternative surgical approach with promising early results for pruritus. J Pediatric Sugery, 33:220-4, 1998.
53. Pires ALG, Ferreira CT, Zanotelli ML, Vieira SS, Silveira TR. Internal ileal diversion with ileocolic anastomosis and fixation of sistal stump in a patient with chronic intrahepatic cholestasis and intractable pruritus. World Congress of Pediatric Gastroenterology Hepatology & Nutrition, S1994:5-9, 2000.
2. Gilchrest BA. Prutitus: pathogenisis, therapy, and significance in systemic disease states. Arch Intern Med, 142:101-5, 1982.
3. Bergasa NV, Jones EA. The pruritus of cholestasis. Evolving pathogenic concepts suggest new therapeutic options. Clinics Liver Dis, 2:391-405, 1998. 4. Bergasa NV, Sabol SL, Young III S et al . Cholestasis is associated with preproenkephalin mRNA expression in the adult rat liver. Am J Physio, 268:G346-G354, 1995.
5. Garden JM, Ostrow JD, Roenig HH. Pruritus in hepatic cholestasis. Arch Dermatalol, 121:1415-20, 1985.
6. Jones EA, Bergasa NV. Why do cholestatic patients itch? Gut, 38:644-5, 1996.
7. Long RG, Scheuer PJ, Sherlock S. Presentation and course of asymptomatic primary biliary cirrhosis. Gastroenterology, 72:1204-7, 1997.
8. Dantas W. Prurido da colestase fisiopatologia e tratamento. GED,16:151-3, 1997.
9 . Whitington PF, Balistreri WF. Liver transplantation in pediatrics: indications, counter indications, and pretransplant management. J Pediatrics, 118:169-77, 1991.
10. Bergasa NV, Jones EA. The pruritus of cholestais. Hepatology, 29:1003-6, 1999.
11. Basbaum AI, Jessell TM. The perception of pain. In: Kandel ER, Scwartz JH, Jessell TM (eds.). Principles of Neural Science. New York, McGraw-Hill, 2002, pp. 472-91.
12. Greaves MW, Wall PD. Pathophysiology of itching. Lancet, 348(5):938-40, 1996.
13. Greaves MW, Wall PD. Pathophysiology of itching. Lancet, 348:1513-4, 1996.
14. Price DD. Psychological and neural mechanismis of the affective dimension of pain. Scienc, 288:1769-72, 2000.
15. Woolf CJ, Salter MW. Neuronal plasticity: increasing the gain in pain. Scienc, 288:1765-8, 2000.
16. Bergasa N, Jones EA. The pruritus of cholestasis: potencial pathogenic and therapeutic implications of opioids. Gastroenterol, 108:1582-8, 1995. 17. Spivey JR, Jorgrnsen RA, Gores GJ, Lindor KE. Methionine-enkephalin concentrations correlate with stage of disease but not pruritus in patients with primary biliary cirrhosis. Am J Gastroenterol, 89:2028-2, 1994.
18. Thomas DA, Willians GW, Iwata K, Kenshalo DR Jr, Dubner R. Efects of central administration of opioid on facial scratching in monkeys. Brain Res, 585:315-7, 1992.
19. Ferreira AR, Roquete MLV. Prurido na colestase. In: Penna FJ, Mota JAC, Roquete MLV, Ottoni CMC. Série Gastroenterologia Pediátrica, 1999, pp. 331-52 .
20. Raiford DS. Pruritus of chronic cholestasis. Q J Med, 88:603-7, 1995.
21. Bergasa NV, Jones EA. The pruritus of cholestasis. Semin Liver Dis, 13:319-27, 1993.
22. Cançado ELR, Leitão RMC, Carrilho FJ et al . Unexpected clinical remission of cholestasis after rifampicin therapy in patients with normal or slightly increased levels of g-glutamyl transpeptidase. Am J Gastroenterol, 93:1510-7, 1998.
23. Airede A, Weerasinghe HD. Rifampicin and the relief of pruitus of hepatic cholestatic origin. Acta Paediatr, 85:8878, 1996.
24. Cynamon HA, Andres HM, Lafrate RP. Rifampicin relieves pruritus in children with cholestatic disease. Gastroenterology, 98:1013-6, 1990.
25. Gregorio GV, Ball CS, Mowat AP et al . Effect of rifampicin in the treatment of patient in hepatic cholestasis. Arch Dis Child, 69:141-3, 1993.
26. Yerushalmi B, Sokol RJ, Narkewicz MR, Smith D, Karrer FM. Use of rifampin for severe pruritus in children with chronic cholestasis. J Ped Gastroenterol Nutrition, 29:442-7, 1999.
27. Wietholtz H, Marchal HU, Sjovall J, Mater S. Stimulation of the bile acid 6α-hydroxylation by rifampin. J Hepatol, 24:713-8, 1996.
28. Grosset J, Leventis S. Adverse effects of rifampin. Rev Infec Dis, 5:S440-S446, 1983.
29. Degot C, Zafrani ES, Callard P et al . Histopatological study of primary biliary cirrhosis and the effect of ursodeoxycholic acid treatment on histology progression. Hepatology, 29:1007-12, 1999.
30. Souto EO, Jorgensen RA, Lindor KD. The natural history of pruritus in patients with PBC and effects of medical therapy. Hepatology, 32(pt 2): 133A, 2000.
31. Bergasa NV, Jones EA. Management of the pruritus of cholestasis: potencial role of opiate antagonists. Am J Gastroenterol, 86:1404-12, 1991.
32. Jones EA, Bergasa NV. The pruritus of cholestasis and the opioid system. JAMA, 268:3359-62, 1992.
33. Bergasa NV, Alling DW, Talbot TL et al . Effects of naloxone infusions in patients with the pruritus of cholestasis. Ann Int Med, 123:161-7, 1995.
34. Carson KI, Tran TT, Cotton P et al . Pilot study of the use of naltrexone to treat the severe pruritus of cholestatic liver disease. Am J Gastroenterol, 91:1022-3, 1996.
35. Jones EA, Dekker LRC. Florid opioid withdrawal-like reaction precipitated by naltrexone in a patient with chronic cholestais. Gastroenterology, 118:431-2, 2000.
36. Terg R, Coronel E. Oral naltrexone treatment for cholestatic pruritus: a randomized, double blind, crossover study. Hepatology, 32:167A, 2000.
37. Terra SG, Tsunoda DM. Opioid antagonists in the treatment of pruritus from cholestatic liver disease. The Annals of Pharmacotherapy, 33:1228-30, 1998.
38. Wolfhagen FHJ, Sternieri E, Hop WCJ, Vitale G, Bertolotti M, Buuren HRV. Oral naltrexone treatment for cholestatic pruritus: a double-blind, placebo-controlled study. Gastroenterology, 113:1264-69, 1997.
39. Bergasa NV, Alling DW, Talbot TL et al. Oral nalmefene therapy reduces scratching activty due to the pruritus of cholestasis: a controlled study. J Am Acad Dermatol, 431-4, 1999.
40. Bergasa NV, Schimitt JM, Talbot TL et al. Open-label trial of oral nalmefene therapy for the pruritus of cholestasis. Hepatology, 27(3):679-84, 1998.
41. Borgeat A, Wilder-Smith OHG, Mentha G. Subhypnotic doses of propofol relieve pruritus associated with liver disease. Gastroenterology, 104:244-7, 1993.
42. Raderer M, Müller C, Sheithauer W. Ondansetron for pruritus due to cholestasis. N Engl J Med, 330:1540, 1994.
43. Schwörer H, Ramadori G. Improvement of cholestatic pruritus by ondansetron. Lancet, 341:1277, 1993.
44. Schwörer H, Hartmann H, Ramadori G. Relief of cholestatic pruritus by a novel class of drugs – 5-hydroxytryptamine type 3(5-HT3) receptor antagonists: effectiveness of ondansetron. Pain, 61:33-7, 1995.
45. Trioche P, Samuel D, Odièvre M, Labrune P. Ondansetron for pruritus in child with chronic cholestasis. Eur J Pediatr, 155:990-6, 1996.
46. Cerio R, Murphy GM, Slanden GE e t al . A combination of phototherapy and cholestyramine for the relief of pruritus in patients with primary biliary cirrhosis. Brith J Dermatol, 116:265-7,1987.
47. Rosenthal E, Diamond E, Benderly A, Etzioni A . Cholestatic pruritus: effect of phototherapy on pruritus and excretion of bile acids in urine. Acta Paediatr, 83:888-91, 1994.
48. Villamil AG, Bandi JC, Galdame O, Gerona S, Chao S, Ciardullo M et al . Efficacy of lidocaine in the treatment of pruritus in patients with chronic cholestatic liver diseases. Hepatology, 32:168A, 2000.
49. Ng VL, Ryckman FC, Porta G, Miura IK, Carvalho E e t al . Long-term outcome after partial external biliary diversion for intractable pruritus in patients with intrahepatic cholestais. J Ped Gastroenterol Nutrition, 30:152-6, 2000.
50. Melter MI, Rodeck B, Kardorff R, Hoyer PF, Petersen C et al . Progressive familial intrahepatic cholestasis: partial biliary diversion normalizes serum lipids and improves growth in noncirrhotic patients. Am J Gastroenterol, 95:3522-8, 2000.
51. Rebhandl W, Felberbauer FX, Turnbull J, Paya K, Barcik U e t al . Biliary diversion by use of the appendix (cholecystoappendicostomy) in progressive familial intrahepatic cholestasis. J Ped Gastroenterol Nutrition, 28:217-9, 1999.
52. Hollands CM, Rivera-Pedrogo FJ. Gonzales-Vallina R e t al . Ileal Exclusion for Byler´s disease: an alternative surgical approach with promising early results for pruritus. J Pediatric Sugery, 33:220-4, 1998.
53. Pires ALG, Ferreira CT, Zanotelli ML, Vieira SS, Silveira TR. Internal ileal diversion with ileocolic anastomosis and fixation of sistal stump in a patient with chronic intrahepatic cholestasis and intractable pruritus. World Congress of Pediatric Gastroenterology Hepatology & Nutrition, S1994:5-9, 2000.
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2002-09-30
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1.
Azevedo RA de, Kondo M, Oliveira A de SB de. O Prurido da Colestase . Rev Neurocienc [Internet]. 30º de setembro de 2002 [citado 5º de outubro de 2026];10(3):158-63. Disponível em: https://periodicos.unifesp.br/neurociencias/article/view/10309
