Role of plasmapheresis in primary biliary cirrhosis.

Cohen, Lauren; Ambinder, Edward P.; Wolke, Anita; Field, Steven; Schaffner, Fenton

doi:10.1136/gut.26.3.291

Cited by 86 publications

(43 citation statements)

References 12 publications

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“…Inter ventions using extra corporeal removal of pruritogens (bile acids, histamine) have been proposed including hemodialysis, charcoal hemoperfusion, or plasmapheresis [5] . Among these methods, only plasmapheresis provided relief, but with transient efficiency [6] . Plasmapheresis, an extracorporeal exchange procedure used to remove large-molecular-weight substances from the plasma, is generally safe although rare complications have been reported (bleeding, infection, coagulation abnormalities and electrolyte disturbances) [7] .…”

Section: Discussionmentioning

confidence: 99%

Albumin liver dialysis as pregnancy-saving procedure in cholestatic liver disease and intractable pruritus

Lemoine¹,

Revaux²,

Francoz³

et al. 2008

WJG

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Progressive familial intrahepatic cholestasis type 3 (PFIC3) is a rare cholestatic liver disease. Such liver disease can get worse by female hormone disorder. Albumin dialysis or Molecular Adsorbent Recirculating System (MARS) has been reported to reverse severe cholestasis-linked pruritus. Here, we report the first use of MARS during a spontaneous pregnancy and its successful outcome in a patient with PFIC3 and intractable pruritus. Albumin dialysis could be considered as a pregnancy-saving procedure in pregnant women with severe cholestasis and refractory pruritus.

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Section: Discussionmentioning

confidence: 99%

Albumin liver dialysis as pregnancy-saving procedure in cholestatic liver disease and intractable pruritus

Lemoine¹,

Revaux²,

Francoz³

et al. 2008

WJG

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“…Naloxone (27) and naltrexone (28), opioid antagonists, may be helpful in patients who do not respond to any of the above. Large volume plasmapheresis is almost always effective if there is intractable pruritus that fails to respond to all of the above (29). However, it is expensive and time consuming and usually reserved for those awaiting liver transplantation.…”

Section: Management Of Chronic Cholestasis and Its Complicationsmentioning

confidence: 99%

Management of primary sclerosing cholangitis

Lee¹

2002

The American Journal of Gastroenterology

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PREAMBLEGuidelines for clinical practice are intended to indicate preferred approaches to medical problems as established by scientifically valid research. Double blind, placebo-controlled studies are preferable, but reports and expert review articles are also utilized in a thorough review of the literature conducted through the National Library of Medicine's MEDLINE. When only data that will not withstand objective scrutiny are available, a recommendation is identified as a consensus of experts. Guidelines are applicable to all physicians who address the subject, without regard to specialty training or interests, and are intended to indicate the preferable but not necessarily the only acceptable approach to a specific problem. Guidelines are intended to be flexible and must be distinguished from standards of care that are inflexible and rarely violated. Given the wide range of specifics in any health care problem, the physician must always choose the course best suited to the individual patient and the variables in existence at the moment of decision.Guidelines are developed under the auspices of the American College of Gastroenterology and its Practice Parameters Committee and approved by the Board of Trustees. Each has been intensely reviewed and revised by the Committee, other experts in the field, physicians who will use them, and specialists in the science of decision of analysis. The recommendations of each guideline are therefore considered valid at the time of their production based on the data available. New developments in medical research and practice pertinent to each guideline will be reviewed at an established time and indicated at publication to assure continued validity. (Am J Gastroenterol 2002;97:528 -534.

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“…Eight patients with chronic cholestasis found relief for 24h to 5 months after extracorporeal charcoal column perfusion (55). Plasmapheresis has also been shown to improve refractory pruritus, although only for as long as the procedure is continued (56,57). These methods are costly, and not routinely available.…”

Section: Adams D Clements and E Eliasmentioning

confidence: 99%