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Cholestatic pruritus is the sensation of itch due to nearly any liver disease, but the most commonly associated entities are primary biliary cholangitis, primary sclerosing cholangitis, obstructive choledocholithiasis, carcinoma of the bile duct, cholestasis (also see drug-induced pruritus), and chronic hepatitis C viral infection and other forms of viral hepatitis.
An itch can be caused by various reasons. The cause of senile pruritus is not clearly known, this type of itch in elderly patients may be a result of other reasons, like: [7] allergies; drug-induced pruritus; diseases mentioned under the Classification section of this article; underlying conditions, like kidney failure or gallbladder diseases ...
seek treatment during middle-age, although PN can occur at any age. have a history of chronic severe pruritus. have a significant medical history for unrelated conditions. develop liver or kidney dysfunctions. develop secondary skin infections. have a personal or family history of atopic dermatitis. have other autoimmune disorders.
The hepatopulmonary syndrome results from the formation of microscopic intrapulmonary arteriovenous dilatations in patients with both chronic, and far less commonly acute liver failure. The mechanism is unknown but is thought to be due to increased liver production or decreased liver clearance of vasodilators, possibly involving nitric oxide. [1]
Portopulmonary hypertension (PPH) [1] is defined by the coexistence of portal and pulmonary hypertension. PPH is a serious complication of liver disease, present in 0.25 to 4% of all patients with cirrhosis. Once an absolute contraindication to liver transplantation, it is no longer, thanks to rapid advances in the treatment of this condition. [2]
If it is felt all over the body, then it is called generalized itch or generalized pruritus. [4] Generalized itch is infrequently a symptom of a serious underlying condition, such as cholestatic liver disease. If the sensation of itching persists for six weeks or longer, then it is called chronic itch or chronic pruritus.
Pruritus can be seen with hepatic and renal disease such as cholestasis, alcoholic liver disease, primary biliary cholangitis, hepatitis B and C, and chronic kidney disease. [ 5 ] [ 6 ] [ 7 ] Drug and alcohol use can contribute to pruritus as well so it is worthwhile to gather a social history.
Pathogenesis in pulmonary hypertension due to left heart disease (WHO Group II) is completely different in that constriction or damage to the pulmonary blood vessels is not the issue. Instead, the left heart fails to pump blood efficiently, leading to pooling of blood in the lungs and back pressure within the pulmonary system.