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Table of Contents
Vol. 192, No. 3, 1996
Issue release date: 1996
Section title: Clinical and Laboratory Investigation
Dermatology 1996;192:222–226
(DOI:10.1159/000246370)

Clinical and Pathophysiological Aspects of Hydroxyethyl Starch-Induced Pruritus: Evaluation of 96 Cases

Gall H.a · Schultz K.-D.b · Boehncke W.-H.a · Kaufmann R.c
aDepartment of Dermatology, University of Ulm, bDepartment of Clinical Immunology and Asthma OPD, Free University, Berlin, cDepartment of Dermatology. University of Frankfurt, Germany

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Article / Publication Details

First-Page Preview
Abstract of Clinical and Laboratory Investigation

Received: March 14, 1995
Accepted: September 05, 1995
Published online: October 07, 2009
Issue release date: 1996

Number of Print Pages: 5
Number of Figures: 0
Number of Tables: 0

ISSN: 1018-8665 (Print)
eISSN: 1421-9832 (Online)

For additional information: http://www.karger.com/DRM

Abstract

Background: It has been recently recognized that long-term infusions of hydroxyethyl starch (HES) as a substitute of human plasma may lead to deposits within the human skin and clinically induces severe pruritus in approximately one-third of the patients treated. Objective: To analyze the clinical features and pathophysiology of HES-induced itching. Methods: Clinical data of 86 patients were analyzed retrospectively. Furthermore, 10 patients were followed prospectively, in whom we also performed routine laboratory tests, skin biopsies, allergological investigations (skin prick, basophil degranulation test), and substance P measurements in stimulated macrophages. Results: Special features of HES-induced pruritus included long latency of onset and persistence. Noteworthy, itching is not always generalized. 30% of patients present with localized pruritus. Symptoms were not relieved by antihistaminics. Accordingly, the basophil degranulation test after HES exposure was negative. Also, substance P release from macrophages was not increased following HES stimulation. Deposits were found mainly in macrophages and endothelial cells. Conclusions: Our findings indicate that pruritus in HES-infused patients is most likely not triggered by pruritogenic mediators. We support data from the recent literature, suggesting a direct stimulation of cutaneous nerves by HES deposits. In patients suffering from long-standing itching it seems important to consider previous HES exposure as a possible cause not only in generalized pruritus but also in localized symptoms.

© 1996 S. Karger AG, Basel


Article / Publication Details

First-Page Preview
Abstract of Clinical and Laboratory Investigation

Received: March 14, 1995
Accepted: September 05, 1995
Published online: October 07, 2009
Issue release date: 1996

Number of Print Pages: 5
Number of Figures: 0
Number of Tables: 0

ISSN: 1018-8665 (Print)
eISSN: 1421-9832 (Online)

For additional information: http://www.karger.com/DRM


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Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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