ABSTRACT
Cholestasis is defined as impaired secretion of bile.1 Pruritus is a complication of cholestasis including that associated with mutations in genes that code for transporters in the hepatocyte2,3 and from inflammatory liver diseases.4,5 In this regard, pruritus is more common in conditions characterized by bile duct inflammatory destruction and ductopenia including primary bile cirrhosis primary biliary cirrhosis (PBC)5 than in those characterized by hepatocellular injury such as chronic viral hepatitis.4 The pruritus of cholestasis tends to be generalized. It leads to scratching, sometimes violent, resulting in excoriations and prurigo nodularis. This type of pruritus can lead to sleep deprivation, and in some patients, to suicidal ideations. Intractable pruritus from liver disease is an indication for liver transplantation even in the absence of liver failure.6,7 Accordingly, pruritus is a complication of liver disease that requires specific management and intense research in an effort to design effective antipruritic medications.
