Hydroxyethyl starch-induced pruritus - Revision history

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2025-04-07T04:48:35Z

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			{{SI}}
			{{Infobox medical condition
			\| name = Hydroxyethyl starch-induced pruritus
			\| image = [[File:Hydroxyethylstärke.svg\|left\|thumb\|Structure of hydroxyethyl starch]]
			\| caption = Structure of hydroxyethyl starch
			\| field = [[Dermatology]]
			\| symptoms = [[Pruritus]] (itching)
			\| causes = Administration of [[hydroxyethyl starch]]
			\| risks = Use of hydroxyethyl starch solutions
			\| diagnosis = Clinical evaluation
			\| differential = Other causes of pruritus
			\| treatment = Symptomatic relief, discontinuation of hydroxyethyl starch
			\| frequency = Rare
			}}
	{{Short description\|A condition of itching caused by hydroxyethyl starch}}		{{Short description\|A condition of itching caused by hydroxyethyl starch}}

	'''Hydroxyethyl starch-induced pruritus''' is a condition characterized by intense itching that occurs as a side effect of the administration of hydroxyethyl starch (HES), a synthetic colloid used as a plasma volume expander in medical settings.		'''Hydroxyethyl starch-induced pruritus''' is a condition characterized by intense itching that occurs as a side effect of the administration of hydroxyethyl starch (HES), a synthetic colloid used as a plasma volume expander in medical settings.

	==Pathophysiology==		==Pathophysiology==
	Hydroxyethyl starch is used to treat or prevent hypovolemia, a condition where there is a decrease in the volume of blood plasma. It works by expanding the plasma volume, thereby improving circulation and oxygen delivery to tissues. However, one of the adverse effects associated with HES is pruritus, or itching.		Hydroxyethyl starch is used to treat or prevent hypovolemia, a condition where there is a decrease in the volume of blood plasma. It works by expanding the plasma volume, thereby improving circulation and oxygen delivery to tissues. However, one of the adverse effects associated with HES is pruritus, or itching.

	The exact mechanism by which HES induces pruritus is not fully understood. It is hypothesized that the accumulation of HES molecules in the skin may lead to the activation of [[mast cells]] and the release of [[histamine]], a compound involved in allergic reactions and itching. Additionally, HES may alter the function of [[nerve endings]] in the skin, contributing to the sensation of itch.		The exact mechanism by which HES induces pruritus is not fully understood. It is hypothesized that the accumulation of HES molecules in the skin may lead to the activation of [[mast cells]] and the release of [[histamine]], a compound involved in allergic reactions and itching. Additionally, HES may alter the function of [[nerve endings]] in the skin, contributing to the sensation of itch.

	==Clinical Presentation==		==Clinical Presentation==
	Patients experiencing hydroxyethyl starch-induced pruritus typically report severe itching that can be widespread or localized. The itching may occur days to weeks after the administration of HES and can persist for several weeks or even months. The intensity of the pruritus can significantly affect the quality of life, leading to sleep disturbances and psychological distress.		Patients experiencing hydroxyethyl starch-induced pruritus typically report severe itching that can be widespread or localized. The itching may occur days to weeks after the administration of HES and can persist for several weeks or even months. The intensity of the pruritus can significantly affect the quality of life, leading to sleep disturbances and psychological distress.

	==Diagnosis==		==Diagnosis==
	The diagnosis of hydroxyethyl starch-induced pruritus is primarily clinical, based on the history of recent HES administration and the characteristic itching. It is important to differentiate this condition from other causes of pruritus, such as [[allergic reactions]], [[dermatitis]], or [[systemic diseases]].		The diagnosis of hydroxyethyl starch-induced pruritus is primarily clinical, based on the history of recent HES administration and the characteristic itching. It is important to differentiate this condition from other causes of pruritus, such as [[allergic reactions]], [[dermatitis]], or [[systemic diseases]].

	==Management==		==Management==
	Management of hydroxyethyl starch-induced pruritus involves symptomatic treatment. Antihistamines may be used to alleviate itching, although their effectiveness can be variable. Topical treatments, such as emollients and corticosteroids, may provide some relief. In severe cases, systemic treatments such as [[gabapentin]] or [[pregabalin]] may be considered.		Management of hydroxyethyl starch-induced pruritus involves symptomatic treatment. Antihistamines may be used to alleviate itching, although their effectiveness can be variable. Topical treatments, such as emollients and corticosteroids, may provide some relief. In severe cases, systemic treatments such as [[gabapentin]] or [[pregabalin]] may be considered.

	Avoidance of further exposure to HES is crucial to prevent recurrence of pruritus. In patients who require volume expansion, alternative agents such as [[albumin]] or [[crystalloids]] may be used.		Avoidance of further exposure to HES is crucial to prevent recurrence of pruritus. In patients who require volume expansion, alternative agents such as [[albumin]] or [[crystalloids]] may be used.

	==Prognosis==		==Prognosis==
	The prognosis for patients with hydroxyethyl starch-induced pruritus is generally good, as the condition is self-limiting and resolves with time. However, the duration of symptoms can vary, and some patients may experience prolonged itching.		The prognosis for patients with hydroxyethyl starch-induced pruritus is generally good, as the condition is self-limiting and resolves with time. However, the duration of symptoms can vary, and some patients may experience prolonged itching.
			==See also==
	==~~Related pages~~==
	* [[Pruritus]]		* [[Pruritus]]
	* [[Hypovolemia]]		* [[Hypovolemia]]
	* [[Mast cell]]		* [[Mast cell]]
	* [[Histamine]]		* [[Histamine]]

	[[Category:Dermatology]]		[[Category:Dermatology]]
	[[Category:Medical conditions related to intravenous therapy]]		[[Category:Medical conditions related to intravenous therapy]]

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-{{Infobox medical condition (new)
+{{Short description|A condition of itching caused by hydroxyethyl starch}}
-An updated clinical review on storage in different tissues describes a pattern of storage in the [[reticuloendothelial system]] and also the skin (Wiedermann). Differential storage described via [[immuno-electron microscopy]], see Ständer 2001 below.
+'''Hydroxyethyl starch-induced pruritus''' is a condition characterized by intense itching that occurs as a side effect of the administration of hydroxyethyl starch (HES), a synthetic colloid used as a plasma volume expander in medical settings.
-==See also==
+==Pathophysiology==
-* [[Pruritus]]
+Hydroxyethyl starch is used to treat or prevent hypovolemia, a condition where there is a decrease in the volume of blood plasma. It works by expanding the plasma volume, thereby improving circulation and oxygen delivery to tissues. However, one of the adverse effects associated with HES is pruritus, or itching.
-==References==
+==Management==
-{{reflist}}
+Management of hydroxyethyl starch-induced pruritus involves symptomatic treatment. Antihistamines may be used to alleviate itching, although their effectiveness can be variable. Topical treatments, such as emollients and corticosteroids, may provide some relief. In severe cases, systemic treatments such as [[gabapentin]] or [[pregabalin]] may be considered.
-==Further reading==
+Avoidance of further exposure to HES is crucial to prevent recurrence of pruritus. In patients who require volume expansion, alternative agents such as [[albumin]] or [[crystalloids]] may be used.
-[[Category:Pruritic skin conditions]]
+==Prognosis==
-{{Cutaneous-condition-stub}}
+==Related pages==
-{{dictionary-stub1}}
+* [[Pruritus]]
-<gallery>
+[[Category:Dermatology]]
-File:Hydroxyethylstärke.svg|Hydroxyethyl starch-induced pruritus
+[[Category:Medical conditions related to intravenous therapy]]

Prab at 00:01, 17 March 2025

2025-03-17T00:01:32Z

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	File:Hydroxyethylstärke.svg\|Hydroxyethyl starch-induced pruritus		File:Hydroxyethylstärke.svg\|Hydroxyethyl starch-induced pruritus
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2025-02-20T01:34:08Z

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New page

{{Infobox medical condition (new)
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| specialty = dermatology
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'''Hydroxyethyl starch-induced pruritus''' is an intense [[itch]]ing, lasting for as long as one year, occurring following [[hydroxyethyl starch]] intravenous infusion for vascular insufficiency.<ref>{{cite journal|doi=10.1111/j.1365-2133.2004.06272.x | pmid=15656795 | volume=152 | issue=1 | title=Pruritus precipitated by hydroxyethyl starch: a review | journal=British Journal of Dermatology | pages=3–12 | author=Bork K| year=2005 }}</ref><ref name="Fitz2">Freedberg, et al. (2003). ''Fitzpatrick's Dermatology in General Medicine''. (6th ed.). McGraw-Hill. {{ISBN|0-07-138076-0}}.</ref>{{rp|401}}There is no treatment for the itch.

An updated clinical review on storage in different tissues describes a pattern of storage in the [[reticuloendothelial system]] and also the skin (Wiedermann). Differential storage described via [[immuno-electron microscopy]], see Ständer 2001 below.

==See also==
* [[Pruritus]]

==References==
{{reflist}}

==Further reading==
* {{cite journal | pmid=24257970 | doi=10.1007/s00134-013-3156-9 | volume=40 | issue=2 | title=Accumulation of hydroxyethyl starch in human and animal tissues: a systematic review | year=2014 | journal=Intensive Care Med | pages=160–70 |vauthors=Wiedermann CJ, Joannidis M }}
* {{cite journal | pmid=11396719 | volume=304 | issue=2 | title=Differential storage of hydroxyethyl starch (HES) in the skin: an immunoelectron-microscopical long-term study | year=2001 | journal=Cell Tissue Res. | pages=261–9 |vauthors=Ständer S, Szépfalusi Z, Bohle B, Ständer H, Kraft D, Luger TA, Metze D | doi=10.1007/s004410000324}}

[[Category:Pruritic skin conditions]]

{{Cutaneous-condition-stub}}
{{dictionary-stub1}}