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- W4254272142 abstract "26 Naltrexone is an opiate receptor antagonist which has recently proven efficacious in the treatment of adults with severe cholestatic pruritus [Gastroenterology 1997;113(4)1264-9]. We report the successful use of oral naltrexone in 4 children with debilitating pruritus refractory to phenobarbital, ursodeoxycholic acid and rifampin. Patient 1 is a 4 year old girl with Alagille's syndrome and serum bile acids of 570 µg/dl. Due to severe itching, she developed cellulitis of her right elbow necessitating treatment with systematic antibiotics. After oral naltrexone 2mg/kg/day for 15 months, her itching disappeared with the exception of mild nighttime pruritus. Patient 2 is a 9 year old girl with Alagille's who had developed lichenification of both feet unresponsive to local emollient therapy. Serum bile acids were 980 µg/dl. She was started on naltrexone 2 mg/kg/day and she subsequently complained of occasional daytime pruritus. Patient 3 is a 13 year old girl status post liver transplantation for Alagille's who developed liver failure secondary to chronic graft rejection and cholangitis. Serum alkaline phosphatase was 573 IU/L. She was treated with 2mg/kg/day of naltrexone for 3 months with significant improvement in daytime pruritus. Patient 4 is an 18 year old girld with primary sclerosing cholangitis and ulcerative colitis. Serum bile acids were 670 µg/dl, and gammaglutamic transferase was 317 IU/L. She was treated with 50mg of naltrexone (∼1mg/kg/day) for 4 months with marked improvement in her daytime and nighttime pruritus. All children tolerated naltrexone well, without opiate withdrawal symptoms; patient 3 was discontinued from therapy after 1 month due to abdominal pain. Conclusions: Oral naltrexone appears to be safe in the treatment of pruritus in children. Controlled pediatric trials would be needed to further assess the efficacy of naltrexone in the treatment of cholestatic pruritus in childhood." @default.
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- W4254272142 date "1998-10-01" @default.
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- W4254272142 title "USE OF ORAL NALTREXONE FOR SEVERE PRURITUS DUE TO CHOLESTATIC LIVER DISEASE IN CHILDREN" @default.
- W4254272142 doi "https://doi.org/10.1097/00005176-199810000-00046" @default.
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