Journal
EUROPEAN JOURNAL OF GASTROENTEROLOGY & HEPATOLOGY
Volume 13, Issue 11, Pages 1393-1394Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/00042737-200111000-00022
Keywords
cholestasis; liver transplantation; opiate antagonist; pruritus
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A woman with stage III (pre-cirrhotic) primary biliary cirrhosis was referred for liver transplantation because of intractable pruritus. Oral administration of 50 mg naltrexone precipitated a severe opioid withdrawal-like reaction. Subsequently, when oral naltrexone therapy was reintroduced following a cautious infusion of naloxone, no reaction occurred and the pruritus resolved completely. Liver transplantation should not be considered for apparently intractable pruritus of cholestasis before an adequate trial of opiate antagonist therapy. (C) 2001 Lippincott Williams & Wilkins.
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