pica and Pruritus

Generalized or localized itch without primary skin manifestations may be the presenting symptom of serious internal diseases. Five characteristic cases of pruritus are discussed: Hodgkin's disease, primary sclerosing cholangitis, polycythemia vera, iron deficiency (with pica), and uremia. Other important causes must be considered; all forms of cholestasis, including primary biliary cirrhosis, drug-induced, pregnancy-related, and extrahepatic cholestasis; other hematologic and malignant disorders such as non-Hodgkin's lymphoma, leukemia, multiple myeloma, solid tumors, and myelodysplastic syndromes; metabolic and endocrine diseases, most notably diabetes mellitus, hyperthyroidism, hypothyroidism, and carcinoid syndrome; focal neurologic diseases such as brain tumors, cerebral infarctions and multiple sclerosis; adverse drug reactions without rash; infectious diseases, especially parasitic and HIV infections. A diagnostic laboratory screening for pruritus of undetermined origin is suggested.

Topics: Adult; Aged; Anemia, Iron-Deficiency; Cholangitis, Sclerosing; Diagnosis, Differential; Female; Hematologic Diseases; Hodgkin Disease; Humans; Liver Diseases; Male; Metabolic Diseases; Middle Aged; Pica; Polycythemia Vera; Pruritus; Uremia

Topics: Aged; Anemia, Hypochromic; Animals; Bloodletting; Child; Deglutition Disorders; Exercise Test; Female; Heart; Hematocrit; Humans; Male; Middle Aged; Neuromuscular Diseases; Pica; Platelet Count; Polycythemia Vera; Pruritus; Rats