vitamin-k-semiquinone-radical and Pruritus

Intrahepatic cholestasis of pregnancy (ICP) is the most common liver disease during pregnancy, characterized by otherwise unexplained pruritus in late second and third trimester of pregnancy and elevated bile acids and/or transaminases. ICP is associated with an increased risk of adverse perinatal outcomes for the fetus and the later development of hepatobiliary disease for the mother. Bile acids should be monitored throughout pregnancy since fetal risk is increased at serum bile acids >40 µmol/l. Management of ICP consists of treatment with ursodeoxycholic acid, which reduces pruritus. Early elective delivery is common practice but should be performed on an individualized basis as long as strong evidence supporting this practice is lacking. Mothers should be followed-up for normalization of liver function tests 6-12 weeks after delivery. Future research in large-scale studies is needed to address the impact of ursodeoxycholic acid and early elective delivery on fetal outcome.

Topics: Antifibrinolytic Agents; Bile Acids and Salts; Cholagogues and Choleretics; Cholestasis, Intrahepatic; Female; Fetal Death; Histamine Antagonists; Humans; Labor, Induced; Nucleic Acid Synthesis Inhibitors; Pregnancy; Pregnancy Complications; Premature Birth; Pruritus; Rifampin; Ursodeoxycholic Acid; Vitamin K

We report a child with an isolated complex III respiratory chain deficiency and global developmental delay who had severe pruritus with elevated plasma bile acid levels. A liver biopsy showed micronodular cirrhosis, and enzymologic evaluation demonstrated an isolated complex III deficiency in both liver and muscle. His pruritus improved and serum bile acid levels decreased after treatment with menadione and vitamin C.

Topics: Anemia, Iron-Deficiency; Ascorbic Acid; Bile Acids and Salts; Child, Preschool; Developmental Disabilities; Drug Therapy, Combination; Electron Transport; Electron Transport Complex III; Humans; Male; Metabolism, Inborn Errors; Pruritus; Vitamin K

Chronic cholestasis is associated with a variety of symptoms and dysfunction of most organs. Among them, jaundice and pruritus are the first to be recognized, usually prompting the patients to see a physician. Besides the skin, however, cholestasis also affects, inter alia, the metabolism of plasma lipids and fat-soluble vitamins, as well as bone and liver. In the following article the pathogenesis and therapy of metabolic disturbances and organ dysfunctions occurring frequently in patients with chronic cholestasis are discussed.

Topics: Bone Diseases, Metabolic; Cholestasis, Extrahepatic; Humans; Hyperlipidemias; Liver Cirrhosis; Malabsorption Syndromes; Pruritus; Vitamin D; Vitamin K

In four patients the development of erythematous plaques after vitamin K injections was apparently due to delayed hypersensitivity reactions. The 36 cases described in the literature indicate that most patients with the reaction received vitamin K injections for liver disease and that a late sclerodermatous reaction develops rarely.

Topics: Adolescent; Adult; Drug Eruptions; Drug Hypersensitivity; Erythema; Female; Humans; Hypersensitivity, Delayed; Pruritus; Vitamin K

Topics: Agammaglobulinemia; Blood Protein Disorders; Bromides; Candidiasis, Cutaneous; Carcinoid Tumor; Dermatitis, Exfoliative; Drug Eruptions; Edema; Foot Dermatoses; Hand Dermatoses; Humans; Hypergammaglobulinemia; Keratosis; Leukemia; Lymphatic Diseases; Lymphoma; Penicillamine; Pruritus; Skin Diseases; Skin Manifestations; Vitamin K; Xanthomatosis

Topics: Alkaline Phosphatase; Aspartate Aminotransferases; Bile Acids and Salts; Bile Ducts; Bile Ducts, Intrahepatic; Bilirubin; Cell Division; Chenodeoxycholic Acid; Cholangiography; Cholestasis; Cholic Acids; Coloring Agents; Diagnosis, Differential; Humans; Liver; Liver Function Tests; Mitochondria, Liver; Pruritus; Vitamin K

Topics: Adrenocorticotropic Hormone; Amino Acids; Cholestyramine Resin; Diet Therapy; Dietary Carbohydrates; Dietary Proteins; gamma-Globulins; Hepatitis A; Hepatitis B; Humans; Pruritus; Rest; Vitamin B 12; Vitamin E; Vitamin K

A 40-year-old woman with no pre-existing hepatic disease developed a cutaneous allergic reaction to intramuscular vitamin K1. She received this medication prophylactically prior to surgery, developed severe localized, and subsequently generalized, dermatitis, beginning 5 days after administration of the Konakion Cremophor-EL form of vitamin K1 by intramuscular injection at four sites on her thighs. Investigation by patch and intradermal testing revealed delayed-type hypersensitivity to Konakion Cremophor-EL, Konakion Mixed Micelles and pure vitamin K1, but not Cremophor-EL vehicle alone. This case is unusual because the patient was also shown to be patch test positive to vitamin K3 sodium bisulfite.

Topics: Adult; Drug Eruptions; Drug Interactions; Female; Humans; Hypersensitivity, Delayed; Injections, Intramuscular; Intradermal Tests; Patch Tests; Pruritus; Vitamin K; Vitamin K 1

Topics: Bile Duct Diseases; Child, Preschool; Cholestyramine Resin; Female; Hemorrhage; Humans; Hypoprothrombinemias; Phenobarbital; Prothrombin Time; Pruritus; Vitamin K

Topics: Humans; Pruritus; Vitamin K

Topics: Alkaline Phosphatase; Bilirubin; Cholestasis; Cholesterol; Cholestyramine Resin; Female; Humans; Liver Diseases; Pregnancy; Pregnancy Complications; Pruritus; Recurrence; Transaminases; Vitamin K

Topics: Adult; Blood Chemical Analysis; Cholestasis; Cholesterol; Cholestyramine Resin; Female; Humans; Liver Diseases; Liver Function Tests; Pregnancy; Pregnancy Complications; Progesterone; Pruritus; Pruritus Ani; Uterine Hemorrhage; Vitamin K

Topics: Adult; Age Factors; Alkaline Phosphatase; Body Height; Child; Child, Preschool; Cholestasis; Consanguinity; Edema; Fats; Feces; Female; Hemorrhage; Heterozygote; Humans; Hyperbilirubinemia; Hyperlipidemias; Infant; Infant, Newborn; Liver; Malabsorption Syndromes; Male; Metabolism, Inborn Errors; Pedigree; Pruritus; Tooth Discoloration; Transaminases; Vitamin K

Topics: Biotin; Humans; Pruritus; Riboflavin; Sympathomimetics; Vitamin A; Vitamin K; Vitamins