Primary Sclerosing Cholangitis Pruritus Treated with Plasmapheresis

Abstract Evidence regarding the efficacy of plasmapheresis for pruritus due to hepatobiliary disease is sparse. The mechanism of pruritus in this context is poorly understood. Some candidates for the offending agents are bile salts and histamine. Primary sclerosing cholangitis is one such disease and appears to have an autoimmune component. The rationale for plasmapheresis for patients who are refractory to medical therapy has some plausibility because the nonspecific nature of plasmapheresis may significantly decrease one or more of the offending substances in the patient's plasma. We share our experience of a patient with pruritus due to primary sclerosing cholangitis who benefited from plasmapheresis.