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Long-term therapy of a patient with summerskill-walshe-tygstrup syndrome by applying prometheus® liver dialysis: a case report.
[benign recurrent intrahepatic cholestasis]
Summerskill-
Walshe-
Tygstrup
syndrome
is
a
rare
benign
chronic
liver
disease
characterized
by
recurring
cholestasis
with
jaundice
and
severe
pruritus
.
Due
to
insufficient
conservative
treatment
,
liver
dialysis
by
Prometheus
(
®
)
was
applied
to
a
45
-
year
-old
female
patient
with
resistant
pruritus
.
Initially
,
other
possible
liver
diseases
were
excluded
and
the
patient
was
treated
symptomatically
since
the
diagnosis
of
Summerskill-
Walshe-
Tygstrup
was
stated
in
1998
.
As
conservative
and
endoscopic
methods
progressively
failed
to
relieve
the
patient
's
suffering
,
Prometheus
(
®
)
liver
dialysis
was
performed
regularly
since
2006
at
3
-
month
intervals
and
successfully
led
to
a
decrease
in
the
patient
's
symptoms
.
Cholestatic
liver
enzymes
and
also
serum
bile
acids
could
be
lowered
significantly
from
an
average
of
22
.
5
±
2
.
7
to
7
.
3
±
1
.
7
µmol
/
l
.
Consequently
,
Prometheus
(
®
)
liver
dialysis
may
be
a
beneficial
option
for
patients
with
benign
recurrent
intrahepatic
cholestasis
suffering
from
therapy-resistant
symptoms
and
may
be
used
as
well
as
other
extracorporeal
liver
support
devices
which
have
already
been
reported
to
improve
cholestatic
pruritus
.
Diseases
Validation
Diseases presenting
"pruritus"
symptom
benign recurrent intrahepatic cholestasis
cholangiocarcinoma
cutaneous mastocytosis
dystrophic epidermolysis bullosa
erdheim-chester disease
lamellar ichthyosis
pleomorphic liposarcoma
pyomyositis
zellweger syndrome
This symptom has already been validated