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Pruritus pp 267-270 | Cite as

Endocrine Diseases

  • Andreas E. KremerEmail author
  • Elke Weisshaar
Chapter

Abstract

Chronic pruritus accompanies a broad range of systemic disorders among which are hematologic and lymphoproliferative disorders, metabolic and endocrine diseases, solid tumours, and infectious diseases. Among endocrine disorders chronic pruritus is commonly observed in patients suffering from diabetes mellitus, thyroid and parathyroid disorders, anorexia nervosa, celiac disease, carcinoid syndrome, and multiple endocrine neoplasia type 2. The molecular mechanisms involved in pruritus in these diseases remain largely enigmatic. Treatment options are limited as so far no clinical studies have been performed addressing itching in endocrine disorders.

Keywords

Diabetes mellitus Carcinoid Celiac disease Endocrine disorders Graves disease Itch Parathyroid Pruritus Thyroid 

Abbreviations

MEN2A

Multiple endocrine neoplasia type 2A

PTH

Parathyroid hormone

TNF

Tumour necrosis factor

References

  1. 1.
    Bolotin D, Petronic-Rosic V. Dermatitis herpetiformis. Part I. Epidemiology, pathogenesis, and clinical presentation. J Am Acad Dermatol. 2011;64:1017–24; quiz 25–6.CrossRefPubMedGoogle Scholar
  2. 2.
    Bugalho MJ, Limbert E, Sobrinho LG, et al. A kindred with multiple endocrine neoplasia type 2A associated with pruritic skin lesions. Cancer. 1992;70:2664–7.CrossRefPubMedGoogle Scholar
  3. 3.
    Caravati Jr CM, Richardson DR, Wood BT, et al. Cutaneous manifestations of hyperthyroidism. South Med J. 1969;62:1127–30.CrossRefPubMedGoogle Scholar
  4. 4.
    Carmichael AJ, McHugh MM, Martin AM, et al. Serological markers of renal itch in patients receiving long term haemodialysis. Br Med J. 1988;296:1575.CrossRefGoogle Scholar
  5. 5.
    Cho YL, Liu HN, Huang TP, et al. Uremic pruritus: roles of parathyroid hormone and substance P. J Am Acad Dermatol. 1997;36:538–43.CrossRefPubMedGoogle Scholar
  6. 6.
    Chou FF, Ho JC, Huang SC, et al. A study on pruritus after parathyroidectomy for secondary hyperparathyroidism. J Am Coll Surg. 2000;190:65–70.CrossRefPubMedGoogle Scholar
  7. 7.
    Greenwood AM. A study of the skin in 500 cases of diabetes. JAMA. 1927;89:774–6.CrossRefGoogle Scholar
  8. 8.
    Gupta MA, Gupta AK, Voorhees JJ. Starvation-associated pruritus: a clinical feature of eating disorders. J Am Acad Dermatol. 1992;27:118–20.CrossRefPubMedGoogle Scholar
  9. 9.
    Hamilton DV, Gould DJ. Generalized pruritus as a presentation of idiopathic haemochromatosis. Br J Dermatol. 1985;112:629.CrossRefPubMedGoogle Scholar
  10. 10.
    King NK, Siriwardana HP, Coyne JD, et al. Intractable pruritus associated with insulinoma in the absence of multiple endocrine neoplasia: a novel paraneoplastic phenomenon. Scand J Gastroenterol. 2003;38:678–80.CrossRefPubMedGoogle Scholar
  11. 11.
    Kluger N, Raison-Peyron N, Rigole H, et al. Generalized pruritus revealing hereditary haemochromatosis. Acta Derm Venereol. 2007;87:277.PubMedGoogle Scholar
  12. 12.
    Ko MJ, Chiu HC, Jee SH, et al. Postprandial blood glucose is associated with generalized pruritus in patients with type 2 diabetes. Eur J Dermatol. 2013;23:688–93.PubMedGoogle Scholar
  13. 13.
    Krajnik M, Zylicz Z. Pruritus in advanced internal diseases. Pathogenesis and treatment. Neth J Med. 2001;58:27–40.CrossRefPubMedGoogle Scholar
  14. 14.
    Kremer AE, Feramisco J, Reeh PW, et al. Receptors, cells and circuits involved in pruritus of systemic disorders. Biochim Biophys Acta. 2014;1842:869–92.CrossRefPubMedGoogle Scholar
  15. 15.
    Leznoff A, Josse RG, Denburg J, et al. Association of chronic urticaria and angioedema with thyroid autoimmunity. Arch Dermatol. 1983;119:636–40.CrossRefPubMedGoogle Scholar
  16. 16.
    Logan RF, Ferguson A, Finlayson ND, et al. Primary biliary cirrhosis and coeliac disease: an association? Lancet. 1978;1:230–3.CrossRefPubMedGoogle Scholar
  17. 17.
    Massry SG, Popovtzer MM, Coburn JW, et al. Intractable pruritus as a manifestation of secondary hyperparathyroidism in uremia. Disappearance of itching after subtotal parathyroidectomy. N Engl J Med. 1968;279:697–700.CrossRefPubMedGoogle Scholar
  18. 18.
    Morgan JF, Lacey JH. Scratching and fasting: a study of pruritus and anorexia nervosa. Br J Dermatol. 1999;140:453–6.CrossRefPubMedGoogle Scholar
  19. 19.
    Mullin GE, Eastern JS. Cutaneous signs of thyroid disease. Am Fam Physician. 1986;34:93–8.PubMedGoogle Scholar
  20. 20.
    Neilly JB, Martin A, Simpson N, et al. Pruritus in diabetes mellitus: investigation of prevalence and correlation with diabetes control. Diabetes Care. 1986;9:273–5.CrossRefPubMedGoogle Scholar
  21. 21.
    Nestler JE. Hemochromatosis and pruritus. Ann Intern Med. 1983;98:1026.CrossRefPubMedGoogle Scholar
  22. 22.
    Scribner M. Diabetes and pruritus of the scalp. JAMA. 1977;237:1559.CrossRefPubMedGoogle Scholar
  23. 23.
    Sedlack RE, Smyrk TC, Czaja AJ, et al. Celiac disease-associated autoimmune cholangitis. Am J Gastroenterol. 2002;97:3196–8.CrossRefPubMedGoogle Scholar
  24. 24.
    Seite S, Khemis A, Rougier A, et al. Importance of treatment of skin xerosis in diabetes. J Eur Acad Dermatol Venereol JEADV. 2011;25:607–9.CrossRefPubMedGoogle Scholar
  25. 25.
    Stahle-Backdahl M, Hagermark O, Lins LE, et al. Experimental and immunohistochemical studies on the possible role of parathyroid hormone in uraemic pruritus. J Intern Med. 1989;225:411–5.CrossRefPubMedGoogle Scholar
  26. 26.
    Strumia R, Varotti E, Manzato E, et al. Skin signs in anorexia nervosa. Dermatology. 2001;203:314–7.CrossRefPubMedGoogle Scholar
  27. 27.
    Tsai JC, Feingold KR, Crumrine D, et al. Permeability barrier disruption alters the localization and expression of TNF alpha/protein in the epidermis. Arch Dermatol Res. 1994;286:242–8.CrossRefPubMedGoogle Scholar
  28. 28.
    Tseng HW, Ger LP, Liang CK, et al. High prevalence of cutaneous manifestations in the elderly with diabetes mellitus: an institution-based cross-sectional study in Taiwan. J Eur Acad Dermatol Venereol JEADV. 2015;29:1631–5.CrossRefPubMedGoogle Scholar
  29. 29.
    Verga U, Fugazzola L, Cambiaghi S, et al. Frequent association between MEN 2A and cutaneous lichen amyloidosis. Clin Endocrinol (Oxf). 2003;59:156–61.CrossRefGoogle Scholar
  30. 30.
    Weisshaar E, Dalgard F. Epidemiology of itch: adding to the burden of skin morbidity. Acta Derm Venereol. 2009;89:339–50.CrossRefPubMedGoogle Scholar
  31. 31.
    Yen AW, Fancher TL, Bowlus CL. Revisiting hereditary hemochromatosis: current concepts and progress. Am J Med. 2006;119:391–9.CrossRefPubMedGoogle Scholar
  32. 32.
    Yosipovitch G, Hodak E, Vardi P, et al. The prevalence of cutaneous manifestations in IDDM patients and their association with diabetes risk factors and microvascular complications. Diabetes Care. 1998;21:506–9.CrossRefPubMedGoogle Scholar
  33. 33.
    Zhang F, Hong S, Stone V, et al. Expression of cannabinoid CB1 receptors in models of diabetic neuropathy. J Pharmacol Exp Ther. 2007;323:508–15.CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag London 2016

Authors and Affiliations

  1. 1.Department of Medicine 1, Gastroenterology, Hepatology, Pneumology and EndocrinologyFriedrich-Alexander-University of ErlangenErlangenGermany
  2. 2.Department of Medicine 1Friedrich-Alexander-University of ErlangenErlangenGermany
  3. 3.Department of Clinical Social Medicine, Occupational and Environmental DermatologyUniversity Hospital, Ruprecht Karls-Universität HeidelbergHeidelbergGermany

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