PRURITUS AFTER INFUSION OF HYDROXYETHYL S TARCH - CLINICAL CHARACTERISTICS AND PATHOGENESIS

The development of strong pruritus after intravenous application of hy droxyethyl starch (HES) has been repeatedly observed in the last years , especially in otorhinolaryngology. The characteristics of this disea se are summarized by a review of the literature. Typically generalised pruritus without visible skin lesions (>>sine materia<<) develops wit hin 1 to 3 weeks after application of HES. As a rule there is spontane ous remission of itching. The incidence of pruritus increases with the cumulative dosage and depends on the biochemical properties of the in fused type of HES. Tissue storage of HES in the skin is very likely to be responsible for the itching, allergic mechanisms are of minor impo rtance. In cases with a typical history and clinical picture it is not justified to carry out extensive allergologic tests. The pruritus can hardly be influenced and resists to therapy with antihistaminic drugs or glucocorticosteroids. It is important to avoid well-known provocat ive factors such as mechanical irritation and heat.