Еще один эвиденс, что в основе зуда неясной этиологии наиболее часто может быть латентный железодефицит:
J Eur Acad Dermatol Venereol. 2008 May;22(5):615-618
Positivity of iron studies in pruritus of unknown origin.
Bharati A, Yesudian PD.
We audited 21 patients with Pruritus of unknown origin (PUO), obtaining case-notes from 4 hospitals in Merseyside, United Kingdom. The investigations done in these patients included full blood count (FBC), erythrocyte sedimentation rate (ESR), urea and electrolytes (U & E), liver function tests (LFT), glucose, ferritin, iron studies, thyroid function tests (TFT), IgE, RAST, immunoglobulins and chest X-ray (CXR).
The age range was 27 to 89 years (mean, 66.7 years), with 15 female and 6 male patients. The average number of investigations done for each patient was 5.3 (range, 0–9). The mean number of investigations per patient varied from hospital to hospital (range, 2.5–6.8).
Ferritin, iron studies or both had been done in 17 patients and an abnormality found in 8 (47%). Ferritin was abnormal in 4 (44%) of 9 patients and iron studies in 4 (36%) of 11 patients. LFTs showed an abnormality in 20%, whereas the positivity rate was less for other investigations. CXR, immunoglobulins and RAST were normal in all patients.
The causes of PUO are wide-ranging and include chronic renal failure, cholestasis, iron deficiency and internal malignancy. The mechanism underlying the association between iron deficiency and PUO remains unclear. Restoring the serum ferritin to normal levels by iron supplementation therapy has been reported to result in the resolution of pruritus of iron deficiency.
In our audit, none of the investigations were found to be significantly useful except ferritin and iron studies. With the high positivity rate in our audit for iron studies and ferritin, we recommend that they should be done in all patients with PUO.
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