Two case reports of corticosteroid administration-prolonged and pulsed therapy-in treatment of pruritus in cholestatic hepatitis A patients

Cholestasis following hepatitis A affects around 0.8% of hepatitis A patients. It is considered a distressing complication in spite of its good prognosis. Despite being subject to multiple studies, causes of cholestasis are still controversial. Many treatments (discussed later) have shown some improvements of the accompanied pruritus. In the following article, we present two cholestatic hepatitis A patients who suffered from severe pruritus. Prednisolone was administered via two different methods: prolonged and pulsed. Both showed great improvement of the pruritus in a short time frame. To the best of our knowledge, our management using pulsed corticosteroid therapy in treatment of pruritus in cholestatic hepatitis A is considered the first experimental management in medical literature. The importance of this experimental case lies in reducing the doses and the duration of steroid intake, thus reducing steroid side effects as far as possible.