الفهرس 
Chronic Liver DiseasesOnly 14 pages are availabe for public view
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Abstract
A complex relationship exists between itching and chronic liver disease. Itch is a complication of liver disease (Golombek and Rosenstein, 2010).
Intractable pruritus is reported to be the prevalent in manifestation of liver diseases. Itch is the complication of liver disorders, in particular those characterized by cholestasis (Michalak et al., 2011), Cholestasis is defined as impaired secretion of bile (Bergasa, 2011).
Hepatitis C virus (HCV) is considered the most common etiology of chronic liver disease (CLD) in Egypt (Valva et al., 2010).
The direct link between itching and chronic liver disease is due to deposition of bile salts in the skin.
To fullfil the aim of the work, this study was designed to assess the prevalence of itching in patients with chronic liver disease, as well as the factors associated with its development.
This study was conducted in Tropical Medicine Department, Ain-Shams University. It included patients who were attending the out-patient clinic of Tropical Medicine Department, Ain-Shams University Hospital in the period from March 2011 to April 2014.
The study was performed on 200 patients with proven chronic liver disease according to the pre-designed inclusion criteria. As well as, a Control group included 50 cases with other diseases than liver disease..
All patients were subjected to the following; careful history, thorough clinical examination and laboratory investigations [liver enzymes (AST and ALT), serum albumin, INR, total bilirubin, complete blood picture, viral markers (HCV-Ab & HBs-Ag), and Abdominal ultrasound.
Concerning the clinical presentations of cases with chronic liver disease, lower limb edema and jaundice were the most frequent clinical presentations among them.
Regarding the laboratory findings, ALT, AST, T. bilirubin, INR, creatinine and serum uric acid were significantly higher in study group than in control group, while albumin, hemoglobin and platelets were significantly lower in study group than in control group.
In the current study, regarding the etiology of chronic liver disease, viral infection (HBV and HCV) was the most frequent cause of chronic liver disease among the study group in about 175 patients (87.5%).
In the present study, Itching was significantly more frequent in study group than in control group, itching was present in study group in 55.5% of patients while in control group in 38% of patients.
Concerning clinical presentations, jaundice was significantly more frequent in cases with itching.
In the present study, between those with itching and those without, T. bilirubin, INR and uric acid were significantly higher in cases with itching, while albumin, hemoglobin and platelets were significantly lower in cases with itching.
Child C grade was significantly more frequent in cases with itching than those without itching.
Therefore, the association between chronic liver disease and itching is of considerable clinical significance.