[Pruritus--a side effect of hydroxyethyl starch? First report]

It is generally assumed that a disturbance of microcirculation is the common pathogenic pathway of various cochleovestibular disorders. Several studies have demonstrated that hydroxyethyl starch (HES) has better rheological effects than dextran 40, and fewer side-effects. Therefore, we changed from dextran 40 to hydroxyethyl starch in 1987 for the treatment of several otoneurological disorders. However, some patients complained of general pruritus after 1 or 2 weeks of therapy with HES. Therefore, a retrospective study was performed using a questionnaire of 491 patients treated for various cochleovestibular disorders. We received answers from 94 (20%): 25 of 59 (42.4%) patients treated with HES complained of pruritus compared with only 4 of 35 (11.4%) patients treated with dextran 40. The difference was significant (P less than 0.01). Critical points are the retrospective study design and the small number of patients, so that no conclusions can be drawn about the incidence of pruritus after therapy with HES. However, we would like to focus attention on this side-effect, which has been neglected in the literature but is extremely uncomfortable and socially embarrassing for some patients.