The use of naltrexone in the management of severe generalized pruritus in biliary atresia: report of a case.

Generalized pruritus secondary to cholestasis is a difficult dermatologic condition to treat. We present a case of a 17-month-old child with congenital biliary atresia with generalized pruritus refractory to treatment with oral antihistamines, topical steroids, cholestyramine, and rifampin but improved remarkably with the addition of naltrexone. Naltrexone is a well-tolerated medication with little adverse effects. We believe that naltrexone may be an effective adjuvant treatment in the management of cholestatic pruritus in the pediatric population.