Which hematologic disorders are known to present with pruritus?

Polycythemia rubra vera and Hodgkin’s lymphoma are the two most common hematologic disorders known to cause pruritus. Between 14% and 52% of patients with polycythemia rubra vera suffer from pruritus. Pruritus is classically triggered by a sudden decrease in temperature (i.e., sudden cooling off after emerging from a warm bath). Treatment of the underlying disease is necessary to treat this symptom. A patient suffering from Hodgkin’s lymphoma may present with a pruritus that precedes the diagnosis by as many as 5 years. The pruritus can be intolerably severe and continuous, or, less commonly, the patient may complain of a burning sensation. A review of 10 studies on Hodgkin’s disease noted that 35% of patients suffered from pruritus sometime during the disease course, 15% presented with pruritus along with other symptoms, and 7% presented only with the symptom of pruritus. The significance of pruritus as a prognostic sign in Hodgkin’s disease is unknown. Treatment of the lymphoma is the best therapy for pruritus of Hodgkin’s disease.

Stadie V, Marsch WC: Itching attacks with generalized hyperhidrosis as initial symptoms in Hodgkin’s disease, J Eur Acad Dermatol Venereol 17:559–561, 2003.