Chronic Idiophatic Urticaria and Helicobacter Pylori: A Specific Pattern of Gastritis and Urticaria Remission after Helicobacter Pylori Eradication

Abstract

Chronic urticaria (CU) is defined as the occurrence of spontaneous wheals for a duration of more than 6 weeks and is the most frequent skin disease, with prevalence ranging between 15 and 25%, and is a seriously disabling condition, with social isolation and mood changes causing a significant degree of dysfunction and quality of life impairment to many patients. The main clinical features of CU are the repeated occurrence of transient eruptions of pruritic wheals or patchy erythema on the skin that last less than 24 hours and disappear without sequelae. CU is often defined as Chronic idiopathic urticaria (CIU) because the causes of CU remain unknown in the great majority (70-95%) of patients. Drugs, food, viruses, alimentary conservative substances or inhalant substances often seem to be involved in determining CIU skin flare. Despite a general agreement that bacteria infections and parasitic infestations can be involved in the pathogenesis of CIU, proven evldence of these relationships is lacking. The aim of the present study is to evaluate the prevalence of Helicobacter pylori (Hp) infection, and the extension and severity of gastritis in a group of CIU patients compared to controls and to evaluate the effectiveness of eradication of Hp on the CIU symptomatology, and the role of Hp infection in pathogenesis of CIU.Helicobacter pylori (Hp), a microaerophilic gram negative bacterium, was first isolated from the human stomach by Marshall and Warren in 1983. It is an ubiquitous infection in the adult population. The prevalence among middle-aged adults is over 80% in many developing countries, as compared with 20% to 50% in industrialized countries. Mainly, the infection is acquired in infancy and is generally transmitted within families in early childhood. Hp has been demonstrated as the cause of gastritis and peptic ulcer and as being associated to gastric cancer and mucosa-associated-lymphoma i.e. MALT lymphoma (1-3). There is evidence that Hp infection is associated with extra-digestive pathologies such as autoimmune, vascular and skin diseases. The pathogenic mechanisms involved are related to the persistent inflammatory response to Hp infection with release of immune associated substances, increase in gastric permeability and/or release of mediators acting on cutaneous sensitivity. In recent studies a possible association between Hp infection and CIU has been suggested. In fact, in some studies,

Relación entre infección por Helicobacter pylori y urticaria crónica

“…Resultados similares mostraron Vázquez RM et al en España. 16,17,18,19 Se necesitan más estudios acerca del tema, pero la evidencia avala que en los pacientes con urticaria crónica, incluso con ausencia de síntomas digestivos, debe considerarse la posibilidad de la infección y la indicación de exámenes que ayuden al diagnós-tico certero de la enfermedad y a la mejoría clínica de los pacientes.…”

Helicobacter pylori in Rosacea: Epiphenomenon, Etiologic Agent or Maintenance Factor? Summary of 10 Years of Experience in Clinical Microbiological Practice

“…There are many theories that present rosacea as an extra gastric manifestation of Helicobacter pylori infection, similar to what has happened in the case of idiopathic chronic urticaria [8,9], where it went from being considered as an epiphenomenon to verify an important role as initiator or maintenance factor of chronic inflammatory responses, which when modulated or eliminated by eradication therapy with the elimination of gastric infection, significant clinical improvements and healing of dermatological pathology are observed [10][11][12][13]. That is why, at present, several authors have gathered evidence of the importance of making the proper diagnosis of active gastric infection by Helicobacter pylori in patients with rosacea, and consider its eradication therapy as part of its thera-peutic protocol, as it is associated with clinical improvement of skin pathology [14][15][16][17].…”

Detection and allergen analysis of serum IgE in pediatric patients with chronic urticaria

“…4 - 6 On the other hand, multiple antigen simultaneous test (MAST) is a quick, sensitive, reliable and specific IgE detection method in vitro . 7 …”