Clinical and Laboratory Examinations in the Subgroups of Chronic Urticaria

Abstract

Background: The aetiology of chronic urticaria is heterogeneous. Physical urticaria (PU) is estimated at around 35%, autoimmune urticaria (AIU) at 25% and chronic idiopathic urticaria (CIU) at 35% of all chronic urticaria cases. Methods: Differences in clinical and laboratory parameters among AIU, PU and CIU groups were examined. AIU was diagnosed if the basophil CD63 assay was positive. Demographic data, severity of symptoms and association with allergic and autoimmune diseases were analysed by the aid of a questionnaire. Immunoassays were carried out and the effectiveness of therapy was also investigated. Results: Concerning the urticaria score, AIU patients had significantly higher total urticaria scores than patients with CIU (p = 0.013), dermatographic urticaria (p = 0.05) or cholinergic urticaria (p = 0.038). Between CIU and dermatographic urticaria and between CIU and cholinergic urticaria patients, we found insignificant differences in the urticaria score (p = 0.707 and p = 0.336, respectively). AIU was more frequently associated with autoimmune diseases in the personal history (p < 0.001) and with other types of urticaria in the family history (p < 0.001). Also, anti-thyroid antibodies were more frequently detected in the AIU group. Antihistamine therapy was less effective in the AIU group (12.8%) than in the PU (70.3%) and CIU groups (68.6%), but there were no significant differences between the CIU and PU groups regarding the effectiveness of antihistamine therapy. Conclusion: The autoimmune subgroup represents the most severe form of chronic urticaria. On the other hand, there were no significant differences between the CIU and PU groups neither in urticaria scores nor in response to antihistamine therapy.

Accompanying conditions in patients with chronic spontaneous urticaria and urticarial vasculitis: Results of a retrospective study

“…Bununla birlikte ürtikeryal lezyonları olan ve kuşkulanılan olgularda ÜV tanısını dışlamak için biyopsi alınmasının gerekliliğinden bahsedilmiştir 1,2 . Kadınlarda erkeklere göre yaklaşık üç kat daha fazla görülen ve genellikle orta yaş grubunu etkileyen KSÜ'nün ortalama süresi 3-5 yıl arasında değişmekle birlikte bazı olgularda 40 yıla kadar uzayabildiğinden söz edilmiştir 7,8 . Olguların yaklaşık %85'ini kadınların oluşturduğu ÜV ise, her yaşta görülebilse de ortalama görülme yaşı 4. dekad civarındadır.…”

“…Çalışmamıza alınan her iki grupta da demografik verilerin literatürle uyumlu olduğu gözlenmiştir. Yapılan geniş olgu serili çalışmalarda KÜ olgularının yaklaşık %18-50'sinde büyük çoğunluğunu allerjik rinit oluşturmak üzere kişisel atopi öyküsü alınmış, %35-48'inde ailesel atopi öyküsü ve %10-15'inde de ailesel ürtiker öyküsü alınmıştır 7,10 . ÜV'li olguların ise %14'ünde yine en sık allerjik rinit olmak üzere bir atopik hastalık belirlenmiş, ancak atopi prevalansının normal popülasyonla karşılaştırıldığında yüksek olmadığı gözlenmiştir 9 .…”

The autoimmune nature of chronic urticaria

“…20 In a recent study that compared clinical and laboratory features of patients with autoimmune urticaria versus chronic idiopathic urticaria and physical urticaria, urticaria scores were significantly elevated in the autoimmune urticaria group, as were individual parameters including pruritus, frequency, duration, and distribution of wheals. 32 In addition, patients with autoimmune urticaria were more likely to require thirdline treatment (cyclosporin). These results support previous studies in patients with autoimmune urticaria.…”

Successful Treatment of Autoimmune Urticaria with Low-Dose Prednisolone Therapy Administered for a Few Months: A Case Series of 42 Patients

“…Presently, the ASST is used in clinical practice to detect AIU. In AIU, the incidence of anti-thyroid antibodies is higher, and patients should be screened for anti-thyroid peroxidase and anti-thyroglobulin antibodies [19]. …”