Evaluation of D-dimer serum levels among patients with chronic urticaria, psoriasis and urticarial vasculitis

Criado, Paulo Ricardo; Antinori, Lidi Che Leon; Maruta, Celina Wakisaka; Reis, Vítor Manoel Silva dos

doi:10.1590/abd1806-4841.20131532

Cited by 37 publications

(26 citation statements)

References 21 publications

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“…In patients with CU, the increased level of D-dimer and its association with disease severity has been also confirmed in other studies (52)(53)(54). In addition, it has been shown that patients with active CU have elevated plasma D-dimer levels compared to patients with CU in remission and patients with psoriasis (53).…”

Section: Coagulation Biomarkers In Chronic Urticariasupporting

confidence: 66%

Chronic urticaria and coagulation: pathophysiological and clinical aspects

Tedeschi

Kolkhir

Asero³

et al. 2014

Allergy

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Chronic urticaria (CU) is a widespread skin disease, characterized by the recurrence of transient wheals and itch for more than 6 weeks. Besides autoimmune mechanisms, coagulation factors, in particular tissue factor and thrombin, might also participate in the disease pathophysiology. Tissue factor expressed by eosinophils can induce activation of blood coagulation generating thrombin which in turn can increase vascular permeability both directly, acting on endothelial cells, and indirectly, inducing degranulation of mast cells with release of histamine, as demonstrated in experimental models. D-dimer, a fibrin degradation product, generated following activation of the coagulation cascade and fibrinolysis, has been found to be increased during urticaria exacerbations; moreover, it has been proposed as a biomarker of severity and resistance to H1-antihistamines in CU patients. The possible role of coagulation in CU is also supported by case reports, case series and a small controlled study showing the efficacy of anticoagulant therapy in this disease. The purpose of this review was to summarize the available data on the possible contribution of coagulation to the pathophysiology of CU focusing on clinical aspects and possible future therapeutic developments.Chronic urticaria (CU) is a widespread skin disease characterized by the recurrence of transient wheals and itch for more than 6 weeks. It is believed that over 50% of CU cases are accompanied by a deep subcutaneous and/or submucosal edema, called angioedema (AE; 1).It is well known that the characteristic symptoms of urticaria appear following the activation of mast cells (MCs) and basophils in the skin by various stimuli. These cells release several biologically active substances, the most important of which is histamine. Histamine induces vasodilation, increases vascular permeability and stimulates sensory nerve endings. These effects lead to the appearance of erythema, wheals and itch (2). It is supposed that other biologically active substances may have similar effects. These include serotonin, C3a and C5a anaphylatoxins, platelet-activating factor (PAF), neuropeptides, and arachidonic acid metabolites (prostaglandin D2, leukotrienes C4, D4 and E4; 3).Activation and degranulation of basophils and MCs may occur by immunological (formation of immune complexes, complement activation, IgE cross-linking), nonimmunological (pseudoallergy, infection, or direct effect of agents on MCs), or mixed mechanisms. The mechanism and cause of urticaria remain unclear in many patients with CU.In recent years, attention was paid to several important aspects of the disease pathogenesis. It is believed that about 30-50% of patients have CU symptoms associated with autoimmune reactions and synthesis of autoantibodies against IgE (4) and/or the FceRI a-subunit on MCs and basophils (autoimmune/autoreactive urticaria; 5). Furthermore, these patients show an increased frequency of HLA DRB1*04 (DR4) as it occurs in other autoimmune diseases (6). The role of coagulation casc...

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Section: Coagulation Biomarkers In Chronic Urticariasupporting

confidence: 66%

Chronic urticaria and coagulation: pathophysiological and clinical aspects

Tedeschi

Kolkhir

Asero³

et al. 2014

Allergy

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“…By releasing potent vasoactive mediators, vasodilation is induced, increasing capillary permeability and resulting in erythema and papule formation. 5 …”

Section: Introductionmentioning

confidence: 99%

Correlation between the histopathology of chronic urticaria and its clinical picture

Criado

Filho

et al. 2016

An. Bras. Dermatol.

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BACKGROUNDChronic urticaria is characterized by transient, pruritic lesions of varying sizes, with central pallor and well-defined edges, with disease duration longer than six weeks. Its cellular infiltrate consists of neutrophils, lymphocytes and eosinophils. There is a subgroup of patients with eosinophilic or neutrophilic urticaria, resistant to the treatment with antihistamines, but that respond to a combination of antihistamine with other drugs.OBJECTIVETo evaluate the present infiltration in chronic urticaria biopsies and correlate it with the clinical disease activity and response to treatment.METHODSForty-one patients with chronic urticaria were classified according to the score of severity of the disease, response to treatment and type of perivascular infiltrate. Inflammatory infiltrates were divided in eosinophilic (46.30%), neutrophilic and mixed.RESULTSAn association was found between the eosinophilic infiltrate and clinical scores of greater severity (p = 0.002).CONCLUSIONThis association shows that the eosinophilic inflammatory infiltrates denote high clinical activity, which means more severe and exuberant clinical pictures of the disease.

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“…Interestingly, eosinophils might be in turn activated and recruited by mediators, cytokines, chemokines, or other as yet unknown factors released by mast cells [15][16][17][18]. The findings summarized above have been confirmed by several independent groups [19][20][21][22][23][24][25][26]. Thus, it seems likely that coagulation may play a role in the pathogenesis of chronic urticaria.…”

Section: Introductionmentioning

confidence: 95%