Utility Of Routine Laboratory Testing In Management Of Chronic Urticaria/Angioedema

Tarbox, James; Gutta, Ravi; Ching, E; Radojicic, Cristine; Lang, David M.

doi:10.1016/j.jaci.2008.12.379

Cited by 2 publications

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“…Of 285 patients treated with thyroid medication, CSU was improved in 120 (42%) patients. Fourteen studies reported complete remission of CSU in 68 patients (24%) and partial improvement in 28 patients (10%) . Beneficial effects were not specified in 24 (8%) of 285 patients in two studies and were not seen in six studies in all patients.…”

Section: Resultsmentioning

confidence: 98%

Comorbidity of chronic spontaneous urticaria and autoimmune thyroid diseases: A systematic review

Kolkhir

Metz

Altrichter

et al. 2017

Allergy

149

118

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Patients with chronic spontaneous urticaria (CSU) are widely held to often have other autoimmune disorders, including autoimmune thyroid disease. Here, we systematically evaluated the literature on the prevalence of thyroid autoimmunity in CSU and vice versa. There is a strong link between CSU and elevated levels of IgG antithyroid autoantibodies (AAbs), with most of a large number of studies reporting rates of ≥10%. Levels of IgG against thyroid peroxidase (TPO) are more often elevated in CSU than those of other IgG antithyroid AAbs (strong evidence). Levels of IgG antithyroid AAbs are more often elevated in adult patients with CSU than in children (strong evidence). Patients with CSU exhibit significantly higher levels of IgG antithyroid AAbs (strong evidence) and IgE-anti-TPO (weak evidence) than controls. Elevated IgG antithyroid AAbs in CSU are linked to the use of glucocorticoids (weak evidence) but not to disease duration or severity/activity, gender, age, or ASST response (inconsistent evidence). Thyroid dysfunction rates are increased in patients with CSU (strong evidence). Hypothyroidism and Hashimoto's thyroiditis are more common than hyperthyroidism and Graves' disease (strong evidence). Thyroid dysfunction is more common in adult patients with CSU than in children (strong evidence) and in female than in male patients with CSU (weak evidence). Urticaria including CSU is more prevalent in patients with thyroid autoimmunity than in controls (weak evidence). CSU can improve in response to treatment with levothyroxine or other thyroid drugs (strong evidence). Pathogenic mechanisms in CSU patients with thyroid autoimmunity may include IgE against autoantigens, immune complexes, and complement.

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Section: Resultsmentioning

confidence: 98%

Comorbidity of chronic spontaneous urticaria and autoimmune thyroid diseases: A systematic review

Kolkhir

Metz

Altrichter

et al. 2017

Allergy

149

118

View full text Add to dashboard Cite

show abstract

“…However this, along with routine laboratory testing, has no beneficial implications on patients' management as yet [13]. As a second line of approach, the guidelines recommend treatment targeted at symptom relief [9].…”

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confidence: 99%

Update and insights into treatment options for chronic spontaneous urticaria

Marrouche¹,

Grattan

2014

Expert Review of Clinical Immunology

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Chronic spontaneous urticaria (CSU) is defined as itchy weals, angio-oedema, or both, arising spontaneously without external physical stimuli. Symptoms of the disease continue to develop for more than 6 weeks. It carries a high socioeconomic burden with considerable health care costs. Second generation H1-antihistamines are the mainstay of urticaria treatment and are the only licensed option. However, many patients are resistant to H1-antihistamine therapy. Omalizumab has proven to be an effective therapeutic option in patients with recalcitrant chronic urticaria. Ciclosporin appears to be more beneficial in patients with functional histamine releasing autoantibodies as a cause of their disease. This review article will highlight the major therapeutic options available today for the management of CSU knowing that good quality evidence for efficacy of many agents is scarce except for H1-antihistamines and omalizumab.

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Utility Of Routine Laboratory Testing In Management Of Chronic Urticaria/Angioedema

Cited by 2 publications

References 0 publications

Comorbidity of chronic spontaneous urticaria and autoimmune thyroid diseases: A systematic review

Comorbidity of chronic spontaneous urticaria and autoimmune thyroid diseases: A systematic review

Update and insights into treatment options for chronic spontaneous urticaria

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