Association between Chronic Urticaria and Thyroid Autoimmunity: A Prospective Study Involving 99 Patients

Abstract

Background: The association between chronic urticaria and thyroid autoimmunity has been a subject of debate. However, this link was suggested in studies searching thyroid microsomal antibodies (TMA), which are less sensitive and less specific than anti-thyroperoxidase antibodies, moreover these studies did not measure anti-TSH receptor antibodies, nor did they use a control group. As a consequence, the results of these studies are difficult to interpret. Objective: The aim of this study was to determine whether chronic urticaria is statistically associated with thyroid autoimmunity. Methods: In a prospective case-control study, we compared the frequency of thyroid autoantibodies in 45 patients with chronic urticaria and in 30 healthy adult volunteers; we also compared the frequency of chronic urticaria in 32 patients with thyroid diseases with thyroid autoantibodies and in 22 patients with thyroid diseases without thyroid autoantibodies. Thyroid autoantibodies and thyroid hormones were measured in all the subjects; antinuclear antibodies, rheumatoid factors, complement, IgE were assessed and routine laboratory tests were done in patients with chronic urticaria. Fisher’s exact statistics were used to test our hypothesis. Results: The frequency of thyroid autoantibodies was significantly higher in patients with chronic urticaria than in healthy controls (26.7%/3.3%; p < 0.01). All the patients with thyroid autoantibodies had thyroid hormone concentrations within the normal limits. The frequency of chronic urticaria was not significantly different (12.5%/9.1%; p = 0.7) in patients with thyroid diseases with or without thyroid antibodies. The rest of the biological investigations revealed only 1 patient with connective tissue disease. Conclusion: This study shows a significant association between chronic urticaria and thyroid autoimmunity, and that tests to detect thyroid autoantibodies are relevant in patients with chronic urticaria, whereas extensive laboratory tests are not.

Histamine release positive test associates with disease remission in chronic spontaneous urticaria: a proof-of-concept study

“…No statistical association of autoimmune thyroid dysfunction (or isolated thyroid autoimmunity) with HR or APST/ASST results was observed in our cohort. The mutual relationship of these two conditions is well known and accounts for 10 to 27% of cases in literature (17,18,19). In our cohort the percentage of thyroid disease is slightly greater, perhaps as a consequence of a selection bias of those patients with an antihistamine resistant CSU.…”

Avaliação da associação entre doença auto-imune de tireóide e urticária crônica idiopática

“…Como resultado desses esforços, vários autores encontraram maior prevalência de DAT em pacientes com UCI (7)(8)(9)(10)(11)(12)(13)(14). Esses achados levantam a possibilidade de uma relação entre essas doenças.…”

“…No entanto, a freqüência de DAT em pacientes com UC variou, nos diversos estudos, de 1,14% a 28,6% (7)(8)(9)(10)(11)(12)(13)(14)16,17). Alguns autores, procurando reforçar a associação encontrada em muitos trabalhos, investigaram a freqüência de UCI em pacientes com DAT, obtendo resultados discrepantes (13,18).…”

“…Alguns autores, procurando reforçar a associação encontrada em muitos trabalhos, investigaram a freqüência de UCI em pacientes com DAT, obtendo resultados discrepantes (13,18). Assim, apesar de muitos trabalhos na literatura terem encontrado uma associação entre DAT e UC, ocorreu uma grande variabilidade entre as freqüências encontradas, seja por diferenças relacionadas à população em estudo e motivos específicos que serão discutidos oportunamente ou por dificuldades metodoló-gicas, encontrados em alguns desses trabalhos.…”

Hashimoto’s Thyroiditis in Adolescents

“…There is a greater incidence of HT in patients with certain chromosomal alterations such as Down syndrome, 24 Turner syndrome, 25 and Klinefelter syndrome. The AITD may also be associated with chronic urticaria 26 and, rarely, glomerulonephritis.…”