Endogenous Allergy

Urbach, Erich

doi:10.1001/archderm.1942.01500100058007

Cited by 15 publications

(5 citation statements)

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“…126 Ageappropriate malignancy screening is, therefore, strongly encouraged for early detection and treatment, which will improve the outcomes of both cancer and urticaria. 89,93,97,126 The high prevalence of thyroid autoantibodies in both geriatric and adult CU suggests the relationship between CU and thyroid autoimmunity, 10,11,40,67,70,120,123,127 even though this study and the previous report showed no difference of thyroid autoantibodies between the two groups. 11 Focusing on infections, hepatitis B virus was the only infection in this study that was reported at higher prevalence (12.7%) than in previously reported general CU patients (0-3.6%).…”

Section: Dovepresscontrasting

confidence: 54%

“… 126 Age-appropriate malignancy screening is, therefore, strongly encouraged for early detection and treatment, which will improve the outcomes of both cancer and urticaria. 89 , 93 , 97 , 126 …”

Section: Discussionmentioning

confidence: 99%

“…More specifically, the following treatments, prescriptions, or procedures improved CU symptoms in the elderly: treatment for Helicobacter pylori (H. pylori) infection, 63 treatment for Strongyloides infection, 92 treatment for thyroid diseases, 73,88 prescription of immunosuppressants for malignancies, 79,83,93 prescription of intravenous immunoglobulin (IVIG) 53,54,60 or sulfasalazine to treat recalcitrant CSU, 94 and surgical removal of adenoma/neoplasms. 69,84,85,89,[95][96][97] Follow-Up Time, Tapering, Relapse, and Mean Duration of Treatment…”

Section: Treatment Of Secondary Causes Should Be Considered a Strateg...mentioning

confidence: 99%

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Prevalence, Clinical Manifestations, Treatment, and Clinical Course of Chronic Urticaria in Elderly: A Systematic Review

Kulthanan¹,

Rujitharanawong²,

Munprom³

et al. 2022

JAA

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Purpose Data specific to the epidemiology, clinical features, and management of chronic urticaria (CU) in the geriatric population remain limited and not well understood. We aim to systematically review the prevalence, clinical manifestations, treatment, and clinical course of elderly patients with CU. Patients and methods Original articles that included data of elderly (aged >60 years) with CU that were published until February 2021 were searched in PubMed, Scopus, and Embase using predfefined search terms. Related articles were evaluated according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations. Results Among the included 85 studies and 1,112,066 elderly CU patients, most (57.4%) were women. The prevalence of elderly CU in the general population ranged from 0.2–2.8%, and from 0.7–33.3% among all CU patients. Compared to adult CU, elderly CU patients had a higher percentage of wheal alone (73.9%), and lower rate of positive autologous serum skin test and atopy. Gastrointestinal diseases were the most common comorbidity (71.9%), and there was a high rate of malignancies and autoimmune diseases. Second generation H 1 -antihistamines were commonly used, and achievement of complete control was most often reported. Omalizumab was prescribed in 59 refractory patients, and a significant response to treatment was reported in most patients. The treatment of comorbidities also yielded significant improvement in CU. Conclusion Elderly CU was found to be different from adult CU in both clinical and laboratory aspects. H 1 - antihistamines are effective as first-line therapy with minimal side-effects at licensed doses. Treatment of secondary causes is important since the elderly usually have age-related comorbidities.

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Section: Dovepresscontrasting

confidence: 54%

Section: Discussionmentioning

confidence: 99%

Section: Treatment Of Secondary Causes Should Be Considered a Strateg...mentioning

confidence: 99%

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Prevalence, Clinical Manifestations, Treatment, and Clinical Course of Chronic Urticaria in Elderly: A Systematic Review

Kulthanan¹,

Rujitharanawong²,

Munprom³

et al. 2022

JAA

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“…Five cases of pulmonary neoplasms associated with chronic urticaria have been reported, of which 3 cases (60%) corresponded to adenocarcinomas, 1 case (20%) to small cell carcinoma and 1 case (20%) to large cell carcinoma. In addition, a case of chronic pruritus associated adenocarcinoma without dermal lesions was also reported[ 33 ].…”

Section: Discussionmentioning

confidence: 99%

Chronic urticaria associated with lung adenocarcinoma — a paraneoplastic manifestation: A case report and literature review

Jiménez¹,

Castellón²,

Marenco³

et al. 2022

WJCC

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BACKGROUND Urticaria is one of the most common causes of emergency room visits. It is defined as an acute inflammatory dermatosis, characterized by localized degranulation of mast cells, with consequent dermal microvascular and formation of edematous and pruritic plaques called hives. Urticaria affects the skin and tissues of the superficial mucosa. Sometimes it is accompanied by angioedema, which is characterized by deeper edema of the dermis and subcutaneous cellular tissue known as the urticarial-angioedema syndrome. About 15%-25% of the general population has suffered at least one type of urticaria at some point during their lifetime and hyperpermeability estimated at 7.6%-16% and has experienced acute urticaria that is usually self-limited and spontaneously resolves without requiring medical attention. CASE SUMMARY We present the case of a young male patient who was referred to our department with a clinical picture of 4 mo of pruritus associated with hives of variable sizes, irregular borders, with interlesional confluence, that were non-painful, without involvement of the palms and soles of the feet but with a tendency to progression in a generalized manner. He had multiple emergency room visits and poor response to antihistamines and systemic corticosteroids. Imaging studies demonstrated nodules in the lower lingula segment, at the level of the greater fissure and in the anterior contour of the left anterior basal segment associated with parahiliar adenopathies in the absence of findings suggestive of infectious or autoimmune etiology. Segmental lobectomy was performed by thoracoscopy with resection of a lung nodule in the lingula and biopsy of the para-aortic mediastinal ganglion. The histopathological report showed the presence of poorly differentiated invasive adenocarcinoma with a solid morphological and acinar pattern with immunohistochemical description of lung tissue that expresses strong positive and diffuse reaction for thyroid transcription factor 1 (TTF-1) with negativity to P40 for a histopathological diagnosis of malignant epithelial neoplasia with expression of infiltrating adenocarcinoma. Spontaneous chronic urticaria is considered possibly secondary to lung adenocarcinoma. CONCLUSION Chronic spontaneous urticaria is considered a paraneoplastic dermatosis with a controversial association in the literature. In the presented case, a young patient presented with chronic refractory urticaria and after an exhaustive clinical work-up was found to have a diagnosis of poorly differentiated lung adenocarcinoma with high expression of TTF-1. According to the Curth criteria, the urticaria presented by the patient is related to the oncological diagnosis. In addition, the high expression of TTF-1 documented in this case could be acting as an autoantigen that would cause chronic spontaneous urticaria. Further research evaluating a causal relationship between the TFF-1 protein and urticaria in lung cancer is needed.

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“…The association between CU and malignancies remains controversial ( 37 ). The first implication of a causal relationship between CU and cancer was described in 1942, when the removal of a rectal carcinoma in a 70-year-old male was associated with CU remission ( 102 ). Since then anecdotal cases of urticaria linked to malignancies have been reported in the literature ( 103 ).…”

Section: Cu and Malignanciesmentioning

confidence: 99%

Comorbidities of Chronic Urticaria: A glimpse into a complex relationship

et al. 2022

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Chronic Urticaria (CU) is a chronic inflammatory, predominantly mast cell-driven disease, characterized by the development of wheals and/or angioedema for more than 6 weeks. It affects approximately 1%–5% of the total population worldwide and imposes a substantial burden on health-related quality of life, significantly affecting patients' daily life. The economic impact on the health system is also not negligible, with an estimated cost per patient per year of approximately 2.000 $ in the United States. Although the underlying pathophysiology is not fully explored, autoimmune mechanisms have been proposed, including type I (“autoallergy” by means of autoantibodies to self-antigens) and type IIb (autoimmunity). Atopic, autoimmune, and psychiatric disorders are prevalent comorbidities in both children and adults with Chronic Spontaneous Urticaria (CSU). Although malignancies, cardiovascular diseases and other comorbidities have also been reported as associated diseases in patients with CSU, data remain scarce. It is still unknown whether the aforementioned comorbidities share common pathophysiological mechanisms with specific endotypes of CSU. The current review aims to overview current data on comorbidities of CU, and furthermore to comment on the potential linked pathways underlying these diseases.

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Endogenous Allergy

Cited by 15 publications

References 0 publications

Prevalence, Clinical Manifestations, Treatment, and Clinical Course of Chronic Urticaria in Elderly: A Systematic Review

Prevalence, Clinical Manifestations, Treatment, and Clinical Course of Chronic Urticaria in Elderly: A Systematic Review

Chronic urticaria associated with lung adenocarcinoma — a paraneoplastic manifestation: A case report and literature review

Comorbidities of Chronic Urticaria: A glimpse into a complex relationship

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