Helicobacter pylori infection in patients with chronic urticaria: correlation with pathologic findings in gastric biopsies

Abstract

Helicobacter pylori may have a role in the exacerbation of urticarial symptoms, even though it is not involved directly in its etiology, and its eradication may lead to symptom improvement in a considerable number of infected urticaria patients. The severity of symptoms is dependent on the density of bacterial infection and the intensity of inflammatory infiltrate in the gastric biopsy.

Clinicoepidemiologic Features of Chronic Urticaria in Patients with versus without Subclinical <b><i>Helicobacter pylori</i></b> Infection: A Cross-Sectional Study of 150 Patients

“…However, researchers have also shown no significant etiologic correlation between the two, or therapeutic improvement of urticarial symptoms following eradication therapy [21][22][23][24]. Abdou et al [10] assessed the prevalence of H. pylori infection in 35 patients of chronic urticaria and 10 normal control subjects. They did not find a statistically significant difference for the presence of H. pylori in the 2 groups (57 vs. 40%).…”

“…However, a greater number (96 vs. 15) of patients with positive test results had a significantly higher (p < 0.05) mean number of systemic symptoms than patients with negative results. Furthermore, the prevalence of H. pylori-associated gastrointestinal symptoms remains variable, from being symptomatic to the complete absence of symptoms [2,8,10,28]. In their 57% urticaria patients with positive H. pylori, Abdou et al [10] reported no gastric symptoms.…”

“…Helicobacter pylori infection has also been linked to chronic urticaria wherein it has been implicated in 60% of chronic urticaria patients in one study, while associated gastritis was present in about 71% of 68 patients in another study [7][8][9]. Although it may not establish a causal relationship, H. pylori eradication treatment leads to the remission of urticaria in up to 80% of patients, including antihistamine-unresponsive cases [7,[9][10][11][12][13]. A recent meta-analysis of studies comparing the prevalence of H. pylori infection in chronic urticaria patients and controls suggested that H. pylori infection is significantly, though weekly, associated with an increased risk of chronic urticaria [14].…”

“…In contrast, studies have found that evidence for a reported benefit of H. pylori eradication was weak and conflicting, eradication therapy may itself trigger urticaria, and the stated benefits might have been from eradication of other undiagnosed/asymptomatic infections [15,16]. Various mechanisms have been speculated to explain the possible association of H. pylori with chronic urticaria [9][10][11][16][17][18]. H. pylori is suggested to increase the secretion of gastric acid and pepsin, which induces active inflammation in the gastrointestinal tract leading to the recruitment of neutrophils, eosinophils, and lymphocytes, which release a family of histamine-releasing factors that induce mast cell degranulation.…”

Chronic Urticarial in Childhood. Immune Pathology of Chronic Urticarial in Children (Part I)

“…При хронической крапивнице у детей антигенная мимикрия опи-сана при инфицировании Helicobacter pylori (40-90%), Yersinia enterocolitica (31-39%), Streptococcus pyogenes [17,25].…”