Infektfokus und chronische spontane Urtikaria

Abstract

Urticaria represents a common skin reaction pattern that can be induced by different factors. Triggering by infections has been discussed for many years but the exact role and mechanism of mast cell activation by infectious processes is unclear. In acute spontaneous urticaria, there is no doubt about a causal relationship to infections and all chronic urticaria must start as acute. Remission of annoying spontaneous chronic urticaria has been reported after successful treatment of persistent infections. Summarizing available studies evaluating the course after proven Helicobacter eradication demonstrates a statistically significant benefit compared to not-eradicated or Helicobacter-negative patients. The licensed treatment with a standard dose of H1-antihistamines is not effective in a significant number of patients and infections can be easily treated. Therefore, appropriate diagnostic procedures should be included in the routine work-up, especially the search for Helicobacter pylori.

Role of Small Intestinal Bacterial Overgrowth and Helicobacter pylori Infection in Chronic Spontaneous Urticaria: A Prospective Analysis

“…These data thus agree with the results of some previous studies (26,27). However, we have to consider that the triple therapy for HP infection shows broad-spectrum activity and could eradicate other unrecognized subclinical infections related to CSU symptoms.…”

“…Although some authors report a lack of association between HP eradication and remission of CSU (24,25), other authors describe a beneficial role of HP eradication therapy on CSU (26)(27)(28)(29).…”

¿Es posible simplificar el abordaje diagnóstico de urticaria crónica? Una lista de verificación de información clínica

“…6 En 10 % de los casos, la etiología es conocida y en 80 % se debe a autorreactividad, 4 intolerancia alimentaria 4,6,7 e infecciones crónicas, 8,9 incluyendo infecciones virales como hepatitis B y C, virus Epstein-Barr y virus del herpes simple, infecciones por Helicobacter pylori e infecciones parasitarias helmínticas. 9,10.11 Un estudio en Ecuador reveló que 57 % de los casos de urticaria crónica es de etiología idiopática y 12 % de urticaria vasculítica.…”

“…9 y hongos (Candida, dermatofitosis). -Picadura de insecto: mosquitos, moscas, pulgas, chinches, garrapatas (urticaria aguda, ocasionalmente crónica).…”

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

“…В детском возрасте установлена более частая хронизация крапивницы при на-личии сопутствующих инфекций, которые так-же рассматриваются и как триггеры обострений [59]. Их выявляемость достигает 35% среди детей с данной патологией [76] Наиболее часто выявляемыми инфекциями у детей, страдающих хронической крапивницей, являются инфекции урогенитального тракта, вы-званные Е. соli [15], дыхательных путей, обуслов-ленные С. pneumoniae, Streptococcus pyogenes [25], вирусные заболевания, такие как инфекционный мононуклеоз ВЭБ-этиологии и цитомегалови-русная инфекция [61], хеликобактерная инфек-ция [7], паразитарные инвазии [1].…”