The clinical and laboratory characteristics of acute spontaneous urticaria and its progression to chronic spontaneous urticaria

Magen, Eli; Зуева, Е. Е.; Mishal, Joseph; Schlesinger, Menachem

doi:10.2500/aap.2016.37.3971

Cited by 27 publications

(21 citation statements)

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“…No significant difference in the prevalence of elevated IgG‐anti‐TG and/or IgG‐anti‐TPO was observed between patients with CSU and patients with acute urticaria, urticarial vasculitis, rheumatoid arthritis, or systemic lupus erythematosus . In contrast, some studies showed that patients with CSU had significantly higher levels of IgG antithyroid AAbs compared to patients with acute and chronic inducible urticaria. The difference in IgG antithyroid AAb levels was not statistically significant when CSU patients with atopic diseases were compared to nonatopic CSU patients .…”

Section: Resultsmentioning

confidence: 95%

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

Kolkhir

Metz

Altrichter

et al. 2017

Allergy

145

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: 95%

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

Kolkhir

Metz

Altrichter

et al. 2017

Allergy

145

118

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“…Furthermore, this was one of the first studies comparing ASST positivity among AU and CSU patients. In PubMed search with key words of AU and ASST, there was only one research paper published by Magen et al [8]. They reported ASST positivity as 63.4% in the CSU, and 23.3% in the AU group.…”

Section: Frequency Of Asst Positivitymentioning

confidence: 99%

“…Acute urticaria (AU) which lasts shorter than 6 weeks, has identifiable aetiology only in 50% of patients. General laboratory studies are not indicated in AU, however etiologic examination including ASST was shown to presume progression toward CSU [8].…”

Section: Introductionmentioning

confidence: 99%

Rationale for the autologous serum skin test in acute versus chronic urticaria

Demirkan

Baççıoğlu

2019

pdia

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A b s t r a c t Introduction: Autologous serum skin test (ASST) is a rapid, in-vivo clinical test to detect functional autoantibodies in patients with chronic spontaneous urticaria (CSU), but the rationale for its use in acute urticaria (AU) is unknown. Aim: To evaluate the efficacy of ASST among patients with AU or CSU. Material and methods: Treatment-naïve adult (age ≥ 18 years) patients with a diagnosis of AU (< 6 weeks' duration) and CSU were enrolled prospectively in a cross-sectional study. Healthy age-and sex-matched subjects served as controls. Besides a detailed history and physical examination, ASST, total immunoglobulin E (IgE), freeT3 (fT3), freeT4 (fT4), anti-thyroglobulin, and anti-TPO levels were assessed in all subjects. Results: Of 101 subjects, mean age was 34.35 ±12.68 years and the study comprised 58.4% of females with no difference between AU (n = 27), CSU (n = 46), and control groups (n = 28). The ratio of positivity in ASST was similar between AU (25.9%) and CSU groups (21.7%), but higher than in controls (10.7%, p = 0.33 for all). The ratio of patients with high total IgE levels (> 100 IU/ml) in AU (85.2%) and CSU (65.2%) groups was similar (p = 0.06), but significantly higher than in the control group (10.7%) (p < 0.001 and p < 0.001). The CSU group had significantly higher abnormal thyroid test results (45.7%) than AU (14.8%) and control groups (3.6%) (p = 0.01 and p < 0.001), whereas patients with clinically diagnosed thyroiditis were only in the CSU group (6.5%). In logistic regression analysis, there was no relation found among the possible risk factors for ASST, even if analysed separately as AU, CSU and control groups. Conclusions: Even though thyroid function test levels were found to be related with CSU, and total IgE was associated with urticaria, ASST was found to be of importance. This study confirms that ASST was insufficient to demonstrate autoimmunity and acute-chronic urticaria nature. Further tests indicating auto-antibodies in AU and CSU are needed.

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“…In transitioning to urticaria, one of the most challenging and poorly understood cutaneous diseases for which the allergist/immunologist offers expertise, Magen et al 11 sought to identify clinical and laboratory patient attributes that may be predictive of the progression of acute spontaneous urticaria to chronic spontaneous urticaria. By studying 114 patients with acute urticaria without identifiable causes, the researchers reported that patients with acute spontaneous urticaria who progressed toward chronic spontaneous urticaria were characterized by a positive autologous serum skin test, thyroid autoimmunity, and profound basophilopenia at baseline.…”

Section: P Hysicians and Patients Often Have Different Viewsmentioning

confidence: 99%

Relievers, controllers, and inhaler technique: A physician-patient challenge

Bellanti¹,

Settipane²

2016

allergy asthma proc

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The clinical and laboratory characteristics of acute spontaneous urticaria and its progression to chronic spontaneous urticaria

Abstract: The patients with ASU who progressed toward CSU were characterized by a positive ASST result, thyroid autoimmunity, and profound basopenia at baseline.

Cited by 27 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

Rationale for the autologous serum skin test in acute versus chronic urticaria

Relievers, controllers, and inhaler technique: A physician-patient challenge

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