A retrospective review of clinical presentation, thyroid autoimmunity, laboratory characteristics, and therapies used in patients with chronic idiopathic urticaria

Ann Allergy Asthma Immunol. 2009 Dec;103(6):496-501. doi: 10.1016/S1081-1206(10)60266-9.

Abstract

Background: Our knowledge of autoimmune characteristics of chronic idiopathic urticaria (CIU) is limited.

Objective: To study the demographic, laboratory, and clinical patterns of a cohort of patients with CIU.

Methods: We evaluated 236 patients with CIU seen in a recent 2-year span. For serum basophil activation testing (BAT-CD203), the samples were sent to the National Jewish Medical and Research Center for donor basophil CD203 expression assay (5% cell surface expression was considered a positive result).

Results: Of the 236 patients with CIU, 77% were females with a mean age of 39 years. The mean age of males was 43 years. Of patients tested for BAT-CD203 (50 females and 8 males), 38% of females (n = 19) and 13% of males (n = 1) had positive test results. Of the 146 females and 42 males tested for thyroid autoimmunity (TA), 34% of females (n = 50) and 17% of males (n = 7) had underlying TA. Nine BAT-CD203-positive females (47%) had TA compared with 11 of 30 BAT-CD203-negative females (37%). No correlation was found between antinuclear antibodies and BAT-CD203. Cyclosporine or corticosteroids were used in 28% of the study population, with another 16% requiring a trial of additional third-line agents with or without prednisone/cyclosporine. There was no significant difference in the maximum number of medications used in subgroups based on the presence or absence of BAT-CD203 and TA.

Conclusions: The frequency of TA in patients with CIU was 30%, which is higher than that previously reported. The frequency of TA and BAT-CD203 positivity was higher in females. In this clinical cohort, there was no correlation between BAT-CD203 and TA.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Angioedema / complications
  • Antibodies, Antinuclear / blood
  • Autoantibodies / blood
  • Autoantibodies / immunology
  • Autoimmunity / immunology*
  • Basophil Degranulation Test
  • Chronic Disease
  • Cohort Studies
  • Cyclosporine / therapeutic use
  • Female
  • Histamine Antagonists / therapeutic use
  • Humans
  • Immunoglobulin E / blood
  • Male
  • Middle Aged
  • Prednisone / therapeutic use
  • Receptors, IgE / immunology
  • Retrospective Studies
  • Skin Tests
  • Thyroid Gland / immunology*
  • Urticaria / blood*
  • Urticaria / drug therapy*
  • Urticaria / immunology*
  • Young Adult

Substances

  • Antibodies, Antinuclear
  • Autoantibodies
  • FcepsilonRI alpha-chain, human
  • Histamine Antagonists
  • Receptors, IgE
  • anti-thyroglobulin
  • Immunoglobulin E
  • Cyclosporine
  • Prednisone