The Role of Autoimmune Testing in Chronic Idiopathic Urticaria

Overview

Journal Ann Allergy Asthma Immunol

Specialties Allergy & Immunology
Pulmonary Medicine

Date 2012 May 1

PMID 22541405

Citations 15

Authors

Ravi K Viswanathan

Mark J Biagtan

Sameer K Mathur

Affiliations

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Abstract

Background: The clinical implications of autoimmune testing in chronic idiopathic urticaria (CIU) are not well established.

Objective: To identify the association of autoimmune biomarkers in CIU with disease severity.

Methods: We retrospectively evaluated 195 patients with a diagnosis of CIU for the presence of antinuclear antibody (ANA), anti-thyroglobulin antibody (ATG), anti-thyroperoxidase antibody (ATPO), and Chronic Urticaria (CU) Index. The patients were categorized into controlled and refractory subgroups based on their response to antihistamines with or without a leukotriene receptor antagonist.

Results: The percentage of patients with a positive test for ANA (titer>1:160), ATG, ATPO, and CU Index were 29%, 6%, 26%, and 38%, respectively. Among those tested, the percentage of patients categorized as refractory was significantly higher in those with a positive CU index (80% vs 46%; P = .01) or a positive ANA titer (50% vs 30%; P = .04) than those with negative test results; however, a similar relationship was not observed for ATPO or ATG antibodies. Odds ratios of individual or combinations of autoimmune biomarkers in CIU were examined for associations with refractoriness to antihistamines with or without a leukotriene receptor antagonist. The CU Index alone has an odds ratio of 4.5 (P = .005), whereas the combination of ANA, ATG, and ATPO has an odds ratio of 3.1 (P = .01) and ANA alone has an odds ratio of 2.3 (P = .04) for correlating with a refractory outcome.

Conclusion: Our data indicate the CU Index independently has the strongest correlation with disease severity followed by the combination of ANA, ATG, and ATPO and the ANA alone.

Citing Articles

Do Antinuclear Antibodies Influence the Clinical Features of Chronic Spontaneous Urticaria?: A Retrospective Cohort Study.

Arunkajohnsak S, Jiamton S, Tuchinda P, Chularojanamontri L, Rujitharanawong C, Chanchaemsri N Biomed Res Int. 2022; 2022:7468453.

PMID: 36483629 PMC: 9726248. DOI: 10.1155/2022/7468453.

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

Kulthanan K, Rujitharanawong C, Munprom K, Trakanwittayarak S, Phumariyapong P, Prasertsook S J Asthma Allergy. 2022; 15:1455-1490.

PMID: 36299736 PMC: 9590340. DOI: 10.2147/JAA.S379912.

Clinical and laboratory characteristics of chronic spontaneous urticaria with connective tissue diseases: A cross-sectional study.

Cildag S, Sargin G, Senturk T Arch Rheumatol. 2022; 37(2):205-211.

PMID: 36017211 PMC: 9377178. DOI: 10.46497/ArchRheumatol.2022.8784.

A Comprehensive Approach to Urticaria: From Clinical Presentation to Modern Biological Treatments Through Pathogenesis.

Folci M, Ramponi G, Brunetta E Adv Exp Med Biol. 2021; 1326:111-137.

PMID: 33385176 DOI: 10.1007/5584_2020_612.

Refractory chronic urticaria in adults: clinical characterization and predictors of severity.

Coutinho I, Regateiro F, Fernandes R, Pita J, Gomes R, Coelho C Allergy Asthma Clin Immunol. 2020; 16(1):97.

PMID: 33292453 PMC: 7661155. DOI: 10.1186/s13223-020-00496-0.

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