Predictive features associated with chronic spontaneous urticaria recurrence. 2021

Elias Toubi, and Zahava Vadasz
Department of Allergy and Clinical Immunology, Rappaport Faculty of Medicine, Technion, Haifa, Israel.

When chronic spontaneous urticaria (CSU) is resolved, patients are often apprehensive about the likelihood of recurrence, and want to know if we can predict this using clinical or laboratory markers. This question is crucial because CSU is frequently accompanied by a high incidence of stressful comorbidities, and the fear of experiencing this again can be devastating to the patient. This study was designed with the aim of focusing on the prevalence and characteristics of the recurrence of CSU. We used our CSU patient registry that includes data on 180 patients who are followed periodically. In 23 (13%) patients, CSU was resolved during the first year. In 47 (26%) patients, CSU lasted more than 5 years. The recurrence of CSU was recorded in 21% of our patients after having experienced a full remission anywhere between 1 to 10 years (mean ± 2.9 years). While investigating predictive clinical or laboratory markers, we noticed that bronchial asthma existed in 10/25 (40%) of patients in whom CSU recurred as compared with 45/180 (25%) in the general CSU population (p = 0.049). In addition, increased levels of total immunoglobulin (Ig)E were found in 10/25 (40%) of the recurrence group as compared with 34/150 (23%) of the general CSU group (p = 0.04). Anti-thyroid peroxidase antibodies were also found in 11/25 (44%) of the recurrence group as compared with 32/160 (20%) of the general group (p = 0.003). The prevalence of CSU recurrence after a full remission is significantly higher among patients with existing bronchial asthma, increased levels of total IgE, and autoimmunity. Further studies are required in order to substantiate this important issue.

UI MeSH Term Description Entries
D002908 Chronic Disease Diseases which have one or more of the following characteristics: they are permanent, leave residual disability, are caused by nonreversible pathological alteration, require special training of the patient for rehabilitation, or may be expected to require a long period of supervision, observation, or care (Dictionary of Health Services Management, 2d ed). For epidemiological studies chronic disease often includes HEART DISEASES; STROKE; CANCER; and diabetes (DIABETES MELLITUS, TYPE 2). Chronic Condition,Chronic Illness,Chronically Ill,Chronic Conditions,Chronic Diseases,Chronic Illnesses,Condition, Chronic,Disease, Chronic,Illness, Chronic
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000080223 Chronic Urticaria Wheals (urticaria) and/or angioedema presented with daily symptoms lasting for more than 6 weeks. It may be classified into chronic spontaneous and chronic inducible urticaria depending on whether a specific trigger can be linked to the development of vascular reaction. Autoimmune Urticaria,Chronic Autoimmune Urticaria,Chronic Idiopathic Urticaria,Chronic Spontaneous Urticaria,Idiopathic Chronic Urticaria,Autoimmune Urticaria, Chronic,Autoimmune Urticarias,Chronic Autoimmune Urticarias,Chronic Idiopathic Urticarias,Chronic Spontaneous Urticarias,Chronic Urticaria, Idiopathic,Chronic Urticarias,Idiopathic Chronic Urticarias,Idiopathic Urticaria, Chronic,Spontaneous Urticaria, Chronic,Urticaria, Autoimmune,Urticaria, Chronic,Urticaria, Chronic Autoimmune,Urticaria, Chronic Idiopathic,Urticaria, Chronic Spontaneous,Urticaria, Idiopathic Chronic
D014581 Urticaria A vascular reaction of the skin characterized by erythema and wheal formation due to localized increase of vascular permeability. The causative mechanism may be allergy, infection, or stress. Hives,Urticarial Wheals,Urticarial Wheal,Urticarias,Wheal, Urticarial,Wheals, Urticarial
D015551 Autoimmunity Process whereby the immune system reacts against the body's own tissues. Autoimmunity may produce or be caused by AUTOIMMUNE DISEASES. Autoimmune Response,Autoimmune Responses,Autoimmunities
D015897 Comorbidity The presence of co-existing or additional diseases with reference to an initial diagnosis or with reference to the index condition that is the subject of study. Comorbidity may affect the ability of affected individuals to function and also their survival; it may be used as a prognostic indicator for length of hospital stay, cost factors, and outcome or survival.

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