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Sample records for chronic idiopathic urticaria

  1. Vitamin D deficiency in chronic idiopathic urticaria.

    Science.gov (United States)

    Movahedi, Masoud; Tavakol, Marzieh; Hirbod-Mobarakeh, Armin; Gharagozlou, Mohammad; Aghamohammadi, Asghar; Tavakol, Zahra; Momenzadeh, Kaveh; Nabavi, Mohammad; Dabbaghzade, Abbas; Mosallanejad, Asieh; Rezaei, Nima

    2015-04-01

    Chronic urticaria is the most common skin diseases, characterized by chronic cutaneous lesions which severely debilitates patients in several aspects of their everyday life. Vitamin D is known to exert several actions in the immune system and to influence function and differentiation of mast cells, central role players in the pathogenesis of chronic idiopathic urticaria. This study was performed to evaluate the relationship between vitamin D levels and susceptibility to chronic idiopathic urticaria. One hundred and fourteen patients with chronic idiopathic urticaria were recruited in this study along with one hundred and eighty seven sex-matched and age-matched healthy volunteers as the control group. For each patient, urticaria activity score was calculated and autologous serum skin test was done. Vitamin D metabolic statue was measured in serum as 25 hydroxyvitamin D using enzyme immunoassay method. Patients with chronic idiopathic urticaria significantly showed lower levels of vitamin D. Vitamin D deficiency was significantly associated with increased susceptibility to chronic idiopathic urticaria. There was a significant positive correlation between vitamin D levels and urticaria activity score. This study showed that patients with chronic idiopathic urticaria had reduced levels of vitamin D, while vitamin D deficiency could increase susceptibility to chronic idiopathic urticaria.

  2. Chronic Idiopathic Urticaria (CIU) is no longer idiopathic

    DEFF Research Database (Denmark)

    Maurer, M; Bindslev-Jensen, C; Gimenez-Arnau, A;

    2013-01-01

    for the same type of urticaria, which has implications for comparing study outcomes and drug licensing. Consequently, there is an urgent need for a harmonized and universally accepted nomenclature and classification of urticaria and to avoid the routine use of the outdated aetiological term, chronic idiopathic......During recent years our knowledge of the aetiology and pathogenesis of urticaria has advanced considerably allowing us to better characterize urticaria subtypes. However, although the classification of urticaria has undergone some revisions during this time (1), authors still use different names...... urticaria (CIU)....

  3. AUTOLOGOUS SERUM SKIN TESTING (ASST) IN CHRONIC IDIOPATHIC URTICARIA

    OpenAIRE

    Arun; Suresh; Raghavendra; Vijay; Ramesh,; Asha; Manali; Jitendra

    2014-01-01

    Chronic idiopathic urticaria (CIU) is a form of urticaria , in which there appears to be persistent activation of mast cells , but the mechanism of mast cell triggering is unknown. The Autologous serum skin test (ASST) is an in vivo test which assesses auto reactivity. ASST could be good screening test for Autoreactive urticaria a subset of chronic idiopathic urticaria. AIMS : To study the clinical profile of chronic idiopathic urticaria and pattern of A...

  4. Oral iron therapy and chronic idiopathic urticaria: sideropenic urticaria?

    Science.gov (United States)

    Guarneri, Fabrizio; Guarneri, Claudio; Cannavò, Serafinella Patrizia

    2014-01-01

    Chronic urticaria (CU) is frequent, remains often idiopathic despite diagnostic efforts, and sometimes poorly responds to oral antihistamines and/or corticosteroids. We noticed that hyposideremia is often found in patients with chronic idiopathic urticaria poorly responsive to usual treatments (prCIU), and oral iron therapy is frequently associated to improvement or resolution of urticaria. Between 2003 and 2012, we observed 122 patients with prCIU, of which 81 had moderate hyposideremia at our first visit. They continued the antihistamines already practiced and received oral iron therapy for 30 or 45 days. Two months after our first visit, all had normal serum iron levels; 64 reported complete remission of urticaria and 17 reported improvement superior to 80%. No adverse reactions to treatment were observed. Follow-up visits confirmed stability of results over 6 months. Our preliminary data show that hyposideremia is the only abnormality in many patients with prCIU, and restoration of normal iron serum levels is associated to remission or remarkable clinical improvement of urticaria. In consideration of low cost and potential benefits for some patients, determination of serum levels of iron could be introduced in the diagnostic workup of chronic urticaria, maybe as a second-level exam in patients without other relevant clinical or laboratory abnormalities.

  5. AUTOLOGOUS SERUM SKIN TESTING (ASST IN CHRONIC IDIOPATHIC URTICARIA

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    Arun

    2014-01-01

    Full Text Available Chronic idiopathic urticaria (CIU is a form of urticaria , in which there appears to be persistent activation of mast cells , but the mechanism of mast cell triggering is unknown. The Autologous serum skin test (ASST is an in vivo test which assesses auto reactivity. ASST could be good screening test for Autoreactive urticaria a subset of chronic idiopathic urticaria. AIMS : To study the clinical profile of chronic idiopathic urticaria and pattern of ASST among p atients of chronic idiopathic urticaria. METHODS : Study included 200 patients of CIU that were recruited from outpatient department (OPD. Patient s with a history of urticaria for more than 6 weeks were included in the study. The detailed history , cutaneou s and systemic examination was done. ASST was performed under strict aseptic precaution. RESULTS : Out of 200 patients 100 were male and 100 were female. Mean age of patients was 31.9 yrs. Most common age group was 25 - 34yrs. ASST was found positive in 36(18 % patients. In most of the patients duration of disease was less than 11months (42% with the mean duration of disease 21.74 months. Mean duration of wheal was 64.7 minutes , in which most of the patients (112 having duration of wheal less than 59 min. Hi story of angioedema was positive in 109(54.5% patients. Aggravating factors were positive in 50(25% patients in which drugs and cold were the most common. Family history of urticaria and angioedema was present in 35 patients. None of patient complained a ny adverse reactions during and after ASST. CONCLUSION : ASST is the easily available bed side test for the diagnosis of autoreactive urticaria. It is a simple , inexpensive , semi invasive and easy - to - perform test which can be done and recorded by the dermat ologist himself. ASST may help in diagnosis and management of chronic idiopathic urticaria.

  6. Evaluation of H2 receptor antagonists in chronic idiopathic urticaria

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    Minocha Y

    1995-01-01

    Full Text Available H1-antagonist (hydroxyzine hydrochloride in dosage of 10 mg-25 mg thrice a day failed to elicit satisfactory response in 60 out of 170 patients of chronic idiopathic urticaria. Additional administration of H2-antagonist (cimetidine in dosage of 200 mg four times a day, in patients not responding earlier to H1-antagonist alones exhibited moderate to good improvement of various parameters of urticaria in approximately 85% patients

  7. Clinical efficiency of cyclosporine in chronic idiopathic urticaria in adults

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    V.I. Petrov

    2010-06-01

    Full Text Available The purpose of the research is to evaluate the clinical effectiveness of cyclosporine and other antihistamines in patients with chronic forms of urticaria resistant to basic first-line therapy. Open randomized controlled study has been performed in parallel groups. 53 patients with chronic idiopathic urticaria ages 18-50 years have been examined. In case of ineffectiveness of previous therapy, patients have been randomized into 2 groups: group I receiving cyclosporine (Sandimmune Neoral ® 2,5 mg/kg/day, group II receiving cetirizine (Zyrtec ® 10 mg/day and ranitidine (Zantac ® 300 mg/day orally. It has been found that the administration of cyclosporine in patients with severe chronic idiopathic urticaria provides a more rapid achievement of clinical effect than the therapy with H1/H2 histamine antagonists. It is confirmed by a significant decrease of total index of severity of illness and major symptoms of skin lesions. This tendency towards normalization of quality of life of patients taking cyclosporine remains during 8 weeks after the medication. Thus administration of cyclosporine can be considered as therapy of choice in patients with chronic idio-pathic urticaria with a severe course and ineffective long-term therapy with antihistamines / systemic corticosteroids

  8. The Role of Dehydroepiandrosterone Sulfate In Chronic Idiopathic Urticaria Pathogenesis

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    Filiz Canpolat

    2009-03-01

    Full Text Available Objective: Adrenal androgens, dehydroepiandrosterone (DHEA and dehydroepiandrosterone sulfate (DHEA-S seem implicated in the pathophysiology of autoimmune disorders, as natural immunosuppressors. The relationship of chronic idiopathic urticaria (CIU with circulating concentration of DHEA-S has been reported previously. However, this link and underlying mechanisms remain unknown. The aim of this study was to evaluate circulating DHEA-S concentration in larger patients group suffering from CIU.Materials and Methods: Serum concentration of DHEA-S was measured in 65 patients (34 women, 31 men with CIU and compared with 40 age and sex matched, non atopic healthy volunteers. Disease duration and extent of involvement were recorded.Results: The patients with CIU presented significantly decreased values of DHEA-S levels (102.66±28.95 µg/dl with respect to control group (174.22±39.58 µg/dl (p<0.01. No significant correlation was found between DHEA-S concentration and the duration of the disease, disease activity and gender.Conclusion: Our results support the hypothesis that DHEA-S may be a cause for the development of CIU, regardless of their gender. For definitive role of DHEA-S in CIU pathogenesis, further studies are needed.

  9. Omalizumab for the Treatment of Chronic Idiopathic Urticaria: Systematic Review of the Literature.

    Science.gov (United States)

    Tonacci, Alessandro; Billeci, Lucia; Pioggia, Giovanni; Navarra, Michele; Gangemi, Sebastiano

    2017-02-22

    Omalizumab is recombinant humanized monoclonal antibody to immunoglobulin E. Guidelines for the treatment of chronic idiopathic urticaria (also known as chronic spontaneous urticaria) recommend the use of omalizumab as third-line therapy in addition to high doses of histamine receptor type 1 (H1 ) antihistamines when they are unsuccessful as first- and second-line therapy. We performed a systematic review of the literature to identify studies that evaluated the efficacy of omalizumab for the treatment of chronic idiopathic urticaria, in both controlled and real-world settings, to assess its potential role as a preferred therapy. The PubMed, ScienceDirect, LILACS (Latin American and Caribbean Health Sciences Literature), and Google Scholar databases were searched between January 1, 2000, and November 21, 2016. The search was limited to articles published in peer-reviewed journals in the English language, and 29 studies were included in this review. Omalizumab 300 mg administered every 4 weeks appears to be the most effective and safe dosage, with a rapid response time, for the treatment of chronic idiopathic urticaria, with few minor adverse effects, and appears to be safe in the offspring of pregnant patients who received the drug. However, as published studies of omalizumab are sparse, future studies are warranted. When findings are confirmed in larger studies, due to its efficacy, safety, and increased benefit/cost ratio, omalizumab could become the preferred method of treatment for chronic idiopathic urticaria in patients unresponsive to H1 antihistamines.

  10. Comparison Of Levocetirizine And Cetirizine In Chronic Idiopathic Urticaria

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    Rathi Sanjay K

    2004-01-01

    Full Text Available The aim of the study was to compare efficacy, onset of action, and sedative effects of cetirizine (CTZ and levocetirizine (levoCTZ in chronic idiopathic urtcaria with fifteen patients in each group. They were found to be equipotent and the onset of action was almost same. Twenty percent in CTZ and 13.33% in levoCTZ exhibited mild sedation.

  11. Chronic urticaria

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    Sandeep Sachdeva

    2011-01-01

    Full Text Available Chronic urticaria (CU is a disturbing allergic condition of the skin. Although frequently benign, it may sometimes be a red flag sign of a serious internal disease. A multitude of etiologies have been implicated in the causation of CU, including physical, infective, vasculitic, psychological and idiopathic. An autoimmune basis of most of the ′idiopathic′ forms is now hypothesized. Histamine released from mast cells is the major effector in pathogenesis and it is clinically characterized by wheals that have a tendency to recur. Laboratory investigations aimed at a specific etiology are not always conclusive, though may be suggestive of an underlying condition. A clinical search for associated systemic disease is strongly advocated under appropriate circumstances. The mainstay of treatment remains H1 antihistaminics. These may be combined with complementary pharmacopeia in the form of H2 blockers, doxepin, nifedipine and leukotriene inhibitors. More radical therapy in the form of immunoglobulins, plasmapheresis and cyclophosphamide may be required for recalcitrant cases. Autologous transfusion and alternative remedies like acupuncture have prospects for future. A stepwise management results in favorable outcomes. An update on CU based on our experience with patients at a tertiary care centre is presented.

  12. Diagnostic dilemmas in chronic urticaria.

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    Toubi, E; Grattan, C; Zuberbier, T

    2015-06-01

    The European Academy of Allergy and Clinical Immunology (EAACI)/Global Allergy and Asthma European Network (GA(2) LEN)/European Dermatology Forum (EDF)/World Allergy Organization (WAO) recently published updated recommendations for the classification, diagnosis and management of chronic urticaria (CU). This article discusses several cases of CU that provide examples of how the recommendations in the guidelines can be implemented in the diagnosis of chronic spontaneous urticaria (CSU) (also called chronic idiopathic urticaria [CIU]), chronic inducible urticaria (CINDU) or CU with comorbidities.

  13. Efficacy and safety of omalizumab in patients with chronic idiopathic/spontaneous urticaria who remain symptomatic on h1 antihistamines

    DEFF Research Database (Denmark)

    Saini, Sarbjit S; Bindslev-Jensen, Carsten; Maurer, Marcus;

    2015-01-01

    ASTERIA I was a 40-week, randomized, double-blind, placebo-controlled study to evaluate the efficacy and safety of subcutaneous omalizumab as add-on therapy for 24 weeks in patients with chronic idiopathic urticaria/spontaneous urticaria (CIU/CSU) who remained symptomatic despite H1 antihistamine....... The omalizumab 300-mg group met all nine secondary end points, including a significant decrease in the duration of time to reach minimally important difference response (⩾5-point decrease) in weekly ISS (Purticaria activity score over 7...

  14. The Role of Food Additives and Natural Foods Containing Vasoactive Amines in Chronic Idiopathic Urticaria

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    Fuat Erel

    2007-10-01

    Full Text Available Most patients with chronic idiopathic urticaria (CIU need long-term treatment but there is little known about the prognosis of CIU. The aim of this study was to evaluate the natural course of CIU and to find out if there are risk factors that predict the prognosis. In this prospective study, we obtained data from patients first diagnosed and treated for CIU between September 2003 and September 2005. This study was included 157 patients with CIU. We observed duration of the disease, effects of food additives and preservatives in CIU. As possible prognostic factors we observed sex, age, atopy, intolerance to food additives and preservatives. Allergic reactions were seen to appear in 37% (n=50 cases due to natural foods, in 36% (n=49 cases due to foods containing additives, and in 27% (n=37 cases due to both natural foods and foods containing additives. For patients with CIU, food colors, sweeteners and preservatives that are added into foods are an important etiological factor. Moreover, histamine and histamine-like endogen pharmacological agents can cause allergic reactions. Hence, these foods should be taken into consideration in etiology especially in patients with CIU, and due to potential etiology, elimination of patients from these foods for a while is a significant step in treatment. [TAF Prev Med Bull. 2007; 6(5: 351-356

  15. Loratadine versus levocetirizine in chronic idiopathic urticaria: A comparative study of efficacy and safety

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    Anuradha P

    2010-01-01

    Full Text Available Background : Treatment of chronic idiopathic urticaria (CIU is challenging because of its unpredictable course and negative influence on the quality of life. New treatments are being developed, but antihistaminics remain the cornerstone of the therapeutic approach. Newer generation antihistaminics such as loratadine and levocetirizine have already proved to be safe and efficacious for CIU. Objective : To choose the better drug between loratadine and levocetirizine for CIU, by comparing their efficacy and safety. Methods : A randomized, open, outdoor-based clinical study was conducted on 60 patients of CIU, to compare the two drugs. After initial clinical assessment and baseline investigations, loratadine was prescribed to 30 patients and levocetirizine to another 30 patients for four weeks. At follow-up, the patients were re-evaluated and then compared using different statistical tools. Result : The comparative study showed that the changes in differential eosinophil count (P = 0.006 and absolute eosinophil count (P = 0.003 in the levocetirizine group was statistically significant. The results of the Total Symptom Score showed better symptomatic improvement of CIU with levocetirizine as compared to loratadine. The overall incidence of adverse drug reactions was also found to be less in the levocetirizine group. Conclusion : An analysis of the results of all the parameters of safety and efficacy proves the superiority of levocetirizine over loratadine for CIU.

  16. Efficacy and safety of omalizumab in patients with chronic idiopathic/spontaneous urticaria who remain symptomatic on h1 antihistamines

    DEFF Research Database (Denmark)

    Saini, Sarbjit S; Bindslev-Jensen, Carsten; Maurer, Marcus;

    2015-01-01

    ASTERIA I was a 40-week, randomized, double-blind, placebo-controlled study to evaluate the efficacy and safety of subcutaneous omalizumab as add-on therapy for 24 weeks in patients with chronic idiopathic urticaria/spontaneous urticaria (CIU/CSU) who remained symptomatic despite H1 antihistamine...... treatment at licensed doses. Patients aged 12-75 years with CIU/CSU who remained symptomatic despite treatment with approved doses of H1 antihistamines were randomized (1:1:1:1) in a double-blind manner to subcutaneous omalizumab 75 mg, 150 mg, or 300 mg or placebo every 4 weeks for 24 weeks followed by 16...... event. Omalizumab 300 mg administered subcutaneously every 4 weeks reduced weekly ISS and other symptom scores versus placebo in CIU/CSU patients who remained symptomatic despite treatment with approved doses of H1 antihistamines....

  17. Clinical-laboratory characteristics of ANA-positive chronic idiopathic urticaria.

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    Magen, Eli; Waitman, Dan-Andrei; Dickstein, Yoav; Davidovich, Valentina; Kahan, Natan R

    2015-01-01

    Despite the established association between chronic idiopathic/spontaneous urticaria (CIU) and presence of antinuclear antibodies (ANAs), the prevalence of autoimmune comorbidities in this population has not been analyzed. Here, we aim to identify clinical and laboratory manifestations associated with ANA-positive CIU. ANA-positive patients were identified via electronic data capture from the electronic patient record database of Leumit Health care Services (LHS) of Israel. Patient characteristics, medical histories, and details of diagnostic workup, medical treatment, and follow-up were retrieved by performing a chart review of electronic patient records (EPRs). The prevalence of target diseases among ANA(+) CIU(+), ANA(+) CIU(-), and ANA(-) CIU(+) patients was calculated. A total of 91 ANA(+) CIU(+), 3131 ANA(+) CIU(-), and 478 ANA(-) CIU(+) patients were identified. The ANA(+) CIU(+) group was characterized by higher prevalence of Sjögren's syndrome (SS)-A 52 antibodies (Ab) (7.7% versus 2.4%; p = 0.008), SS-A 60 Ab (11% versus 2.8%; p = ANA(-) CIU(+) group. Additionally, ANA(+) CIU(+) patients were more likely to be diagnosed with thyroid autoimmune diseases, higher C-reactive protein (6.4 ± 10.3 versus 4.1 ± 8.8 mg/L; p = 0.027), and more profound basopenia (0.04 ± 0.09 versus 0.15 ± 0.11 cell/mm(3); p ANA(-) CIU patients. More ANA(+) CIU(+) patients were resistant to four-fold standard licensed doses of antihistamines than ANA(-) CIU(+) patients [11 (12.1%) versus 29 (6.1%); p = 0.046]. ANA-positive CIU is characterized by higher prevalence of SS-A 52, SS-A 60, and SS-B antibodies and poorer clinical response to antihistamine medications.

  18. Autoantibody production in chronic idiopathic urticaria is not associated with Helicobacter pylori infection

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    Atta A.M.

    2004-01-01

    Full Text Available Chronic idiopathic urticaria (CIU is a dermatological syndrome, characterized by raised erythematous skin lesions, that affects 20% of the general population and has been associated with autoimmunity. However, some reports have also suggested a close relationship between CIU and Helicobacter pylori infection, which is endemic in developing countries and associated with chronic gastritis, peptic ulcer disease, and gastric carcinoma. In the present study, we investigated the occurrence of autoantibodies in sera from 23 CIU subjects infected with H. pylori and from 23 CIU subjects without this infection. The presence of anti-thyroid antibodies was determined by indirect hemagglutination assay and the presence of autoantibodies to IgE and C1INH was determined by ELISA. Antibodies to thyroid antigens were detected at low titers from 100 to 400 in three of 23 (13% CIU-infected subjects and in four of 23 (17% CIU-noninfected subjects. The titers of anti-IgE autoantibodies were similar in these CIU groups, presenting absorbances of 1.16 ± 0.09 and 1.07 ± 0.16, respectively, while a titer of 1.14 ± 0.15 was detected in the healthy control group. The concentration of anti-C1INH autoantibodies was the same in the CIU-infected and -noninfected subjects (7.28 ± 1.31 and 7.91 ± 2.45 ng/ml, respectively, and was 7.20 ± 2.25 ng/ml in the healthy control group. However, the serum levels of complexed anti-C1INH antibodies were increased in CIU-infected subjects compared to CIU-noninfected subjects and healthy controls with an absorbance of 1.51 ± 0.21 vs 1.36 ± 0.16 and 1.26 ± 0.23, respectively (P < 0.05, indicating an impaired clearance of immune complexes in CIU-infected patients. In conclusion, no correlation was observed between H. pylori infection and autoantibody production in CIU patients consistent with reports of clinical studies.

  19. Chronic autoimmune urticaria : Where we stand ?

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    Goh C

    2009-01-01

    Full Text Available It is well-recognized that 30-40% of chronic idiopathic urticaria is autoimmune in nature. Chronic autoimmune urticaria is caused by anti-FcåRI and less frequently, by anti-IgE autoantibodies that lead to mast cell and basophil activation, thereby giving rise to the release of histamine and other proinflammatory mediators. Activation of the classical complement pathway and formation of C5a are important in dermal mast cell activation. C5a is also a neutrophil and eosinophil chemoattractant. Chronic autoimmune urticaria has been found to be associated with autoimmune thyroid disease. The autologous serum skin test is used as a screening test for chronic autoimmune urticaria and has a sensitivity and specificity of about 70 and 80%, respectively. The current gold standard diagnostic test is the basophil histamine release assay. The treatment of chronic autoimmune urticaria, as in chronic idiopathic urticaria, is with H1 antihistamines. Oral corticosteroids may be used during acute flares. Refractory cases have been shown to respond to cyclosporine and other immunomodulators. The prevalence of chronic autoimmune urticaria in Singapore is similar to that reported in Western countries at about 42%. The presence of thyroid autoimmunity appears to be higher than reported, with 22.5% of patients with chronic idiopathic urticaria here, exhibiting presence of thyroid autoantibodies.

  20. Management and treatment of chronic urticaria (CU).

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    Maurer, M; Church, M K; Gonçalo, M; Sussman, G; Sánchez-Borges, M

    2015-06-01

    Developments increasing our understanding of chronic urticaria have resulted in the simplification and improvement of available treatments. Currently, many treatments target mast cell mediators, but we can now disrupt mast cell activation with the anti-IgE antibody omalizumab, which has markedly advanced the treatment landscape for patients with difficult-to-treat urticaria. Current guidelines provide a framework for the management and treatment of patients with CU but, as each patient is different, knowledge and experience of specialist dermatologists and allergists are key to effective pharmacotherapy. This article reviews the different therapeutic options for patients with chronic spontaneous urticaria (also called chronic idiopathic urticaria) or chronic inducible urticaria and discusses management of special populations or special circumstances related to CU.

  1. Once daily levocetirizine for the treatment of allergic rhinitis and chronic idiopathic urticaria

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    E Nettis

    2008-12-01

    Full Text Available E Nettis1, G F Calogiuri2, E Di Leo1, F Cardinale3, L Macchia1, A Ferrannini1, A Vacca1,41Section of Allergology and Clinical Immunology, Department of Internal Medicine and Infectious Diseases; 24th Pneumology Department, Pneumologic Hospital A Galateo, San Cesario di Lecce, Italy; 3Department of Biomedicina dell’Età Evolutiva, Pediatrics Unit “S Maggiore”; 4Department of Internal Medicine and Clinical Oncology, University of Bari Medical School, Bari, ItalyAbstract: Levocetirizine is the pharmacologically active enantiomer of cetirizine. It is a potent histamine H-1 receptor antagonist with anti-inflammatory and antiallergic properties. The review analyses the levocetirizine’s properties in terms of safety and efficacy both in allergic rhinitis and urticarioid syndromes.Keywords: allergic rhinitis, chronic idiopatic urticaria, levocetirizine

  2. Etiological approach to chronic urticaria

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    Krupa Shankar D

    2010-01-01

    Full Text Available Background: In 1769, William Cullen introduced the word "urticaria" (transient edematous papules, plaque with itching. Urticaria affects 15-25% of people at least once in their life time. It is a clinical reaction pattern triggered by many factors causing the liberation of vasoactive substances such as histamine, prostaglandins and kinins. Urticaria is classified according to its duration into acute (< 6 weeks duration and chronic (>6 weeks duration. Various clinical investigations may be initiated to diagnosis the cause. Aims: To evaluate the types of chronic urticaria with reference to etiology from history and investigations . Materials and Methods: A total of 150 patients with chronic urticaria of more than six weeks were studied. Autologous serum skin test (ASST was performed after physical urticarias were excluded. Standard batteries of tests were performed after ASST in all patients; and other specific investigations were done where necessary. Skin prick test was done in idiopathic urticaria. Results: The study sample consisted of 62 male and 88 female patients with a mean age of 21-40 years. About 50% of patients showed an ASST positive reaction, 3.9% were positive for antinuclear antibody (ANA, IgE titer was elevated in 37%, H. pylori antibodies was positive in 26.7%. Thyroid antibodies were positive in 6.2%. Giardia and entamoeba histolytica was reported in 3.3% on routine stool examination and on urinalysis 8% had elevated WBC counts; 12% showed para nasal sinusitis, with maxillary sinusitis of 7.3%. Random blood sugar was high in 5.3%. Four patients had ASOM, two had positive KOH mount for dermatophytes, abdominal USG showed cholecystitis in two patients. Recurrent tonsillitis was noted in two patients. Urticaria following intake of NSAIDs was observed in four patients and with oral contraceptive pills in one patient. Contact urticaria to condom (latex was seen in one patient. Cholinergic (4.7% and dermographic (4.7% urticaria were

  3. [Histaminergic angioedema and chronic urticaria].

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    Hacard, Florence; Nosbaum, Audrey; Bensaid, Benoit; Nicolas, Jean-François; Augey, Frédéric; Goujon, Catherine; Bérard, Frédéric

    2015-01-01

    Most angioedemas are histaminergic and correspond to deep urticarial swelling. Recurrent histaminergic angioedema led to the diagnosis of chronic urticaria, even when there are no superficial associated hives. Chronic urticaria is a benign disease, and autoimmune in 40 % of cases. The occurrence of angioedema in chronic urticaria is not a sign of severity. The occurrence of angioedema in chronic urticaria is associated with a longer duration of urticarial disease. NSAIDs and/or systemic corticotherapy are classic triggers of angioedema in chronic urticaria. In the absence of clinical endpoints, there is no need to make further assessment in chronic urticaria good responders to antihistamines.

  4. [Inducible urticaria and chronic spontaneous urticaria].

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    Du Thanh, A

    2014-11-01

    In the recently published 2013 revision of the guidelines of urticaria, chronic urticaria (CU) gathers chronic spontaneous urticaria (CSU) and inducible urticaria (IU), and excludes pseudourticarial rashes with more than 24h-lasting rash or more than 72h-lasting angiœdema. Activity and psychosocial impact of the disease must be measured with validated scores such as Urticaria and Angioedema Activity Scores, Urticaria Control Test, CU-Q2OL, AE-QOL. Although an allergic cause is generaly absent in CU, pathomecanisms remain elusive even since the well-known role of mast cell degranulation and the presence of autoantibodies anti-FcRεI or anti-IgE. Coagulation pathways may be involved, at least as an amplifying phenomenon. Mean duration of CU is 1 to 4 years, but many patients still have symptoms after 10 years, some predictive factors being known as severity, angioedema, a positive autologous serum test, inducible urticaria. Recommended routine diagnosic tests are validated provocation tests for IU (and cryoproteins for cold urticaria), blood cell count and CRP for CSU, since a thorough history and a normal detailed physical examination should avoid unnecessary tests. Management of CU has been improved by the off-label use of increased dosages of second generation anti- H1 antihistamines, but a subsequent therapeutic intensification may be necessary in some cases. Educational program may prevent this intensification. Independent studies evaluating available molecules are needed, along with more fundamental research studies.

  5. Update on the treatment of chronic urticaria.

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    Curto-Barredo, L; Silvestre, J F; Giménez-Arnau, A M

    2014-06-01

    Chronic spontaneous urticaria, also known as chronic idiopathic urticaria or simply chronic urticaria, is a common disorder that has a prevalence in the general population that ranges between 0.5% and 1%. This condition negatively affects the patient's quality of life and has considerable impact on direct and indirect health-related costs. Chronic urticaria is difficult to manage. Nonsedating H1 antihistamines are the first line of therapy, but fewer than 50% of patients experience relief at recommended dosages. Although guidelines call for increasing the dosage when response is inadequate, some patients still do not achieve adequate control of symptoms. New treatment alternatives, with proven efficacy under the standards of evidence-based medical practice, must therefore be developed.

  6. Omalizumab for chronic urticaria

    DEFF Research Database (Denmark)

    Ivyanskiy, Ilya; Sand, Carsten; Thomsen, Simon Francis

    2012-01-01

    urticaria. We present a case series of 19 patients with chronic urticaria treated in a university department with omalizumab and give an overview of the existing literature comprising an additional 59 cases as well as a total of 139 patients enrolled in two randomized controlled trials comparing omalizumab...... with placebo. The collective evidence points to omalizumab as a safe and effective treatment option for patients with chronic urticaria who do not sufficiently respond to standard therapy as recommended by existing guidelines.......Omalizumab is a recombinant humanized monoclonal antibody that blocks the high-affinity Fc receptor of IgE. Omalizumab has been approved for the treatment of moderate to severe asthma; however, there is currently more and more data showing promising results in the management also of chronic...

  7. Advances in Understanding and Managing Chronic Urticaria.

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    Moolani, Yasmin; Lynde, Charles; Sussman, Gordon

    2016-01-01

    There have been recent advances in the classification and management of chronic urticaria. The new term chronic spontaneous urticaria (CSU) has replaced chronic idiopathic urticaria and chronic autoimmune urticaria. In addition, chronic inducible urticaria (CINDU) has replaced physical urticaria and includes other forms of inducible urticaria, such as cholinergic and aquagenic urticaria. Furthermore, novel research has resulted in a new understanding with guidelines being revised in the past year by both the American Academy of Allergy, Asthma, and Immunology (AAAAI) and the European Academy of Allergy and Clinical Immunology (EAACI)/Global Allergy and Asthma European Network (GA (2)LEN)/European Dermatology Forum (EDF)/World Allergy Organization (WAO). There are some differences in the recommendations, which will be discussed, but the core updates are common to both groups. The basic treatment for chronic urticaria involves second-generation non-sedating non-impairing H 1 antihistamines as first-line treatment. This is followed by up to a 4-fold increase in the licensed dose of these H 1 antihistamines. The major therapeutic advance in recent years has been in third-line treatment with omalizumab, a humanized monoclonal anti-immunoglobulin E (anti-IgE) antibody that prevents binding of IgE to the high-affinity IgE receptor. Several multicenter randomized controlled trials have shown safety and efficacy of omalizumab for CSU. There are also some small studies showing efficacy of omalizumab in CINDU. While there were previously many treatment options which were lacking in strong evidence, we are moving into an era where the treatment algorithm for chronic urticaria is simplified and contains more evidence-based, effective, and less toxic treatment options.

  8. Autoimmune thyroid disease as a risk factor for angioedema in patients with chronic idiopathic urticaria: a case-control study

    Directory of Open Access Journals (Sweden)

    Ruy Felippe Brito Gonçalves Missaka

    Full Text Available CONTEXT AND OBJECTIVE: An association between chronic idiopathic urticaria (CIU and autoimmune thyroid disease (ATD has been reported. However, there have not been any reports on whether ATD raises the risk of angioedema, which is a more severe clinical presentation of CIU. Thus, the aim of the present study was to evaluate whether the risk of angioedema is increased in patients with CIU and ATD. DESIGN AND SETTING: Case-control study including 115 patients with CIU at a tertiary public institution. METHODS: The patients were evaluated with regard to occurrence of angioedema and presence of ATD, hypothyroidism or hyperthyroidism. RESULTS: Angioedema was detected in 70 patients (60.9%. There were 22 cases (19.1% of ATD, 19 (16.5% of hypothyroidism and nine (7.8% of hyperthyroidism. The risk among patients with ATD was 16.2 times greater than among those without this thyroid abnormality (confidence interval, CI = 2.07-126.86. The odds ratio for hypothyroidism was 4.6 (CI = 1.00-21.54 and, for hyperthyroidism, 3.3 (CI = 0.38-28.36. CONCLUSIONS: Patients with CIU and ATD presented greater risk of angioedema, which reinforces the idea that a relationship exists between this allergic condition and thyroid autoimmunity. This finding could imply that such patients require specifically directed therapy.

  9. Minimal Important Difference (MID of the Dermatology Life Quality Index (DLQI: Results from patients with chronic idiopathic urticaria

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    Leahy Michael

    2005-05-01

    Full Text Available Abstract Background The Dermatology Quality Life Index (DLQI has seen widespread use as a health-related quality of life measure for a variety of dermatological diseases. The purpose of this study was to estimate the minimal important difference (MID on the DLQI for patients with chronic idiopathic urticaria (CIU. Methods Data from 2 Phase III clinical trials of patients (N = 476 for Study A; N = 468 for Study B with CIU were analyzed separately to estimate the MID for the DLQI for these populations. Both distributional based and anchor based approaches were used for deriving estimates. The anchor based approach relied upon patient self assessments of pruritus severity; the distributional based approaches relied upon estimating the standard error of measurement, as well as one-half the standard deviation of the DLQI from each study. Results The distributional approaches resulted in estimates of MID ranging from 2.24 to 3.10 for the two studies. The anchor based approach resulted in estimates of 3.21 and 2.97 for the two studies. Conclusion An MID for the DLQI in the range of 2.24 to 3.10 is recommended in interpreting results for patients with CIU.

  10. Once-daily rupatadine improves the symptoms of chronic idiopathic urticaria: a randomised, double-blind, placebo-controlled study.

    Science.gov (United States)

    Dubertret, Louis; Zalupca, Lavinia; Cristodoulo, Tania; Benea, Vasile; Medina, Iris; Fantin, Sara; Lahfa, Morad; Pérez, Iñaki; Izquierdo, Iñaki; Arnaiz, Eva

    2007-01-01

    This randomised, double-blind, placebo-controlled, parallel-group, international, dose-ranging study investigated the effect of treatment with rupatadine 5, 10 and 20 mg once daily for 4 weeks on symptoms and interference with daily activities and sleep in 12-65 years-old patients with moderate-to-severe chronic idiopathic urticaria (CIU). Rupatadine 10 and 20 mg significantly reduced pruritus severity by 62.05% and 71.87% respectively, from baseline, over a period of 4 weeks compared to reduction with placebo by 46.59% (p < 0.05). Linear trends were noted for reductions in mean number of wheals and interference with daily activities and sleep with rupatadine 10 and 20 mg over the 4-week treatment period. The two most frequently reported AEs were somnolence (2.90% for placebo, 4.29% for 5 mg-, 5.41% for 10 mg- and 21.43% for 20 mg-rupatadine-treated group) and headache (4.35% for placebo, 2.86% for 5 mg-, 4.05% for 10 mg- and 4.29% for 20 mg-rupatadine-treated group). These findings suggest that rupatadine 10 and 20 mg is a fast-acting, efficacious and safe treatment for the management of patients with moderate-to-severe CIU. Rupatadine decreased pruritus severity, in a dose- and time-dependent manner.

  11. Serological evidence that activation of ubiquitous human herpesvirus-6 (HHV-6) plays a role in chronic idiopathic/spontaneous urticaria (CIU).

    Science.gov (United States)

    Dreyfus, D H

    2016-02-01

    Acute infection with viral pathogens in the herpesviridae family can trigger acute urticaria, and reactivation of herpesviridae is associated with cutaneous urticarial-like syndromes such as drug-induced hypersensitivity syndrome/drug reaction with eosinophilia and systemic symptoms (DRESS). Reactivation of latent herpesviridae has not been studied systematically in chronic idiopathic/spontaneous urticaria (CIU). This review proposes that CIU is an inflammatory disorder with autoimmune features (termed 'CVU' for chronic viral urticaria), based on serology consistent with the hypothesis that reactivation of a latent herpesvirus or -viruses may play a role in CIU. Serology obtained from a cohort of omalizumab (Xolair)-dependent patients with severe CIU was consistent with previous HHV-6 infection, persistent viral gene expression and replication. CIU patients also exhibited serological evidence of increased immune response to HHV-4 (Epstein-Barr virus, or EBV) but not all CIU patients were infected with EBV. These observations, combined with case reports of CIU response to anti-viral therapy, suggest that HHV-6, possibly interacting with HHV-4 in cutaneous tissues, is a candidate for further prospective study as a co-factor in CIU.

  12. Chronic urticaria and Helicobacter pylori

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    Yadav Mukesh

    2008-04-01

    Full Text Available Background: Helicobacter pylori (HP have recently emerged as a novel eliciting factor for chronic urticaria (CU. The possible association between HP and CU has enormous potential, as eradicating HP could cure CU. Aims and Objectives: We conducted a study to assess the prevalence of HP infection and effect of bacterium eradication on skin lesions in patients of chronic idiopathic urticaria (CIU. Settings and Design: Four hundred sixty patients of CU attending the allergy clinic, SMS hospital, Jaipur during the period February 6, 2004, to February 6, 2006, were screened for possible eliciting factors. Patients with CIU were enrolled and others were excluded. Materials and Methods: Sixty-eight patients of CIU and similar number of age and sex matched controls, attending the allergy clinic, SMS Hospital, Jaipur were enrolled in the study. All patients underwent endoscopy with antral biopsy for urease and histopathology to identify HP-associated gastritis. Infected patients were given HP eradication therapy. Eradication of bacterium was confirmed by fecal antigen assay. Subjective response to treatment was judged using chronic urticaria quality-of-life questionnaire (CU-Q 2 oL while objective response to treatment was judged by need for ′rescue medication′ (antihistaminics. Statistical Analysis: Data were analyzed using Chi square and paired′t′ test for their level of significance. Results: HP associated gastritis was present in 48 (70.58% patients, out of which 39 (81.25% patients responded to eradication therapy. Ten (50.00% patients without HP associated gastritis showed response to symptomatic therapy. Overall 49 (72.05% patients responded and 19 (27.94% showed no response. The value of χ2 was 28.571 (P = 0.003, which showed significant association between presence of HP and response to eradication regimen. Conclusion: The response of HP eradication therapy in infected patients of CIU is significant. HP should be included in diagnostic

  13. 慢性特发性荨麻疹从腠理论治%Chronic Idiopathic Urticaria Treatment from Striae and Interstitial Space

    Institute of Scientific and Technical Information of China (English)

    王兴兰; 杨恩品

    2012-01-01

    Striae and interstitial space doctrine is an important part of the theory of traditional Chinese medicine, striae and interstitial space are microscopic gaps of the tissue and the cell, such as a place that defensive qi, body fluid perfuse and transform, and playing an important function of guarding outside. Guarding outside dose not firm, striae and interstitial space being loose is a key cause and pathogenesis of chronic idiopathic urticaria. Strengthen superficies and replenish striae is an effective measure to treat chronic idiopathic urticaria.%腠理学说是中医理论的重要组成部分,腠理属组织、细胞间的细微间隙,是卫气、津液等精微物质灌注、运行、转化的场所,发挥着重要的卫外功能.卫外不固、腠理不密是引起慢性特发性荨麻疹的病机关键,固卫实腠是治疗慢性特发性荨麻疹的有效措施.

  14. Chronic Urticaria: Indian Context—Challenges and Treatment Options

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    Sujoy Khan

    2013-01-01

    Full Text Available Urticaria is a common condition that occurs in both children and adults. Most cases have no specific allergic trigger and the aetiology of urticaria remains idiopathic and occasionally spontaneous in nature. Inappropriate advice such as avoidance of foods (milk, egg, prawn, and brinjal is common place in certain sections of India mostly by nonspecialists that should not be routinely recommended. It is important to look for physical urticarias such as pressure urticaria in chronic cases, which may be present either alone or in combination with other causes. Autoimmune causes for chronic urticaria have been found to play an important role in a significant proportion of patients. Long-acting nonsedating antihistamines at higher than the standard doses is safe and effective. Quality of life is affected adversely in patients with chronic symptomatic urticaria and some may require multidisciplinary management.

  15. High prevalence of autoimmune urticaria in children with chronic urticaria

    DEFF Research Database (Denmark)

    Brunetti, Luigia; Francavilla, Ruggiero; Miniello, Vito L;

    2004-01-01

    The etiology of chronic urticaria (CU) in childhood often remains unrecognized. Recently, in adults it has been shown that approximately 40% of patients with CU have autoimmune urticaria (AU); however, no data are available in children....

  16. Guideline of Chronic Urticaria Beyond.

    Science.gov (United States)

    Fine, Lauren M; Bernstein, Jonathan A

    2016-09-01

    Urticaria is a relatively common condition that if chronic can persist for weeks, months or years and affect quality of life significantly. The etiology is often difficult to determine, especially as it becomes chronic. Many cases of chronic urticaria are thought to be autoimmune, although there is no consensus that testing for autoimmunity alters the diagnostic or management strategies or outcomes. Many times, urticaria is easily managed with antihistamines and/or short courses of oral corticosteroids, but too often control is insufficient and additional therapies must be added. For years, immune modulating medications, such as cyclosporine and Mycophenolate Mofetil, have been used in cases refractory to antihistamines and oral corticosteroids, although the evidence supporting their efficacy and safety has been limited. Omalizumab was recently approved for the treatment of chronic urticaria unresponsive to H1-antagonists. This IgG anti-IgE monoclonal antibody has been well demonstrated to safely and effectively control chronic urticaria at least partially in approximately 2/3 of cases. However, the mechanism of action and duration of treatment for omalizumab is still unclear. It is hoped that as the pathobiology of chronic urticaria becomes better defined, future therapies that target specific mechanistic pathways will be developed that continue to improve the management of these often challenging patients.

  17. Controversies and challenges in the management of chronic urticaria.

    Science.gov (United States)

    Staubach, P; Zuberbier, T; Vestergaard, C; Siebenhaar, F; Toubi, E; Sussman, G

    2016-07-01

    This supplement reports proceedings of the second international Global Urticaria Forum, which was held in Berlin, Germany in November 2015. Despite the clear international guideline, there remain a number of controversies and challenges in the management of patients with chronic urticaria (CU). As a result of major advancements in urticaria over the past 4 years, the current EAACI/GA(2) LEN/EDF/WAO urticaria guideline treatment algorithm requires updating. Case studies from patients with chronic spontaneous urticaria (CSU) [also called chronic idiopathic urticaria (CIU)], chronic inducible urticaria (CIndU) or diseases and syndromes related to CU are useful in describing and exploring challenges in disease management. Case studies of specific CSU patient populations such as children with CU or patients with angio-edema but no hives also require consideration as potentially challenging groups with unmet needs. The current EAACI/GA(2) LEN/EDF/WAO urticaria guideline provides a general framework for the management of patients with CU but, as these cases highlight, a personalized approach based on the expert knowledge of the physician may be required.

  18. Incidence of dental caries in chronic urticaria

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    Kaur Surrinder

    1991-01-01

    Full Text Available Three hundred patients of chronic urticaria were screened for dental affections. Sixty two (20.66% patients were detected to have dental caries. Among the control group which com-prised of 100 patients, 20% had dental caries. There was thus no increased incidence of dental caries among patients with urticaria. Only 2 patients had remission of urticaria following treat-ment of caries. Dental caries therefore is probably not a cause of chronic urticaria.

  19. Evaluation of the efficacy and safety of fexofenadine in the management of chronic idiopathic urticaria: A prospective study with 512 patients

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    Dhar Sandipan

    2002-01-01

    Full Text Available Five hundred and twelve patients with chronic idiopathic urticaria (CIU were treated with fexofenadine at a dose on 180mg/day. Maximum number of patients were between 20 to 40 years of age and female to male ratio was 1.45:1. The severity of itching was calculated on a scale of 0 to 4 and was recorded by the patients. The mean daily total symptom score (TSS was measured as sum of the patients′ pruritus and number of wheal scores (0 to 7. A mean TSS was determined for each week. Baseline TSS came down to ′0′ by 4 weeks in all groups except those with TSS 4. There was no correlation between the baseline TSS and degree of improvement. Of 512, 14 (2.73% patients did not complete the study. The commonest adverse effect was headache (9.04%. There was no report of drowsiness or cardiac arrythmia. In no patient fexofenadine had to be withdrawn because of its adverse effects.

  20. Autoimmune thyroid disease and chronic urticaria.

    Science.gov (United States)

    Monge, Cecilia; Demarco, Paul; Burman, Kenneth D; Wartofsky, Leonard

    2007-09-01

    We report six cases of autoimmune thyroid disease associated with chronic urticaria and briefly review the literature, including the histopathological nature of such lesions, and their aetiology and pathogenesis. In view of the prevalence of thyroid disease in patients with chronic urticaria, screening measurements of thyrotropin and anti-thyroperoxidase antibodies are recommended, although negative antibodies do not exclude a relationship between urticaria and thyroid autoimmunity. After failure of conventional therapy for urticaria, patients who are apparently clinically euthyroid may be considered for a trial with levothyroxine. Improvement of urticaria was seen with levothyroxine treatment in three of four patients with only marginal abnormalities in thyroid function.

  1. Oral Mirtazapine in Persistent Chronic Urticaria

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    Mustafa Kulaç

    2008-05-01

    Full Text Available Chronic urticaria accounts for up to 75% of patients with urticaria attending dermatology clinics and can persist for many years. Chronic urticaria often causes significant quality of life issues due to pruritus and urticarial lesions resistant to treatment. Patients attending urticaria clinics have a similar impairment of quality of life as those with eczema or those with coronary disease awaiting by pass surgery. A good response to standard treatment with oral H1 receptor antagonists occurs in under 50%. Immunomodulatory or immunosuppression therapy might therefore required in patients with severe refractory chronic urticaria. But these treatments have too many adverse effects and difficulties in their using. In two current reports, three cases of severe chronic urticaria, unresponsive to conventional therapy, with a successful response to antidepressant mirtazapine were presented. Herein we present three cases responding oral mirtazapine, resistant combination therapies including antihistaminics, leucotrien antagonists and systemic corticosteroids. (Turkderm 2008; 42: 31-3

  2. Treatment of refractory chronic urticaria

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    Aayushi Mehta

    2015-01-01

    Full Text Available Chronic spontaneous urticaria is a distressing disease encountered frequently in clinical practice. The current mainstay of therapy is the use of second-generation, non-sedating antihistamines. However, in patients who do not respond satisfactorily to these agents, a variety of other drugs are used. This article examines the available literature for frequently used agents including systemic corticosteroids, leukotriene receptor antagonists, dapsone, sulfasalazine, hydroxychloroquine, H2 antagonists, methotrexate, cyclosporine A, omalizumab, autologous serum therapy, and mycophenolate mofetil, with an additional focus on publications in Indian literature.

  3. Urticaria.

    Science.gov (United States)

    Wedi, Bettina; Wieczorek, Dorothea; Raap, Ulrike; Kapp, Alexander

    2014-11-01

    Urticaria is a very common skin disease which was already described in the ancient world. Questions still remain about its pathogenesis and management remain open. Compared to other common skin diseases, the published evidence is rather low. The clinical symptoms with pruritic transient wheals and/or angioedema are caused by mediators (particularly histamine) released by activated mast cells and basophils. The mechanism of target cell activation has not been clarified in detail for most urticaria subtypes. Different urticaria subtypes should be distinguished. Spontaneous forms are more common than inducible forms. Chronic urticaria and urticaria in certain age groups (children, pregnancy) can be difficult to manage. Therefore, international consensus resulting in the regular update of urticaria guidelines can be very helpful. Currently, these updated guidelines include a three-step treatment algorithm for chronic spontaneous urticaria. Only the first step of this algorithm, second generation H1-antihistamine in standard dose, utilized approved drugs. However after omalizumab was established as a third line choice in the guideline algorithm, it has approved in many countries for chronic spontaneous urticaria without response to H1-antihistamines. The exact mechanism of action of omalizumab in urticaria has not been fully elucidated. Unrevealing this mechanism might result in a deeper understanding of urticaria pathogenesis and the development of further therapeutic strategies.

  4. ASSURE-CSU : A real-world study of burden of disease in patients with symptomatic chronic spontaneous urticaria

    NARCIS (Netherlands)

    Weller, Karsten; Maurer, Marcus; Grattan, Clive; Nakonechna, Alla; Abuzakouk, Mohamed; Bérard, Frédéric; Sussman, Gordon; Giménez-Arnau, Ana M.; Ortiz De Frutos, Javier; Knulst, André; Canonica, G. Walter; Hollis, Kelly; McBride, Doreen; Balp, Maria Magdalena

    2015-01-01

    BACKGROUND: Chronic spontaneous urticaria (CSU) formerly known as chronic idiopathic urticaria (CIU) is a severe and distressing skin condition that remains uncontrolled in approximately one half of patients, despite the use of licensed, recommended doses of modern, second-generation H1-antihistamin

  5. TNF-Alpha Inhibitors for Chronic Urticaria

    DEFF Research Database (Denmark)

    Sand, Freja Lærke; Thomsen, Simon Francis

    2013-01-01

    be effective and relatively safe treatment options in a significant proportion of patients with chronic urticaria who do not respond sufficiently to high-dose antihistamines or in whom standard immunosuppressive drugs are ineffective or associated with unacceptable side effects.......Patients with severe chronic urticaria may not respond to antihistamines, and other systemic treatment options may either be ineffective or associated with unacceptable side effects. We present data on efficacy and safety of adalimumab and etanercept in 20 adult patients with chronic urticaria...

  6. Chronic spontaneous urticaria: etiology and pathogenesis.

    Science.gov (United States)

    Saini, Sarbjit S

    2014-02-01

    Urticaria affects individuals of all ages and is commonplace. Nearly 1 in 5 individuals will experience an episode of urticaria in their lifetime, while the chronic form of disease has an estimated annual prevalence of approximately 1% of the population. Given the similarity of chronic urticaria symptoms to those seen in patients suffering an allergic reaction, the condition often leads to a search for an external cause. In most cases, no external trigger factor is identified. At present several theories of pathogenesis exist, none of which is firmly established.

  7. Relation between chronic urticaria and thyroid autoimmunity

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    M. Nabavi

    2008-01-01

    Full Text Available AbstractBackground and Purpose: chronic urticaria is a tormenter and does not have a known etiology. Association between chronic urticaria and thyroid auto-immunity has shown different results. The aim of this study is to evaluate the effect of Levo-thyroxine on the chronic urticaria and association between chronic urticaria with thyroid auto-immunity.Materials and Methods: In a prospective case-control study, we compared the frequency of thyroid auto antibodies in 60 patients (all females, with exception of six males, ages 15 to 60 years with chronic urticaria and compared with 60 mached age healthy volunteers. All cases with chronic urticaria and control group were normal CBC, antinuclear antibodies, rheumatoid factors, complement, stool exam, liver function test (LFT, kidney function and skin prick test, prior to being referred to us. We performed thyroid auto antibodies, thyroid hormones and IgE antibodies before treating all subjects. Half of them with positive anti-thyroid antibody (n=11, received Levo-thyroxine (100 μg daily for 1 month and the remaining half (n=11 were control group.Results: The frequency of thyroid auto antibodies was significantly higher in patients with chronic urticaria than in healthy control (36.6% vs. 9%; p<0.01.( All patients were euthyroid, however, one was found to have increased anti-thyroid antibody levels with sub clinical hypothyroidism (TSH increased, low T4. Total serum IgE increased in ten cases of patients group (16.6% compared with six control groups (10%. Nine patients (40% had complete response, five patients (30% had partial response and five patients (30% did not show any response to treatment compared with control group, in which complete and partial resolution was 30% and others with no resolution.Conclusion: chronic urticaria may be associated with thyroid disorders (positive anti- thyroid antibodies despite normal thyroid function test. For chronic urticaria despite increase serum IgE level

  8. 581 Chronic Urticaria and Infections

    Science.gov (United States)

    Aguilar, Nadia; Lugo-Reyes, Saul; Segura Mendez, Nora Hilda; Mendieta, Elizabeth

    2012-01-01

    Background Chronic Urticaria (CU) is a group of diseases that share a distinct skin reaction pattern. Triggering of urticaria by infections has been discussed for many years but the exact role and pathogenesis of mast cell activation by infectious processes is unclear. The remission of annoying spontaneous chronic urticaria has been reported after successful treatment of persistent infections. Objective To describe the infections found in chronic urticaria patients in our service, by performing a complete medical history, physical examination, laboratory studies and cultures. Methods Universe: Consecutive patients with chronic urticaria, with a detailed history, physical examination, laboratory studies underwent clinical viral panel, cultures, biopsy for detection of H. Pylori. Results A total of 50 patients, mostly women 82% and 18% men, mean age 41 years. 42% of the total population had salmonella, proteus infection in 20% and 8% brucellosis. Crossed with urinary tract infection 6% of the population. Five patients had positive stool in 3 patients Endolimax nana was isolated and 2 patients reported Giardia lamblia, 5 patients (10%) women had undergone cervicovaginitis 2 of them infected with S. haemolyticus, the rest was cultivated E. faecalis, and T. Gardenella vaginalis, respectively. Was isolated in 2 patients and one patient H.pilory HCV infection. Conclusions Infections may play a causal role of UC in some cases. Were identified in 42% of cases and gastrointestinal infections by most common cause Salmonellosis. As for genitourinary tract infections, intestinal parasites, Helicobacter pylori, were treated appropriately with antibiotic therapy, found a successful resolution of urticaria mainly in patients infected with Helicobacter pylori. There is growing evidence that persistent infections in chronic urticaria are important triggers, particularly in the case of infection by Helicobacter pylori, so If an infection is identified, it should be appropriately

  9. Omalizumab in the treatment of chronic urticaria.

    Science.gov (United States)

    Francés, L; Leiva-Salinas, M; Silvestre, J F

    2014-01-01

    Omalizumab is a monoclonal anti-immunoglobulin E antibody currently only approved for use in severe, refractory asthma. In recent years, many authors have reported satisfactory results with omalizumab in patients with difficult-to-treat chronic urticaria. As a result, clinical trials were undertaken to broaden the indication of omalizumab to include chronic urticaria, and the drug was recently cited as a third-line treatment after selective antihistamines at high doses in a consensus document on the treatment of chronic urticaria. In this article our aim is to provide a comprehensive update on the use of omalizumab in the treatment of chronic urticaria. The structure of this biologic agent and its possible mechanisms of actions in this setting will be presented. Treatment strategies and the different dosage regimens used in the series of cases published to date will also be reviewed. Finally, we will discuss the adverse effects that may arise with treatment and the recommended strategies for minimizing the most feared effect, anaphylaxis. Based on the experience of many researchers, omalizumab is emerging as a novel treatment for certain types of spontaneous refractory chronic urticaria and has shown promising results in this setting. The drug has a good safety profile and the main limitation is its high cost.

  10. Evaluation of etiological factors in patients with chronic urticaria.

    Science.gov (United States)

    Colgecen, Emine; Ozyurt, Kemal; Gul, Ali Irfan; Utas, Serap

    2015-01-01

    In the last few decades, increasing understanding of the pathomechanisms involved in chronic urticaria has highlighted the heterogeneity of different subtypes, and chronic urticaria is now classified as chronic spontaneous urticaria and inducible urticaria. Although many factors are thought to be involved in chronic urticaria, the etiology is yet to be clarified. The purpose of this study was to investigate etiological factors in patients with chronic urticaria. Five hundred patients with chronic urticaria, 351 women and 149 men, were studied for etiological factors. The autologous serum skin test was performed on 197 patients. Provocation testing for physical urticaria was performed on 354 patients. Patients with acute urticaria were excluded from the study. We determined at least one focus of infection that might be involved in the etiology of the disease in 18.8% of cases. Patients with infections were treated, and symptoms resolved after treatment in six cases (5.3%). Autologous serum skin tests were positive in 125 patients (63.5%). Provocation tests for physical urticaria were positive in 131 (37%) patients with urticaria. We suggest that physical stimuli and autoantibodies play an important role in the etiopathogenesis of urticaria.

  11. Questions and answers in chronic urticaria: where do we stand and where do we go?

    Science.gov (United States)

    Maurer, M; Church, M K; Marsland, A M; Sussman, G; Siebenhaar, F; Vestergaard, C; Broom, B

    2016-07-01

    This supplement reports proceedings of the second international Global Urticaria Forum, which was held in Berlin, Germany in November 2015. In 2011, a report of the GA(2) LEN task force on urticaria outlined important and unanswered questions in chronic urticaria (CU). These included, but were not limited to, questions on the epidemiology and course of chronic spontaneous urticaria (CSU) [also called chronic idiopathic urticaria (CIU)], the resources allocated for the diagnosis and treatment of CSU, whether patients with angioedema as an isolated symptom can be regarded as a subgroup of CSU, and the efficacy and long-term safety of therapies. Many of these questions have been addressed by recent studies. Some of the answers obtained raise new questions. Here, we summarize some of the key insights on CU obtained over recent years, and we discuss old and new unmet needs and how to address them with future studies. We need to analyze the influence of recent advances in understanding of the burden of CU on patients and society, disease management and the CU patient journey. Our increased understanding of urticarial pathophysiology and consideration of the patient as a whole will need to be translated to better treatment algorithms and protocols. Actions to address these challenges include the 5th International Consensus Meeting on Urticaria, which will take place later this year. The formation of a global network of Urticaria Centers of Reference and Excellence over the next few years has also been proposed, with the aim of providing consistent excellence in urticaria management and a clear referral route, furthering knowledge of urticaria through additional research and educating/promoting awareness of urticaria.

  12. Chronic Urticaria: The Necessity of Laboratory Examination

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    Javad Ghaffari

    2013-04-01

    Full Text Available Background: Urticaria is a common dermatologic disease. About 20 per cent of the population experiences it in a life-time period. The aim of this study was to compare the various laboratory examinations of chronic urticaria patients and healthy individuals and to determine the necessity of laboratory tests in such patients. Materials and Methods: In this study 78 patients suffering from chronic urticaria and 67 healthy individuals (2-50 year-old with analogous demographic features underwent ALT, AST, S/E, ESR, CBC, TSH, T4, C4, C3, CH50, ANA, anti-thyroglobulin, anti-peroxidase, and anti H. pylori antibodies testing.Results: Forty-one per cent of patients had increased IgE in comparison to 14.92% in normal subjects. Anti-thyroid antibodies were positive in 17.94% of cases while only 9% of normal individuals were positive (p0.05. No significant difference found in other variables. Conclusion: Urticaria is often diagnosed based on clinical grounds and no routine laboratory examination is required.

  13. Omalizumab for the treatment of chronic urticaria.

    Science.gov (United States)

    Zuberbier, Torsten; Maurer, Marcus

    2015-02-01

    Urticaria is a common and often debilitating dermatological condition defined by the sudden appearance of wheals, angioedema or both. It is further classified into specific subtypes based on duration and specific triggers. Awareness and understanding of urticaria are important to ensure a correct initial diagnosis and initiate appropriate guideline-based treatment outlining a stepwise approach. However, in chronic urticaria, approximately 50% of patients are refractory to the first step, the use of licensed doses of second-generation H1-antihistamines. If the second step, an increase in the dose of the second-generation H1-antihistamines, is also not successful, in the third step omalizumab (Xolair™, Novartis Pharma AG(©)/Genentech, Inc.(©)), an anti-IgE therapy, is recommended as an add-on. Of all alternative treatments mentioned in the guidelines, omalizumab is currently the only licensed treatment for H1-antihistamine-refractory chronic spontaneous urticaria, has a favorable risk/benefit ratio and was well tolerated in clinical studies.

  14. Urticaria and angioedema

    OpenAIRE

    Kanani Amin; Schellenberg Robert; Warrington Richard

    2011-01-01

    Abstract Urticaria (hives) is a common disorder that often presents with angioedema (swelling that occurs beneath the skin). It is generally classified as acute, chronic or physical. Second-generation, non-sedating H1-receptor antihistamines represent the mainstay of therapy for both acute and chronic urticaria. Angioedema can occur in the absence of urticaria, with angiotensin-converting enzyme (ACE) inhibitor-induced angioedema and idiopathic angioedema being the more common causes. Rarer c...

  15. Chronic urticaria and celiac disease: a case report.

    Science.gov (United States)

    Peroni, Diego G; Paiola, Giulia; Tenero, Laura; Fornaro, Martina; Bodini, Alessandro; Pollini, Federica; Piacentini, Giorgio L

    2010-01-01

    We describe a case of a 9-year-old girl who presented chronic urticaria associated with celiac disease. The prevalence of the manifestation of chronic urticaria in celiac disease is unknown but increase in atopic immunologic disorders has been reported in the setting of gluten enteropathy. Relationship between the clinical manifestations is not clear. The present case of subclinical celiac disease diagnosis in an otherwise asymptomatic child with chronic urticaria further reinforces the evidence that differential for celiac disease warrants to be always considered in children with refractory urticaria.

  16. Leukotriene receptor antagonists in monotherapy or in combination with antihistamines in the treatment of chronic urticaria: a systematic review

    Directory of Open Access Journals (Sweden)

    Gabriele Di Lorenzo

    2008-12-01

    Full Text Available Gabriele Di Lorenzo1, Alberto D’Alcamo1, Manfredi Rizzo1, Maria Stefania Leto-Barone1, Claudia Lo Bianco1, Vito Ditta1, Donatella Politi1, Francesco Castello1, Ilenia Pepe1, Gaetana Di Fede2, GiovamBattista Rini11Dipartimento di Medicina clinica e delle Patologie Emergenti; 2Dipartimento di Discipline Chirurgiche ed Oncologiche, Università degli Studi di Palermo, ItalyAbstract: In vitro and in vivo clinical and experimental data have suggested that leukotrienes play a key role in inflammatory reactions of the skin. Antileukotriene drugs, ie, leukotriene receptor antagonists and synthesis inhibitors, are a class of anti-inflammatory drugs that have shown clinical efficacy in the management of asthma and in rhinitis with asthma. We searched MEDLINE database and carried out a manual search on journals specializing in allergy and dermatology for the use of antileukotriene drugs in urticaria. Montelukast might be effective in chronic urticaria associated with aspirin (ASA or food additive hypersensitivity or with autoreactivity to intradermal serum injection (ASST when taken with an antihistamine but not in mild or moderate chronic idiopathic urticaria [urticaria without any possible secondary causes (ie, food additive or ASA and other NSAID hypersensitivity, or ASST]. Evidence for the effectiveness of zafirlukast and the 5-lipoxygenase inhibitor, zileuton, in chronic urticaria is mainly anecdotal. In addition, there is anecdotal evidence of effectiveness of antileukotrienes in primary cold urticaria, delayed pressure urticaria and dermographism. No evidence exists for other physical urticarias, including cholinergic, solar and aquagenic urticarias, vibratory angioedema, and exercise-induced anaphylaxis.Keywords: chronic idiopathic urticaria, leukotriene receptor antagonists, montelukast, zafirlukast, antihistamine

  17. 消风散联合地氯雷他定治疗小儿慢性特发性荨麻疹的疗效观察%Efficacy observation of Xiaofeng powder combined with loratadine in treatment of children with chronic idiopathic urticaria

    Institute of Scientific and Technical Information of China (English)

    李学燕; 于海凤

    2014-01-01

    目的:研究消风散联合地氯雷他定治疗小儿慢性特发性荨麻疹的临床疗效。方法选取120例小儿慢性荨麻疹患儿,随机分为治疗组与对照组各60例,其中对照组仅采用地氯雷他定治疗,而治疗组应用消风散与地氯雷他定联合治疗,比较两组疗效。结果两组治愈率、总有效率及复发率对比差异显著,具有统计学意义(P<0.05)。结论消风散联合地氯雷他定治疗小儿慢性特发性荨麻疹具有较好的疗效,值得临床推广。%Objective To study the clinical efficacy of Xiaofeng powder combined with loratadine in the treatment of children with chronic idiopathic urticaria. Methods 120 children with chronic idiopathic urticaria were selected and randomly divided into the treatment group and the control group,with 60 patients in each group. The control group received desloratadine treatment and the treatment group received Xiaofeng powder combined with desloratadine. The efficacy of the two groups was compared. Results The two groups were significantly different in the cure rate,total effective rate and recurrence rate,with statistical significance(P < 0.05). Conclusion Xiaofeng powder combined with loratadine shows good efficacy in the treatment of children with chronic idiopathic urticaria,thereby worthy of promotion.

  18. Unmet clinical needs in chronic spontaneous urticaria. A GA²LEN task force report.

    Science.gov (United States)

    Maurer, M; Weller, K; Bindslev-Jensen, C; Giménez-Arnau, A; Bousquet, P J; Bousquet, J; Canonica, G W; Church, M K; Godse, K V; Grattan, C E H; Greaves, M W; Hide, M; Kalogeromitros, D; Kaplan, A P; Saini, S S; Zhu, X J; Zuberbier, T

    2011-03-01

    Chronic spontaneous urticaria, formerly also known as chronic idiopathic urticaria and chronic urticaria (CU), is more common than previously thought. At any time, 0.5-1% of the population suffers from the disease (point prevalence). Although all age groups can be affected, the peak incidence is seen between 20 and 40 years of age. The duration of the disease is generally 1-5 years but is likely to be longer in more severe cases, cases with concurrent angioedema, in combination with physical urticaria or with a positive autologous serum skin test (autoreactivity). Chronic spontaneous urticaria has major detrimental effects on quality of life, with sleep deprivation and psychiatric comorbidity being frequent. It also has a large impact on society in terms of direct and indirect health care costs as well as reduced performance at work and in private life. In the majority of patients, an underlying cause cannot be identified making a causal and/or curative treatment difficult. Nonsedating H₁-antihistamines are the mainstay of symptomatic therapy, but treatment with licensed doses relieves symptoms effectively in < 50% of patients. Although guideline-recommended updosing up to fourfold increases symptom control in many patients, a substantial number of patients have only little benefit from H₁ -antihistamines. Consequently, there is a great need for new therapeutic strategies.

  19. Management of chronic spontaneous urticaria: practical parameters.

    Science.gov (United States)

    Marzano, A V; Pigatto, P; Cristaudo, A; Ayala, F; Rossi, O; Senna, G; Triggiani, M; Asero, R

    2015-04-01

    Chronic urticaria (CU) is a skin disorder characterized by transient, pruritic wheals persisting for longer than 6 weeks. According to the European Academy of Allergy and Clinical Immunology (EAACI) guidelines, CU can be categorized into two main types: chronic spontaneous urticaria (CSU), in which the wheals appear spontaneously, and inducible urticaria, that is triggered by physical agents. CSU may be due to triggering factors such as food allergens or infections, but in at least 40% of cases it is autoimmune in origin, caused by circulating autoantibodies anti-FcεR1 or anti-IgE, or autoreactive. In the present paper, re-evaluating the EAACI guidelines, we have developed a document containing some practical indications which are useful for diagnosis and management of CSU in the context of the Italian situation. Concerning CSU treatment, second generation antihistamines are the first-line treatment; these drugs can be used, as second-line treatment, at a higher than licensed dose in patients who do not respond adequately at licensed doses. The third-line treatment includes leukotriene receptor antagonists which, however, do not have a specific indication for the treatment of CSU, cyclosporine, whose use in this disease is still off-label, and omalizumab. The latter is a recombinant monoclonal IgG antibody that binds free IgE, down regulates mast cell function and induces eosinophil apoptosis. Recently, it has emerged as an effective and safe treatment for antihistamine-unresponsive CSU of both autoimmune/autoreactive and non-autoimmune/non-autoreactive, and has been officially approved for use against this disease.

  20. Physical urticarias and cholinergic urticaria.

    Science.gov (United States)

    Abajian, Marina; Schoepke, Nicole; Altrichter, Sabine; Zuberbier, Torsten; Zuberbier, H C Torsten; Maurer, Marcus

    2014-02-01

    Physical urticarias are a unique subgroup of chronic urticaria in which urticarial responses can be reproducibly induced by different specific physical stimuli acting on the skin. These conditions include urticaria factitia/symptomatic dermographism, delayed pressure urticaria, cold contact urticaria, heat contact urticaria, solar urticaria, and vibratory urticaria/angioedema. Physical urticarias and cholinergic urticarias are diagnosed based on the patients' history and provocation tests including trigger threshold testing where possible. Treatment is mainly symptomatic. Many patients benefit from avoiding eliciting triggers, and desensitization to these triggers can be helpful in some physical urticarias and in cholinergic urticaria.

  1. IS PEPTIC ULCER WITH HELICOBACTER INFEC¬TION THE CAUSE OF CHRONIC URTICARIA?

    Directory of Open Access Journals (Sweden)

    A. Farhoudi

    2000-01-01

    Full Text Available Helicobacter pylori, the most important cause of gastritis and peptic ulcer, has recently been associated with several extradigestive diseases. The aim of this study was to assess the prevalence of Helicobacter pylori infection and effects of bacterium eradication in 50 patients affected by idiopathic chronic urticaria. Helicobacter pylori was assessed by serology or biopsy and urease test or 13C urea breath test. Amoxicillin, bismuth subcitrate (Denol, metronidazole and cimetidine were given to infected patients for 2 weeks. The results of therapy were assessed by urea breath test six weeks after therapy. In response to treatment urticaria clinically regressed in 16 out of 24 patients (66.6%. Thus bacterium eradication was associated with a remission of urticaria symptoms, suggesting a possible role in the pathogenesis of this disorder.

  2. Chapter 21: Urticaria and angioedema.

    Science.gov (United States)

    Carr, Tara F; Saltoun, Carol A

    2012-01-01

    Urticaria, also known as hives, may affect up to 20% of the population at some time in their lives. Urticaria is characterized by extreme pruritus and described as erythematous, raised, circumscribed lesions with central pallor that blanch with pressure. The pathogenesis of urticaria involves mast cell activation, with subsequent release of histamine and other vasoactive mediators, leading to increased vascular permeability of postcapillary venules and development of edema, erythema, and pruritus. Urticaria is closely associated with angioedema in 40% of individuals; ∼10% of patients experience angioedema without urticaria. Urticarial lesions often are generalized with multiple lesions in no specific distribution; angioedema tends to be localized, commonly affecting the face (periorbital and perioral regions), tongue, uvula, soft palate or larynx, extremities, and genitalia. Urticaria is subdivided into acute and chronic urticaria based on duration of symptoms. Acute urticaria lasts Urticaria lasting >6 weeks is designated as chronic urticaria, and an etiology is seldom identified and thus considered idiopathic. Chronic urticaria may have an autoimmune basis. There is a well-documented association between autoimmune hypothyroidism (Hashimoto's disease) and urticaria and angioedema with higher incidence of antithyroid (antithyroglobulin and antiperoxidase) antibodies in these usually euthyroid patients. Furthermore, studies have revealed a circulating IgG antibody directed against the IgE receptor (F(Cε)RIα) or IgE in 40-60% of patients with chronic urticaria. Histamine 1-receptor antagonists (antihistamines) are initial therapy.

  3. H1-antihistamines for chronic spontaneous urticaria.

    Science.gov (United States)

    Sharma, Maulina; Bennett, Cathy; Cohen, Stuart N; Carter, Ben

    2014-11-14

    Background Chronic spontaneous urticaria (CSU) is characterised by the development of crops of red, itchy, raised weals or hives with no identifiable external cause.Objectives To assess the effects of H1-antihistamines for CSU.Search methods We searched the following databases up to June 2014: Cochrane Skin Group Specialised Register, CENTRAL (2014, Issue 5), MEDLINE(from 1946), EMBASE (from 1974) and PsycINFO (from 1806). We searched five trials registers and checked articles for references to relevant randomised controlled trials.Selection criteria We included randomised controlled trials of H1-antihistamines for CSU. Interventions included single therapy or a combination of H1-antihistamines compared with no treatment (placebo) or another active pharmacological compound at any dose.Data collection and analysis We used standard methodological procedures as expected by The Cochrane Collaboration.Our primary outcome measures were proportion of participants with complete suppression of urticaria: 'good or excellent' response,50% or greater improvement in quality of life measures, and adverse events.We present risk ratios (RR) with 95% confidence intervals(CIs). Main results We identified 73 studies (9759 participants); 34 studies provided data for 23 comparisons. The duration of the intervention was up to two weeks (short-term) or longer than two weeks and up to three months (intermediate-term).Cetirizine 10mg once daily in the short term and in the intermediate term led to complete suppression of urticaria by more participants than was seen with placebo (RR 2.72, 95% CI 1.51 to 4.91). For this same outcome, comparison of desloratadine versus placebo in the intermediate term (5 mg) (RR 37.00, 95% CI 2.31 to 593.70) and in the short term (20 mg) (RR 15.97, 95% CI 1.04 to 245.04)favoured desloratadine, but no differences were seen between 5 mg and 10 mg for short-term treatment.Levocetirizine 20 mg per day (short-term) was more effective for complete suppression of

  4. Angioimmunoblastic T Cell Lymphoma Mimicking Chronic Urticaria

    Directory of Open Access Journals (Sweden)

    Mohleen Kang

    2016-01-01

    Full Text Available Angioimmunoblastic T cell lymphoma (AITL is a rare but distinct type of T cell lymphoma with an aggressive course and high mortality. Most patients are diagnosed late in the disease and usually present with generalized lymphadenopathy. A minority have skin lesions at the time of diagnosis, more commonly in the form of nonspecific maculopapular rash with or without pruritus. We report a rare case of AITL presenting with chronic, recurrent angioedema and urticaria-like lesions and no palpable peripheral adenopathy. Primary Care physicians, dermatologists, and allergists must maintain a high index of suspicion for cutaneous manifestations of lymphoma, especially if the skin lesions are refractory to standard treatment. Timely diagnosis is essential to improve survival.

  5. Chronic urticaria. Clinical and pathogenetic studies in 141 patients

    NARCIS (Netherlands)

    Doeglas, Hendrik Maarten George

    1975-01-01

    This study describes a combined clinical, laboratory and experimental approach of the problems of 141 patients with chronic urticaria, collected over a three-year period in a Dermatology department. ... Zie: Summary

  6. Chronic spontaneous urticaria - a management pathway for patients with chronic spontaneous urticaria.

    Science.gov (United States)

    Termeer, Christian; Staubach, Petra; Kurzen, Hjalmar; Strömer, Klaus; Ostendorf, Rolf; Maurer, Marcus

    2015-05-01

    Chronic spontaneous urticaria (CSU) is a common and challenging disease, especially with respect to healthcare provision in the context of the German statutory health insurance system. If treatment with second-generation antihistamines is unsuccessful, current guidelines recommend further therapeutic options. However, most of these are off-label. This discrepancy between treatment according to guidelines and the ability to prescribe drugs at the expense of the statutory health insurance (reimbursability) often leads to uncertainties in everyday clinical practice. In addition, physicians prescribing certain drugs are faced with the difficulty of measuring and documenting therapeutic success/outcome. Respective outcome measurement methods have not yet been established in daily practice. Using a consensus process, a working group composed of dermatologists in private practice and specialized urticaria centers has defined a practical pathway for the implementation of current treatment recommendations based on the 2013 S3 guidelines for urticaria. Here, we present a diagnostic and therapeutic management pathway for CSU. Further, we discuss prescription issues in daily practice, including updosing of antihistamines, with regard to cost-effectiveness and drug approval on the basis of published studies and current legislation. Constituting the highest treatment level, the use of cyclosporine A, montelukast, and omalizumab, which has recently become available as therapeutic option, is reviewed. The urticaria control test (UCT) is presented as a valid outcome measure in routine practice. Our objective was to provide physicians in private practice with a practical guideline-based therapeutic decision tool, taking into account the requirements imposed by the statutory health insurance system. It is not meant to replace individualized history taking or treatment of this heterogeneous disease. Rather, we would like to suggest reference points for clinical diagnosis and treatment

  7. Evaluation Of Prick Test In Atopic Dermatitis And Chronic Urticaria

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    Dhar Sandipan

    1997-01-01

    Full Text Available “Prick test” was carried out in 15 patients with atopic dermatitis (AD and 10 patients with chronic urticaria (CU. Of the various aeroallergens tested, house dust mite (HDM, pollens, aspergillus furnigatus and insects were found to be most commonly positive. The common food allergens showing prick test positivity were egg white, fish, milk, brinjal, dal, groundnut and banana. Use of nasal filters showed 10-20% improvement in AD and 5 â€" 10% improvement in urticaria. Withdrawal of the responsible food article(s showed 20-30% improvement in patients with AD and urticaria.

  8. Updosing of nonsedating anti-histamines in recalcitrant chronic urticaria

    OpenAIRE

    Kiran Godse; Prachi Bhattar; Sharmila Patil; Nitin Nadkarni; Manjyot Gautam

    2016-01-01

    Chronic urticaria (CU) is a persistent, debiliating condition that causes severe impairment on the quality of life (QoL) of patient by interrupting work productivity. Current guidelines recommend second-generation (nonsedating) anti-histamines for the treatment for all forms of urticaria. In patients who do not respond adequately to conventional doses of anti-histamines, it is recommended to increase the dose to up to four times to obtain control. But there are only few controlled studies tha...

  9. Chronic idiophatic urticaria and Helicobacter pylori: a specific pattern of gastritis and urticaria remission after Helicobacter pylori eradication.

    Science.gov (United States)

    Persechino, S; Annibale, B; Caperchi, C; Persechino, F; Narcisi, A; Tammaro, A; Milione, M; Corleto, V

    2012-01-01

    Chronic urticaria (CU) is defined as the occurrence of spontaneous wheals for a duration of more than 6 weeks and is the most frequent skin disease, with prevalence ranging between 15 and 25%, and is a seriously disabling condition, with social isolation and mood changes causing a significant degree of dysfunction and quality of life impairment to many patients. The main clinical features of CU are the repeated occurrence of transient eruptions of pruritic wheals or patchy erythema on the skin that last less than 24 hours and disappear without sequelae. CU is often defined as chronic idiopathic urticaria (CIU) because the causes of CU remain unknown in the great majority (70-95%) of patients. Drugs, food, viruses, alimentary conservative substances or inhalant substances often seem to be involved in determining CIU skin flare. Despite a general agreement that bacteria infections and parasitic infestations can be involved in the pathogenesis of CIU, proven evidence of these relationships is lacking. The aim of the present study is to evaluate the prevalence of Helicobacter pylori (Hp) infection, and the extension and severity of gastritis in a group of CIU patients compared to controls and to evaluate the effectiveness of eradication of Hp on the CIU symptomatology, and the role of Hp infection in pathogenesis of CIU.

  10. Clinical Study on Chronic Idiopathic Urticaria with Mizolastine Combined with Compound Glycyrrhizin in the Treatment of%对慢性特发性荨麻疹采用咪唑斯汀联合复方甘草酸苷治疗的临床探讨

    Institute of Scientific and Technical Information of China (English)

    谭李萍

    2015-01-01

    Objective To observe the clinical effect of mizolastine combined with Compound Glycyrrhizin in the treatment of chronic idiopathic urticaria.Methods 66 patients with chronic idiopathic urticaria were treated in our hospital from February 2013 March to, and were randomly divided into control group and observation group, 33 cases in each group. Simple of mizolastine in the treatment was given to the control group, the observation group in the control group based on the combined with Compound Glycyrrhizin in the treatment, compared two groups of clinical curative effect.Results Observation of the treatment group total effective rate, recurrence rate, nettle rash, itching and erythema number integral were significantly better than the control group (P<0.05) difference has statistical significance.Conclusion in patients with chronic idiopathic urticaria with mizolastine combined with Compound Glycyrrhizin in the treatment of clinical curative effect, worthy of clinical application and promotion.%目的:观察分析咪唑斯汀联合复方甘草酸苷治疗慢性特发性荨麻疹的临床疗效。方法选取我院2013年2月至2015年3月收治的66例慢性特发性荨麻疹患者为研究对象,随机分为对照组与观察组,各33例。对照组给予单纯的咪唑斯汀治疗,观察组在对照组基础上联合复方甘草酸苷治疗,比较两组临床疗效。结果观察组治疗总有效率、疾病复发率、风团、瘙痒及红斑数目积分均显著优于对照组,(P<0.05)差异具有统计学意义。结论对慢性特发性荨麻疹患者采用咪唑斯汀联合复方甘草酸苷治疗的临床疗效显著,值得临床广泛应用及推广。

  11. Autologous serum therapy in chronic urticaria

    Directory of Open Access Journals (Sweden)

    Sharmila Patil

    2013-01-01

    Full Text Available Autologous serum therapy is a promising therapy for treatment resistant urticaria. This is useful in developing countries as this is economical option. Minimum instruments like centrifuge, syringe and needles are required for the procedure.

  12. Efficacy of H, antihistamine, corticosteroids and cyclophosphamide in the treatment of chronic dermographic urticaria

    Directory of Open Access Journals (Sweden)

    Kumar Rajesh

    2002-01-01

    Full Text Available H, antihistamines relieve urticaria by blocking the action of histamine on the target tissue, while demonstration of autoantibodies in the sera of a proportion of the patients having chronic idiopathic urticaria, use of immunosuppressive drugs for the treatment of these patients has acquired the greater rationality. We evaluated the role of corticosteroids and cyclophosphamide in the treatment of chronic dermographic urticaria. Twenty-five patients, 13 males and 12 females, between 18-53 years in age, having chronic dermographic urticaria were taken up for this study. The patients were divided into three groups. Group I patients (n=9 were treated with cetirizine hydrochloride 10 mg per day orally, group II patients (n=7 were treated with betamethasone 2 mg along with cyclophosphamide 50 mg along with cetirizine 10 mg per day for a total period of 4 weeks. The patients were evaluated every week to record the therapeutic response and side effects, and then followed up without treatment for a period of 6 months to look for recurrence of the urticaria, if any. Six patients in group I and all the patients in group II and group III had complete remission while the remaining patients in group I had partial relief. The side effects included drowsiness in 4 patients. All the patients in group II had weight gain, 4 patients had acne and 2 patients developed cushingoid features. Majority of the patients relapsed within 3 days after stopping the treatment. Supplementation of the treatment with oral corticosteroids or cyclophosphamide was more effective in controlling the symptoms as compared to cetirizine alone. But a four weeks supplementation was not adequate for preventing the relapses when the drugs were withdrawn.

  13. Synergistic effect of broad-spectrum Sunscreens and antihistamines in the control of idiopathic solar urticaria

    DEFF Research Database (Denmark)

    Faurschou, A.; Wulf, Hans Chr.

    2008-01-01

    Background: It can be difficult to provide patients with idiopathic solar urticaria adequate protection from sunlight. In a nonrandomized controlled trial, we used a standardized phototest procedure to determine the effects of using sunscreen and antihistamine to control idiopathic solar urticaria....... The patients were then treated with a high-protection, broad-spectrum sunscreen and a nonsedative antihistamine alone and in combination and underwent similar phototesting. The use of sunscreen allowed the patients to tolerate much higher doses of UV radiation (32-38 times the MUD on untreated skin......). Antihistamine use did not increase the patients' MUD but did suppress wheal formation and itch, and only immediate erythema sharply located in the irradiated areas occurred. The combination of sunscreen and antihistamine acted synergistically and increased the tolerance to UV radiation markedly (80-267 times...

  14. RECURRENT, IDIOPATHIC URTICARIA IN A TONGA PONY MARE

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    T. Ahmad, G. Muhammad and M. H. Hussain

    2003-01-01

    Full Text Available A 15-Yearold tonga (a light wheeled horse cart pony mare was presented for the treatment of a condition characterized by generalized urticarial wheals, anemic mucous membranes, concentrated urine, inappetance and unilateral chemosis. Haematological alterations included a marked leucocytosis (WBC = 14x103/ul with monocytosis (2.5x109/L and moderate anemia (RBC count = 4.lx1012/L; PCV = 18; hemoglobin = 8.2 gm/dl. There was no history of exposure to agents known tQtrigger urticaria. Parental administration of a corticosteroid preparation (prednisolone plus dexamethasone and antihistamine (pheniramine maleate in 4 rounds of treatment over a 16 days period was associated with rebounding of signs of urticaria after cessation of each round oftherapyo

  15. Chronic urticaria treated with soft nasal filters

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    Pasricha J

    1995-01-01

    Full Text Available A 22-year-old boy having two attacks of urticaria per day for the last 5 years and intermittent attacks of sneezing and rhinorrhoea, and without any clues to the causative agent in spite of a detailed history and follow up, showed almost complete relief on wearing an ordinary cloth mask for 3 days. He was subsequently trained to use the soft nasal filters and obtained almost 80% relief in urticaria and complete relief in rhinitis during the next 1 year. Wearing the mask for 2 days again led to complete relief and further training in the proper use of the filters was helpful.

  16. Helicobacter pylori: A significant and treatable cause of chronic urticaria and angioedema.

    Science.gov (United States)

    Rasooly, Marjohn M; Moye, Nancy A; Kirshenbaum, Arnold S

    2015-10-16

    Two outpatient medical offices evaluated 204 patients with chronic urticaria during 2012. This article presents a retrospective study showing that 10% of patients with chronic urticaria may be infected with H. pylori. Furthermore, eradication of infection can be followed by remission of urticaria, reduced morbidity from gastric ulcers, and cancer.

  17. Association of Chronic Urticaria and / or Angioedema with Thyroid Autoimmunity

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    M Amini

    2004-10-01

    Full Text Available Introduction: Auto – immune disorders have been implicated as a cause for chronic uricaria and/ or angioedema and thyroid autoimmunity has been increasingly introduced to be associated with that. This study explores the association of thyroid autoimmunity with chronic urticaria and / or angioedema in Isfahani patients. Methods: Anti – thyroperoxidase (Ani – TPO and anti – thyroglobulin (Anti – Tg antibodies, T4 and TSH were detected in 57 patients with chronic urticaria and / or angioedema and were compared with that of normal subjects without chronic urticaria or other autoimmune diseases. Results: Anti – TPO and Anti – Tg antibodies had been increased in 26 (45.6% and 28 (49% of patients in case group, as compared to 8 (13.2% and 10 (16.7% of subjects in control group, respectively. In total, raised titers of thyroid autoantibodies were found in 34 (60% and 12 (20% of subjects in case and control groups, respectively. Conclusion: Considering the high prevalence of thyroid autoantibodies in patients with chronic urticaria and / or angioedema, these antibodies should be detected in affected patients, specially in young and middle– aged women.

  18. Advances in Chronic Urticaria Study%慢性荨麻疹的研究进展

    Institute of Scientific and Technical Information of China (English)

    金如钧; 孙丽萍

    2009-01-01

    目的 阐述慢性荨麻疹的病因、致病机制、临床表现、病理和治疗新进展,为慢性荨麻疹的治疗提供理论依据.方法 以慢性荨麻疹为主题词通过MEDLINE查找1997-2009年度所有英文版公开发表的文章.结果 慢性荨麻疹是一种常见、病因难以明确的疾病,可能与食物、药物、感染、甲状腺疾病有关.在慢性荨麻疹的致病机制中,近年来研究最多的就是在患者的外周血中发现针对肥大细胞表面受体的自身抗体,这类患者往往有较严重而难以控制的病情.主要治疗药物是第一代和第二代抗H受体的抗组胺药;另外,对严重者还包括白三烯受体拮抗剂、糖皮质激素、华法令、奥马珠单抗和免疫调节剂等.结论 在慢性荨麻疹的致病机制中肥大细胞是关键因素.目前尚无理想的治疗方法 ,奥马珠单抗已被用于本病的治疗,但疗效和安全性以及其作用机制尚待将来的进一步研究.%Objective To elucidate an update on the knowledge about the etiology,pathogenesis,clinical manifestations, histo-pathology,treatment of chronic urticaria, so as to provide a theoretic basis for the research of chronic urticaria. Methods A MEDLINE search was performed for the years 1975 to 2009 using the keywords chronic urticaria to identify relevant articles pub-lished in English in peer-reviewed journals. Results Chronic urticaria is a common disease of unknown origin, potential causes include reactions to food,drugs,infections and apart from an increased incidence of thyroid disease. Recent advances in our un-derstanding of the pathogenesis of chronic urticaria include the finding of autoantibedies to mast cell receptors in nearly half of pa-tients with chronic idiopathic urticaria. These patients may have more severe disease and require more aggressive therapies. Phar-macologic therapy consists primarily of the appropriate use of first-and second-generation histamine HI receptor antihistamines

  19. A challenge for pediatrician: non allergic urticaria

    Directory of Open Access Journals (Sweden)

    M. Mandelli

    2013-12-01

    Full Text Available In general population about 15-20% of subjects have suffered from one episode of urticaria-angioedema syndrome in their life. The etiology of his condition is various and multifactorial. In children the principal cause of acute urticaria is infection, while physical factors are the main agents of chronic urticaria. All those conditions which lack an etiology are named chronic idiopathic urticaria, but in reality a considerable number of these patients is affected by a chronic autoimmune urticaria. For this reason, screening out the most frequent causes of chronic urticaria, it’s useful to know when it’s possible to apply specific diagnostic tests for this condition and which therapies are employable.

  20. Omalizumab is efficacious for management of recalcitrant, antihistamine-resistant chronic urticaria.

    Science.gov (United States)

    Lang, D M

    2015-06-01

    Chronic urticaria continues to be a challenging condition for both patients and physicians. Despite improved understanding of chronic urticaria, many patients continue to experience ongoing symptoms and impaired quality of life. Omalizumab is a recombinant humanized monoclonal antibody that binds to the domain at which IgE binds to the high-affinity IgE receptor on mast cells and basophils. The efficacy of omalizumab for antihistamine-resistant chronic urticaria has been demonstrated in several randomized controlled trials as well as observational studies. Omalizumab is generally well tolerated, and is associated with less potential for harm compared with other therapeutic alternatives (e.g., calcineurin inhibitors) for recalcitrant chronic urticaria. Omalizumab has become the best-studied agent for treatment of antihistamine-resistant chronic urticaria, and the agent for which the data in support of its efficacy is most methodologically sound. Omalizumab is an effective therapeutic option for patients with recalcitrant chronic urticaria.

  1. Management of urticaria and angioedema in children: new trends.

    Science.gov (United States)

    Oranje, A P

    2010-12-01

    Urticaria in childhood is a common problem. History of development of urticaria should be carefully taken from a written history/information list. For urticaria, the EAACI/GALEN/EDF consensus guidelines on definition, classification, diagnosis and management of urticaria should be considered. Soon an updated version of a new consensus will appear. The new classification of urticaria includes 3 main groups: spontaneous or idiopathic urticaria (divided in acute urticaria ≥6 weeks), physical urticaria (cold contact urticaria, delayed pressure urticaria) and other urticaria disorders such as aquagenic urticaria. In general aspects, there is no difference between children and adults, except some details. In children most urticaria are acute idiopathic or physical of character. Also, urticarial flares in atopic dermatitis in young children are common as manifestation of food allergy First step of treatment is directed to the cause (that is difficult in chronic urticaria) and triggering factors. The currently recommended first line treatment is application of oral nonsedating H1 antihistamines. If needed, the dosage of antihistamines should be up to two-fold (in adults four-fold), although evidence is lacking for this, whereas alternative treatment should be reserved as add-on therapy for unresponsive patients.

  2. Effector Cells and Mechanisms in Chronic Spontaneous Urticaria

    OpenAIRE

    Borzova, Elena

    2014-01-01

    Background: Chronic spontaneous urticaria (CSU) is characterised by weals, angioedema, or both, which occur for six weeks or more. Itchy, red and raised weals in CSU are thought to occur as a result of skin mast cell activation, local vasodilatation and increased vascular permeability which are the cardinal features of the disease. Serum histamine-releasing activity and abnormal basophil function were implicated in the pathophysiology of CSU. We hypothesized that severe and/or persistent CSU ...

  3. Serum Clusterin as a Prognostic Marker of Chronic Spontaneous Urticaria.

    Science.gov (United States)

    Kim, Ji-Hye; Lee, Hyung-Young; Ban, Ga-Young; Shin, Yoo-Seob; Park, Hae-Sim; Ye, Young-Min

    2016-05-01

    A substantial proportion of patients with chronic spontaneous urticaria (CSU) are refractory to antihistamines. However, identifying the subpopulation whose urticaria is not completely controlled by antihistamines remains difficult. The response of autologous serum skin test (ASST), a clinical test for the detection of basophil histamine-releasing activity upon autoantibodies or autoreactive stimulation, has been suggested as a potential predictor in the control of urticaria. We sought to identify proteins that were differentially expressed in the sera of patients with positive and negative ASST results and to investigate their association with urticaria control.Proteomics analysis was performed using sera from 3 CSU patients with positive ASST results compared with those showing negative ASST results. Seven upregulated and 5 downregulated proteins were identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry in the ASST-positive group compared with the ASST-negative group.Proteins that were differentially expressed according to the ASST results in CSU patients were classified into 6 groups: apolipoproteins, glycoproteins, modified albumin, haptoglobulin, plectin, and others. Among these, apolipoprotein J or clusterin was validated using an enzyme-linked immunosorbent assay. Clusterin levels in 69 ASST-positive patients were significantly higher than those in 69 ASST-negative patients and in 86 healthy controls (231.2 ± 44.0 vs 210.2 ± 36.1 vs 118.7 ± 71.9 μg/mL, P urticaria would be refractory to antihistamines. Serum clusterin can be a prognostic marker to determine the responsiveness to antihistamine treatment in patients with CSU.

  4. Urticaria and angio-oedema.

    Science.gov (United States)

    Roberts-Thomson, P J; Chan, A; Kupa, A; Heddle, R J; Bradley, J

    1984-09-01

    Urticaria and angio-oedema are a symptom complex covering a wide range of clinical disorders. Specific types are now well described, and it appears that many cases of idiopathic chronic urticaria which make up the vast majority of patients referred for assessment are due to intolerance to natural salicylates, preservatives and colouring agents. There is, therefore, an urgent need for legislation to enforce the clear identification of these chemicals in processed food and drugs.

  5. BSACI guideline for the management of chronic urticaria and angioedema.

    Science.gov (United States)

    Powell, R J; Leech, S C; Till, S; Huber, P A J; Nasser, S M; Clark, A T

    2015-03-01

    This guidance for the management of patients with chronic urticaria and angioedema has been prepared by the Standards of Care Committee of the British Society for Allergy and Clinical Immunology (BSACI). The guideline is based on evidence as well as on expert opinion and is aimed at both adult physicians and paediatricians practising in allergy. The recommendations are evidence graded. During the development of these guidelines, all BSACI members were included in the consultation process using a Web-based system. Their comments and suggestions were carefully considered by the Standards of Care Committee. Where evidence was lacking, a consensus was reached by the experts on the committee. Included in this management guideline are clinical classification, aetiology, diagnosis, investigations, treatment guidance with special sections on children with urticaria and the use of antihistamines in women who are pregnant or breastfeeding. Finally, we have made recommendations for potential areas of future research.

  6. Chronic spontaneous urticaria and internal parasites--a systematic review.

    Science.gov (United States)

    Kolkhir, P; Balakirski, G; Merk, H F; Olisova, O; Maurer, M

    2016-03-01

    Chronic spontaneous urticaria (CSU) is defined as persistent wheals, angioedema, or both lasting for >6 weeks due to known or unknown causes. Some epidemiological studies and case reports suggest that internal parasite infections (PI) can cause CSU. Here, we provide a systematic overview of published findings on the prevalence and relevance of PI in CSU and we discuss possible pathomechanisms. The prevalence of PI in CSU was investigated by 39 independent studies and comorbidity reportedly ranged from 0 to 75.4% (two-thirds of these studies reported infection rates of 10% or less). The prevalence of PI in adult and pediatric CSU patients ranged from 0% to 75.4% and from 0% to 37.8%, respectively. CSU patients were more often diagnosed with protozoa and had a significantly higher risk of toxocariasis seropositivity and Anisakis simplex sensitization when compared to healthy controls. Patients with chronic urticaria more frequently had seropositivity of fasciolosis, Anisakis simplex sensitization, and the presence of Blastocystis hominis allele 34 (ST3) as compared with control subjects. In 21 studies, efficacy of treatment with antiparasitic drugs ranged from 0 to 100% (35.7% of 269 CSU patients benefitted). In 9 (42.8%) of 21 studies, more than 50% of efficacy was observed. The reported rate of urticaria comorbidity in PI patients in 18 independent studies is 1-66.7%. Urticaria including CSU might be a quite common symptom of strongyloidiasis and blastocystosis. Pathogenic mechanisms in CSU due to PI may include specific IgE, Th2 cytokine skewing, eosinophils, activation of the complement, and the coagulation systems.

  7. T cell activity in successful treatment of chronic urticaria with omalizumab

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    Gonzalez Ruperto

    2011-07-01

    Full Text Available Abstract Omalizumab, a humanized monoclonal anti-IgE antibody has the potential to alter allergen processing. Recently, it has been postulated the assessment of PHA-stimulated adenosine triphosphate (ATP activity as maker of CD4+ T cells activity in peripheral blood cells. We present the case report of a 35-year-old woman with a history of chronic idiopathic urticaria and angioedema of 8 years of development with poor response to treatment. The patient was partially controlled with cyclosporine at doses of 100 mg/12 h. However, she was still developing hives daily. Finally treatment with omalizumab was started at dose of 300 mg every 2 weeks. The patient experienced a decrease in urticarial lesions 2 days after starting therapy. We also evaluated the effects of omalizumab therapy on the activity of peripheral blood CD4+ T cells from the patient, in order to determine the potential modification of anti-IgE therapy on the process of antigen presentation-recognition. Activity of CD4+ cells by ATP release was clearly increased demonstrating an enlarged CD4 activity. Omalizumab may be useful in the treatment of severe chronic urticaria. ATP activity of peripheral blood CD4+ T cells might be a non-subjective method to assess Omalizumab activity.

  8. Impact of chronic urticaria on the quality of life of patients followed up at a university hospital *

    Science.gov (United States)

    Dias, Gabriela Andrade Coelho; Pires, Gisele Viana; do Valle, Solange Oliveira Rodrigues; Dortas Júnior, Sérgio Duarte; Levy, Soloni; França, Alfeu Tavares; Baiardini, Ilaria; Canonica, Walter Giorgio

    2016-01-01

    BACKGROUND Chronic urticaria is a debilitating disease that considerably affects health-related quality of life, and the Chronic Urticaria Quality of Life Questionnaire is the only questionnaire specifically designed for its evaluation. OBJECTIVE To evaluate the quality of life of patients with chronic urticaria, using the Brazilian Portuguese version of the Chronic Urticaria Quality of Life Questionnaire. METHODS The Chronic Urticaria Quality of Life Questionnaire was self-administered in 112 chronic urticaria patients and disease activity was assessed through the Urticaria Activity Score. Clinical and socio-demographic characteristics of patients were studied, such as: age, sex, etiologic diagnosis of chronic urticaria, duration of disease and Urticaria Activity Score. RESULTS The population studied was composed 85.72% of women with a mean age of 46 years (18-90), while the median disease duration period was 10 years (3 months-60 years). Regarding the etiologic diagnosis, 48.22% had chronic spontaneous urticaria; 22.32% associated with inducible urticaria, 28.57% with chronic autoimmune urticaria, and 23.21% had physical urticaria alone. Disease activity evaluated using the Urticaria Activity Score was 1.04 ± 1.61 (0-6). The total score for the Chronic Urticaria Quality of Life Questionnaire was 36 (0-100) and dimension I (sleep/mental status/eating) had a greater impact on quality of life. The items with the highest mean scores were nervousness and shame over lesions, while the items with the lowest scores were lip swelling and limitations on sporting activities. CONCLUSIONS Chronic urticaria compromises patients' quality of life, mainly those with more severe disease or who are diagnosed with chronic autoimmune urticaria. PMID:28099596

  9. Chronic Urticaria: A Cutaneous Manifestation of Celiac Disease

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    Jessica Haussmann

    2006-01-01

    Full Text Available Celiac disease, or gluten-sensitive enteropathy, is an immune-mediated disease of the small bowel that results in malabsorption. It classically presents with gastrointestinal symptoms including chronic diarrhea, weight loss, abdominal bloating and anorexia. It is becoming more frequently identified in asymptomatic patients with a diagnosis of deficiencies related to malabsorption of iron, folic acid, vitamin B12 and vitamin D. It is increasingly identified as a cause for early or refractory osteoporosis. Occasionally, celiac disease presents with cutaneous manifestations alone. Dermatitis herpetiformis is a well-recognized cutaneous manifestation of celiac disease. Other cutaneous manifestations include alopecia, angular stomatitis and aphthous ulcerations. Described here is a case of a 24-year-old woman who presented with intermittent urticaria and gastrointestinal complaints. She was found to have celiac disease on small-bowel biopsy. Both her gastrointestinal symptoms and urticaria resolved when she was put on a gluten-free diet, suggesting that her urticaria was a cutaneous manifestation of celiac disease.

  10. Pricking, Cupping and Qu Feng Tiao Ying Decoction for Treatment of Chronic Urticaria

    Institute of Scientific and Technical Information of China (English)

    刘代红

    2002-01-01

    @@ Chronic urticaria is a commonly encountered skin illness characterized by protracted course and recurrent episodes. The author had treated 26 cases of chronic urticaria by pricking, cupping and Qu Feng Tiao Ying (QFTY) decoction (祛风调营汤the Wind-dispelling and Ying system-regulating Decoction) with satisfactory results. A report is as follows.

  11. Adverse Reaction to Omalizumab in Patients with Chronic Urticaria: Flare Up or Ineffectiveness?

    Science.gov (United States)

    Ertaş, Ragıp; Özyurt, Kemal; Yıldız, Sinem; Ulaş, Yılmaz; Turasan, Abdullah; Avcı, Atıl

    2016-02-01

    Omalizumab is a recombinant humanized anti-Ig E monoclonal antibody used as the third line treatment of chronic spontaneous urticaria (CSU). We report four patients with severe antihistamine-resistant CSU, who developed angioedema, anaphylaxis and/or flare up of urticaria at different times following omalizumab therapy.

  12. The Effect of Acupuncture on Serum IgE Level in Patients with Chronic Urticaria

    Institute of Scientific and Technical Information of China (English)

    Che Jianli

    2006-01-01

    In order to explore the effect of acupuncture on serum IgE level in patients with chronic urticaria,the changes of the immune indices were observed at various stages in the development of the disease.It was found that the serum IgE level in patients with chronic urticaria was higher than that of the normal healthy subjects; and that acupuncture had a benign regulatory effect on IgE,showing a favorable regulation on the immune functions in patients with chronic urticaria.

  13. The persian version of the chronic urticaria quality of life questionnaire: factor analysis, validation, and initial clinical findings.

    Directory of Open Access Journals (Sweden)

    Marzieh Tavakol

    2014-08-01

    Full Text Available Chronic urticaria (CU also known as chronic idiopathic urticaria results in a lowered quality of life (QoL. Disease specific questionnaires are necessary to assess QoL in CU patients. Chronic Urticaria Quality of Life Questionnaire (CU-Q2oL is the only available and validated disease specific questionnaire in the assessment of QoL in CU patients originally developed in Italian language. The aim of the current study was to develop the Persian version of the CU-Q2oL with an acceptable reliability and validity.Using the standard methods provided by guidelines, CU-Q2oL was translated into Persian. A total number of 110 patients with confirmed diagnosis of CU were asked to fill the questionnaire. Determination of scales was performed in addition to checking the data for internal consistency and known group validity. Urticaria activity score 7 (UAS7 was used to assess the severity of the CU in the population study. The 6 dimensional scale of Persian CU-Q2oL was determined using the Exploratory Factor Analysis. About 68% of the variance was explained by these 6 factor structure higher than 59.9% of the original Italian version.All 6 factors showed acceptable internal consistency as measured by Cronbach α coefficient. There was a significant correlation between UAS7 and total CU-Q2oL score. UAS7 and the presence of angioedema were predictors of CU-Q2oL score.The Persian version of CU-Q2oL was shown to be a valid and reliable tool to be used in the future clinical studies. Cultural considerations must be kept in mind in adoption of CU-Q2oL to other languages.

  14. How effective is autologous serum therapy in chronic autoimmune urticaria

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    Imran Majid

    2015-01-01

    Full Text Available Background: Chronic autoimmune urticaria (CAU is one of the most challenging therapeutic problems faced by a dermatologist. Recently, weekly autologous serum injections have been shown to induce a prolonged remission in this disease. Aim: To evaluate the efficacy of repeated autologous serum injections in patients with CAU. Materials and Methods: Seventy patients of CAU were prospectively analyzed for the efficacy of nine consecutive weekly autologous serum injections with a post-intervention follow-up of 12 weeks. Total urticaria severity score (TSS was monitored at the baseline, at the end of treatment and lastly at the end of 12 weeks of follow up. Response to treatment was judged by the percentage reduction in baseline TSS at the end of treatment and again at the end of 12 weeks-follow-up. Results: Out of the 70 patients enrolled, 11 dropped out of the injection treatment after one or the first few doses only. Among the rest of 59 patients, only 7 patients (12% went into a partial or complete remission and remained so over the follow-up period of 12 weeks. Forty patients (68% did not demonstrate any significant reduction in TSS at the end of the treatment period. Rest of the 12 patients showed either a good or excellent response while on weekly injection treatment, but all of them relapsed over the follow-up period of 12 weeks. Conclusion: Autologous serum therapy does not seem to lead to any prolonged remission in patients of CAU.

  15. Follicular traction urticaria*

    Science.gov (United States)

    Duman, Hatice; Topal, Ilteris Oguz; Kocaturk, Emek

    2016-01-01

    Inducible urticaria is a heterogeneous subgroup of chronic urticarias caused by a wide variety of environmental stimuli, such as exercise, cold, heat, pressure, sunlight, vibration, and water. A new term, follicular traction urticaria, was suggested as an unusual form of inducible urticarias. We report a patient who was diagnosed with follicular traction urticaria.

  16. Inflammation and coagulation in urticaria and angioedema.

    Science.gov (United States)

    Cugno, Massimo; Asero, Riccardo; Tedeschi, Alberto; Lazzari, Riccardo; Marzano, Angelo V

    2012-09-01

    Urticaria is a skin disease characterised by short-lived surface swellings of the dermis (wheals) frequently accompanied by itching. It is classified as acute or chronic depending on whether the wheal recurrence occurs for less or more than six weeks. Acute urticaria is often due to a hypersensitivity reaction, whereas about 50% of the cases of chronic urticaria are regarded as autoimmune. Urticaria may occur alone or in association with a deeper swelling (angioedema) involving the subcutaneous and/or submucosal tissues, and last from hours to a few days. Angioedema can also develop alone, and may be idiopathic or be caused by allergies, inherited or acquired deficiencies of C1-inhibitor protein, or adverse drug reactions. An interplay between inflammation and coagulation has been proposed as a pathomechanism in urticaria and urticaria-associated angioedema (in which histamine and thrombin are involved), as well as in angioedema due to C1-inhibitor deficiency, which involves various biological systems. An increase in the plasma markers of thrombin generation, fibrinolysis and inflammation has been documented during exacerbations of urticaria and angioedema, with the marker levels decreasing to normal during remission. However, the hypercoagulable state in chronic urticaria and angioedema has not been reported to be associated with any increased risk of thrombosis, although there have been a number of reports of cardiovascular events occurring during episodes of acute urticaria. These observations have provided the rationale for the clinical evaluation of anticoagulant and antifibrinolytic drugs, the efficacy of which has sometimes been demonstrated.

  17. Comparative study of positive versus negative autologous serum skin test in chronic spontaneous urticaria and its treatment outcome

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    Yadalla Hari Kishan Kumar

    2016-01-01

    Full Text Available Background: Chronic urticaria (CU is defined as urticaria persisting daily or almost daily for more than 6 weeks and affecting 0.1% of the population. Mast cell degranulation and histamine release are of central importance in the pathogenesis of CU. About 40-50% of the patients with chronic idiopathic urticaria (CIU or chronic spontaneous urticaria (CSU demonstrates an immediate wheal and flare response to intradermal injected autologous serum. This led to the concept of autoimmune urticaria (AIU. Aims: To determine the occurrence, clinical features, associated clinical conditions, comorbidities of AIU, and to compare this with CSU. This study aimed to find the frequency of autologous serum skin test (ASST-positive patients among patients with CSU and to identify the clinical and laboratory parameters associated with positive ASST and to compare the treatment outcome. Materials and Methods: A prospective correlation study in 110 patients with CSU was conducted, after screening 200 CU patients attending the outpatient Department of Dermatology during from January 2012 to May 2013. Patients were subjected to ASST, complete blood counts, urine routine examination, liver function tests, renal function tests, thyroid function tests (T3, T4, and TSH, and urine analysis. Results: Out of 200 CU patients screened, 90 patients had excludable causes based on detailed history and skin prick test, and the remaining 110 patients were considered to have CSU. These 110 patients were further subjected to ASST, serum immunoglobulin E (IgE, and peripheral blood eosinophilia. ASST was positive in 48 patients and negative in 62 patients. Frequency of urticarial attacks and associated diseases such as abnormal thyroid function tests in both ASST-positive and ASST-negative patients did not show any statistical significance. Only attacks of angioedema in ASST-positive individuals were higher and were statistically significant. In the ASST-positive group, 31 (81

  18. Platelet and other hemostatic characteristics in patients with chronic urticaria.

    Science.gov (United States)

    Isiksacan, Nilgun; Koser, Murat; Cemsitoglu, Ferhan; Kucuksezer, Umut C; Gurdol, Figen

    2015-04-01

    Several publications have pointed out the importance of coagulation and fibrinolysis in the occurrence of chronic urticaria (CU), but only a few indicated the direct role of platelets. We assessed platelet aggregation and evaluated parameters of coagulation and fibrinolysis in patients with CU. Patients (n = 34) diagnosed as having CU and 36 healthy controls were enrolled. Platelet aggregation was assayed using an impedance aggregometer and adenosine diphosphate, arachidonic acid, thrombin receptor-activating peptide (TRAP), and ristocetin as agonists. In patients with CU, significantly decreased platelet aggregation to some agonists (ristocetin and TRAP) was observed. The D-dimer levels were elevated, mean platelet volume was decreased, but no alteration was observed in other coagulation assays. Elevated D-dimer levels indicated that coagulation and fibrinolysis are activated in the patients with CU. Evaluation of platelet function may contribute to identify the role of these cells in the pathogenesis of CU.

  19. A Review of International Recommendations for the Diagnosis and Management of Chronic Urticaria.

    Science.gov (United States)

    Beck, Lisa A; Bernstein, Jonathan A; Maurer, Marcus

    2017-02-08

    Both spontaneous and inducible forms of chronic urticaria pose a significant economic burden and have an adverse effect on patients' quality of life. The international guidelines and US practice parameters for the diagnosis and management of chronic urticaria both recommend performing a thorough patient history and physical examination, conducting limited routine laboratory testing, and taking a stepwise approach to treatment. These documents differ in several areas, such as the order of diagnostic procedures and the treatment for patients non-responsive to standard dose H1-antihistamines. Patients with chronic urticaria who visit a specialist have typically been treated with second-generation H1-antihistamines - the recommended first-line treatments. The advantages and disadvantages of each treatment option should be taken into consideration when selecting therapies beyond H1-antihistamines. Greater awareness of the international guidelines and US practice parameters will likely improve the quality of care for patients with chronic urticaria.

  20. Profile of omalizumab in the treatment of chronic spontaneous urticaria

    Directory of Open Access Journals (Sweden)

    Labrador-Horrillo M

    2015-08-01

    Full Text Available Moises Labrador-Horrillo,1 Marta Ferrer2 1Allergy Section, Internal Medicine Department, Vall d’Hebron Hospital, Universitat Autònoma de Barcelona, Barcelona, 2Department of Allergy and Clinical Immunology, Clínica Universidad de Navarra, IDISNA, Instituto de Investigación de Navarra, Pamplona, Spain Abstract: Chronic spontaneous urticaria (CSU is a disease with significant morbidity and relative prevalence that has important effects on the quality of life (QoL of those who suffer from it. Omalizumab is a recombinant humanized anti-immunoglobulin E (IgE antibody that binds to the Cε3 domain of the IgE heavy chain and prevents it from binding to its high-affinity receptor FcεRI. It has been largely studied in the field of asthma and is currently approved for the treatment of both adult and pediatric (children; >6-year-old patients. In addition, in recent, well-controlled clinical trials in patients with CSU resistant to antihistamines, add-on therapy with subcutaneous omalizumab significantly reduced the severity of itching, and the number and size of hives, and increased patients’ health-related QoL and the proportion of days free from angioedema compared with placebo, with an excellent tolerance. Thus, omalizumab is an effective and well-tolerated add-on therapy for patients with CSU who are symptomatic despite background therapy with H1 antihistamines. In this review, we cover the following points: epidemiology, pathogenesis, assessment of activity, impact on QoL, and treatment of CSU, and finally, we focus on omalizumab in the treatment of CSU including the pharmacokinetic properties and mechanism of action, and use in pregnant women, nursing infants, and children. Keywords: omalizumab, chronic spontaneous urticaria, antihistamines, subcutaneous administration, add-on therapy

  1. Urticaria and angioedema

    Directory of Open Access Journals (Sweden)

    Kanani Amin

    2011-11-01

    Full Text Available Abstract Urticaria (hives is a common disorder that often presents with angioedema (swelling that occurs beneath the skin. It is generally classified as acute, chronic or physical. Second-generation, non-sedating H1-receptor antihistamines represent the mainstay of therapy for both acute and chronic urticaria. Angioedema can occur in the absence of urticaria, with angiotensin-converting enzyme (ACE inhibitor-induced angioedema and idiopathic angioedema being the more common causes. Rarer causes are hereditary angioedema (HAE or acquired angioedema (AAE. Although the angioedema associated with these disorders is often self-limited, laryngeal involvement can lead to fatal asphyxiation in some cases. The management of HAE and AAE involves both prophylactic strategies to prevent attacks of angioedema (i.e., trigger avoidance, attenuated androgens, tranexamic acid, and plasma-derived C1 inhibitor replacement therapy as well as pharmacological interventions for the treatment of acute attacks (i.e., C1 inhibitor replacement therapy, ecallantide and icatibant. In this article, the authors review the causes, diagnosis and management of urticaria (with or without angioedema as well as the work-up and management of isolated angioedema, which vary considerably from that of angioedema that occurs in the presence of urticaria.

  2. [The elevated level of anti-thyroid antibodies aTPO in chronic spontaneous urticaria].

    Science.gov (United States)

    Chaykivska, Zlata; Antoszczyk, Grazyna; Czarnobilska, Ewa

    2015-01-01

    Diagnosis and treatment of chronic urticaria (CU - Chronic Urticaria) is one of the most difficult issues in allergy practice. Studies on the etiopathogenesis of chronic urticaria suggest that environmental factors, immune, genetic and hormonal are involved in triggering and maintaining the reaction of hives. In practice, despite detailed diagnosis is usually not possible to determine the real cause of the disease. For this reason, the use of causal treatment for patients suffering from chronic urticaria is not possible and supportive treatment is often ineffective. 0.1% of the population suffers from chronic spontaneous urticaria, which main cause has not been detected. Very often CU coexists with autoimmune thyroid dysfunction. Studies confirm higher incidence of thyroid antibodies in patients with chronic urticaria than in the general population. We analyzed 100 patients who met the criteria for chronic urticaria according to the WHO, in Allergology Clinic of the University Hospital Jagiellonian University Medical College. According to our study 17.4% of patients with chronic spontaneous urticaria occurred elevated titer of anti-TPO antibodies. In patients with non-spontaneous type of CU, elevated titer of anti-TPO antibodies only occurred in 8.3% of patients, and this difference was statistically significant p = < 0.003. All the patients had thyroid levels normal and there were no clinical symptoms of thyroid dysfunction. Our research indicates a link with autoimmune thyroid diseases, especially Hashimoto's disease, with a prevalence of CU. It is necessary to conduct further studies to confirm the relationship of pathogenic autoimmune thyroid disorders with the occurrence of CU, which will help to provide the causal treatment of spontaneous CU coexisting with high levels of anti-TPO antibodies in patients with euthyroid status.

  3. Successful and Safe Treatment of Chronic Spontaneous Urticaria with Omalizumab in a Woman during Two Consecutive Pregnancies

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    Misbah Nasheela Ghazanfar

    2015-01-01

    Full Text Available Chronic spontaneous urticaria is an itching skin disease characterised by wheals, angioedema, or both present for more than six weeks. Omalizumab is a humanized anti-IgE monoclonal antibody recently approved for treatment of chronic urticaria. Several randomised controlled trials have investigated the safety, tolerability, and efficacy of omalizumab for chronic urticaria. The safety of omalizumab in pregnancy is not known. We describe a female patient with chronic spontaneous urticaria who was treated with omalizumab continuously through two consecutive pregnancies with convincing results and no apparent toxicity.

  4. Successful and Safe Treatment of Chronic Spontaneous Urticaria with Omalizumab in a Woman during Two Consecutive Pregnancies

    DEFF Research Database (Denmark)

    Ghazanfar, Misbah Nasheela; Thomsen, Simon Francis

    2015-01-01

    Chronic spontaneous urticaria is an itching skin disease characterised by wheals, angioedema, or both present for more than six weeks. Omalizumab is a humanized anti-IgE monoclonal antibody recently approved for treatment of chronic urticaria. Several randomised controlled trials have investigated...... the safety, tolerability, and efficacy of omalizumab for chronic urticaria. The safety of omalizumab in pregnancy is not known. We describe a female patient with chronic spontaneous urticaria who was treated with omalizumab continuously through two consecutive pregnancies with convincing results...

  5. Chronic urticaria in patients with autoimmune thyroiditis: Significance of severity of thyroid gland inflammation

    Directory of Open Access Journals (Sweden)

    Mustafa Gulec

    2011-01-01

    Full Text Available Background: There is a clear association between autoimmune thyroiditis (AT and chronic urticaria/angioedema (CUA. However, not all patients with AT demonstrate urticaria. Aims: The aim of the study was to investigate in which patients with AT did CUA become a problem. A sensitive inflammation marker, neopterine (NP was used to confirm whether the severity of inflammation in the thyroid gland was responsible for urticaria or not. Methods: Neopterine levels were assessed in patients with AT with urticaria and without urticaria. Furthermore, levels were compared in relation to pre and post levothyroxine treatment. Twenty-seven patients with urticaria (Group 1 and 28 patients without urticaria (Group 2 were enrolled in the study. A course of levothyroxine treatment was given to all patients, and urine neopterine levels before and after the trial were obtained. Results: All patients completed the trial. Mean age in Group 1 and Group 2 was similar (35.70 ± 10.86 years and 38.36 ± 10.38 years, respectively (P=0.358. Pre-treatment urine neopterine levels were significantly higher in Group 1 (P=0.012. Post-treatment levels decreased in each group, as expected. However, the decrease in the neopterine level was insignificant in the patients of Group 2 (P=0.282. In Group 1, a significant decrease in post-treatment neopterine levels (P=0.015 was associated with the remission of urticaria. Conclusion: In patients with CUA and AT, pre-treatment elevated levels of NP, and its decrease with levothyroxine treatment along with symptomatic relief in urticaria, may be evidence of the relationship between the degree of inflammation in thyroid and presence of urticaria.

  6. Food Allergy in Korean Patients with Chronic Urticaria

    Science.gov (United States)

    Chung, Bo Young; Cho, Yong Se; Kim, Hye One

    2016-01-01

    Background The etiology of chronic urticaria (CU) remains unknown in most patients. Possible causes in some cases include food, but the role of allergy to food antigens in patients with CU remains controversial. Objective The aim of this study was to evaluate the association between food allergy and CU. Methods Korean patients with CU were assessed for a previous history of food allergy that caused symptoms of CU. Blood samples were taken from 350 patients to measure food allergen-specific IgE. Based on history and laboratory results, open oral food challenge (OFC) tests were performed. Results Of 350 participants, 46 (13.1%) claimed to have experienced previous food hypersensitivity. Pork (n=16) was the main food mentioned, followed by beef (n=7), shrimp (n=6), and mackerel (n=6). We found that 73 participants (20.9%) had elevated levels of food-specific IgE, with pork (n=30), wheat (n=25), and beef (n=23) being the most common. However, when the open OFC tests were conducted in 102 participants with self-reported food hypersensitivity or raised levels of food-specific IgE, only four participants showed a positive reaction to pork (n=3) or crab (n=1). Conclusion Although some participants claimed to have a history of CU related to food intake, when an open OFC test was conducted, few of them had positive results. We therefore conclude that food allergy is an uncommon cause of chronic CU. PMID:27746634

  7. Late Onset Anaphylaxis in a Hydatid Cyst Case Presenting with Chronic Urticaria

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    Insu Yilmaz

    2013-01-01

    Full Text Available Hydatid cyst is still endemic in various regions of the world. It is the most frequent cause of liver cysts worldwide. Urticaria is sometimes the first manifestation of the disease. However anaphylactic reaction and urticaria have been very rarely reported in the literature. Traditionally, surgery has been the only accepted mode of treatment; however, percutaneous treatment has recently been proposed as an alternative. Cases of anaphylaxis have been reported after percutaneous drainage of hydatid cyst. However, anaphylaxis usually develops within a few hours. Herein, we describe the case of a patient who presented with hydatid cyst causing chronic urticaria and late anaphylactic reaction following percutaneous aspiration of a liver hydatid cyst. We emphasize that physicians should be aware of hydatid cyst as a possible etiology for seemingly chronic spontaneous urticaria, especially in endemic regions. Patients should be kept under observation for at least one day due to the risk of early and late anaphylaxis after percutaneous aspiration treatment.

  8. Up-dosing of non-sedating antihistamines in chronic urticaria: Need for well-designed clinical trials in India

    OpenAIRE

    Anant D. Patil

    2014-01-01

    Urticaria is a heterogeneous group of diseases. Chronic urticaria significantly impacts quality-of-life of patients. Second generation, non-sedating antihistamines are recommended as first line treatment for chronic spontaneous urticaria. In patients with inadequate control of symptoms, increase in dosage of non-sedating antihistamines up to four fold has been recommended. This recommendation is based on low cost, good safety and good evidence of efficacy of non-sedating, second generation an...

  9. Basophil activation test with food additives in chronic urticaria patients.

    Science.gov (United States)

    Kang, Min-Gyu; Song, Woo-Jung; Park, Han-Ki; Lim, Kyung-Hwan; Kim, Su-Jung; Lee, Suh-Young; Kim, Sae-Hoon; Cho, Sang-Heon; Min, Kyung-Up; Chang, Yoon-Seok

    2014-01-01

    The role of food additives in chronic urticaria (CU) is still under investigation. In this study, we aimed to explore the association between food additives and CU by using the basophil activation test (BAT). The BAT using 15 common food additives was performed for 15 patients with CU who had a history of recurrent urticarial aggravation following intake of various foods without a definite food-specific IgE. Of the 15 patients studied, two (13.3%) showed positive BAT results for one of the tested food additives. One patient responded to monosodium glutamate, showing 18.7% of CD203c-positive basophils. Another patient showed a positive BAT result to sodium benzoate. Both patients had clinical correlations with the agents, which were partly determined by elimination diets. The present study suggested that at least a small proportion of patients with CU had symptoms associated with food additives. The results may suggest the potential utility of the BAT to identity the role of food additives in CU.

  10. Profile of omalizumab in the treatment of chronic spontaneous urticaria.

    Science.gov (United States)

    Labrador-Horrillo, Moises; Ferrer, Marta

    2015-01-01

    Chronic spontaneous urticaria (CSU) is a disease with significant morbidity and relative prevalence that has important effects on the quality of life (QoL) of those who suffer from it. Omalizumab is a recombinant humanized anti-immunoglobulin E (IgE) antibody that binds to the Cε3 domain of the IgE heavy chain and prevents it from binding to its high-affinity receptor FcεRI. It has been largely studied in the field of asthma and is currently approved for the treatment of both adult and pediatric (children; >6-year-old) patients. In addition, in recent, well-controlled clinical trials in patients with CSU resistant to antihistamines, add-on therapy with subcutaneous omalizumab significantly reduced the severity of itching, and the number and size of hives, and increased patients' health-related QoL and the proportion of days free from angioedema compared with placebo, with an excellent tolerance. Thus, omalizumab is an effective and well-tolerated add-on therapy for patients with CSU who are symptomatic despite background therapy with H1 antihistamines. In this review, we cover the following points: epidemiology, pathogenesis, assessment of activity, impact on QoL, and treatment of CSU, and finally, we focus on omalizumab in the treatment of CSU including the pharmacokinetic properties and mechanism of action, and use in pregnant women, nursing infants, and children.

  11. Oxidative Stress in Children with Chronic Spontaneous Urticaria

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    Fatih Dilek

    2016-01-01

    Full Text Available The pathogenesis of chronic spontaneous urticaria (CSU has not been fully understood; nevertheless, significant progress has been achieved in recent years. The aim of this study was to investigate the possible role of reactive oxygen species (ROS in the pathogenesis of CSU. Sixty-two children with CSU and 41 healthy control subjects were enrolled in the study. An extensive evaluation of demographic and clinical features was done, and serum oxidative stress was evaluated by plasma total oxidant status (TOS and total antioxidant status (TAS measurements. The median value of plasma TOS was found to be 10.49 μmol H2O2 equiv./L (interquartile range, 7.29–17.65 in CSU patients and 7.68 μmol H2O2 equiv./L (5.95–10.39 in the control group. The difference between the groups was statistically significant (p=0.003. Likewise, the median plasma TAS level in the CSU group was decreased significantly compared to that of the control group (2.64 [2.30–2.74] versus 2.76 [2.65–2.86] mmol Trolox equiv./L, resp., p = 0,001. Our results indicated that plasma oxidative stress is increased in children with CSU when compared to healthy subjects, and plasma oxidative stress markers are positively correlated with disease activity.

  12. Role of Leukotriene receptor antagonist Montelukast in the treatment of chronic urticaria: A hospital based study

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    Iffat Hassan

    2012-01-01

    Full Text Available Introduction: Chronic urticaria is a disabling disease which may be refractory to standard therapies. Leukotriene receptor antagonists like montelukast have been tried in allergic diseases like asthma and find mention as a therapeutic option in chronic urticaria. Purposes: A randomized single-blinded non-placebo controlled study to evaluate the role of montelukast, in addition to the adjunctive role of non-sedating antihistamine levocetirizine (H1, was conducted in patients with chronic urticaria.Methods: Thirty-five patients with chronic urticaria were enrolled. Medication was given for a period of twelve weeks. Montelukast 10mg/day in an adult and 5mg in the age group 6-13 years,4 mg 2-6 years and levocetirizine 5 mg once a day was added, if patient had new weals while on therapy. The improvement was monitored by estimating the episodes of wheals and pruritus in any two weeks period.Results: Twenty-two patients showed a good response with occasional wheals at the end of 2 weeks and no weals at the end of 12 weeks. These included all 8 patients on non-steroidal anti-inflammatory drugs (NSAIDS. Four of these patients relapsed on discontinuation of therapy.Conclusion: Montelukast is effective in chronic refractory urticaria especially in patients on non-steroidal anti-inflammatory drugs with occasional add-on use of a non-sedating anti-histamine.

  13. Role of stressful life events in induction or exacerbation of psoriasis and chronic urticaria

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    Malhotra S

    2008-01-01

    Full Text Available Background: The possibility of a causal influence of emotional stress, especially of stressful life events, on the course of various skin diseases has long been postulated. Previous reports addressing its influence on skin psoriasis and chronic urticaria have been mainly anecdotal. Objective: The aim of this study was to evaluate the stressful events of life within 1 year preceding onset or exacerbation of skin disease in patients of psoriasis vulgaris and chronic urticaria. Method: Fifty consecutive clinically diagnosed psoriasis patients and 50 consecutive clinically diagnosed chronic urticaria patients were examined clinically and administered Gurmeet Singh′s presumptive stressful life events scale. Results: Stressful life events were seen in 26% of the patients in the psoriasis vulgaris group and 16% of the patients in the chronic urticaria group within 1 year preceding onset or exacerbation of skin disease. In the psoriasis vulgaris group, the most common stressful life event seen was financial loss or problems (8%, followed by death of close family member (4%, sexual problems (4%, family conflict (2%, major personal illness or injury (2%,and transfer or change in working conditions (2%, failure in examinations (2%, family member unemployed (2%, illness of family member (2%, getting married or engaged (2%, miscellaneous (2%. In the chronic urticaria group, the most common stressful life event seen was death of a close family member (6%, followed by family conflict (2%, financial loss or problems (2%, sexual problems (2%, illness of family member (2%, getting married or engaged (2%, trouble at work with colleagues, superiors, or subordinates (2%, going on a pleasure trip (2% and extramarital relations (2%. Conclusion: Psychological stress plays a significant role in triggering or exacerbating dermatological diseases. Our study indicates the role of relaxation therapies and stress management programs in chronic diseases such as psoriasis

  14. B淋巴细胞刺激因子对慢性特发性荨麻疹患者产生抗FcεRI抗体和抗IgE抗体的影响%The Affect of the Serum B Lymphocytes Stimulating Factor(BlyS)on the Anti-IgE Antibody and Anti-FcεRI Antibody of the Patients with Chronic Idiopathic Urticaria

    Institute of Scientific and Technical Information of China (English)

    李正学

    2015-01-01

    目的:探讨慢性特发性荨麻疹患者血清B淋巴细胞刺激因子(BlyS)对抗IgE抗体和抗FcεRI抗体的影响。方法:选取慢性特发性荨麻疹患者100例作为疾病组,选取同期体检健康者100例作为健康组。检测两组受试者血清BlyS、抗IgE抗体及抗FcεRI抗体水平;分离培养疾病组患者外周血中的B淋巴细胞,分为两份保存,在其中一份培养液中加入有效水平的BlyS,检测抗IgE抗体及抗FcεRI抗体水平,作为试验组,将另一份作为空白对照组。分析血清BlyS与抗IgE抗体及抗FcεRI抗体之间的关系。结果:疾病组血清BlyS、抗IgE抗体及抗FcεRI抗体水平明显高于健康组,差异具有统计学意义(P<0.05)。试验组培养液中抗IgE抗体及抗FcεRI抗体水平明显高于对照组,差异具有统计学意义(P<0.05);试验组中抗IgE抗体及抗FcεRI抗体水平与BlyS呈正相关(r=0.765、0.722,P<0.05)。结论:慢性特发性荨麻疹患者血清BlyS可刺激B淋巴细胞产生抗IgE抗体和抗FcεRI抗体,这可能与慢性特发性荨麻疹的发病机制有关。%Objective:To investigate the affect of the serum B lymphocytes stimulating factor(BlyS)on the anti-IgE antibody and anti-FcεRI antibody of the patients with chronic idiopathic urticaria. Method:100 cases of patients with chronic idiopathic urticaria were selected as disease group,100 cases of healthy people in the same period were selected as the healthy group. The serum level of the BlyS,anti-IgE antibody and anti-FcεRI antibodies were detected;the B lymphocytes from the peripheral blood of the disease group patients were isolated and cultured,and divided into two shares,add BlyS in one share as the experimental group,another share as blank control group,the level of the anti-IgE antibody and anti-FcεRI antibodies were detected. The relationship among the BlyS,anti-IgE antibody and anti-FcεRI antibodies were analyzed. Result

  15. Efficacy of Fexofenadine in the Indian Population suffering from Alergic Rhinitis & Chronic Urticaria

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    Bikash Medhi

    2006-04-01

    Full Text Available The present study was designed to evaluate the efficacy of fexofenadine in the Indian population sufferingfrom allergic rhinitis and chronic urticaria. A total number of two hundred patients of either sex withsimilar demographic profile were included in the study according to inclusion and exclusion criteria.These patients were treated with fexofenadine 120mg once daily for allergic rhinitis and fexofenadine180mg for chronic urticaria for 7 days. The efficacy was evaluated on the basis of symptoms evaluationscale score and medication effectiveness scale score at baseline, on the 3rd day and on the 7th day ofcompletion of treatment. Results indicate that fexofenadine is highly effective in the Indian population(p<0.001 suffering from allergic rhinitis and chronic urticaria.

  16. Omalizumab for Chronic Urticaria: A Case Series and Overview of the Literature

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    Ilya Ivyanskiy

    2012-01-01

    Full Text Available Omalizumab is a recombinant humanized monoclonal antibody that blocks the high-affinity Fc receptor of IgE. Omalizumab has been approved for the treatment of moderate to severe asthma; however, there is currently more and more data showing promising results in the management also of chronic urticaria. We present a case series of 19 patients with chronic urticaria treated in a university department with omalizumab and give an overview of the existing literature comprising an additional 59 cases as well as a total of 139 patients enrolled in two randomized controlled trials comparing omalizumab with placebo. The collective evidence points to omalizumab as a safe and effective treatment option for patients with chronic urticaria who do not sufficiently respond to standard therapy as recommended by existing guidelines.

  17. A disease marker for aspirin-induced chronic urticaria.

    Science.gov (United States)

    Hsieh, Chia-Wei; Lee, Jeen-Wei; Liao, En-Chih; Tsai, Jaw-Ji

    2014-07-15

    There are currently no diagnostic methods in vitro for aspirin-induced chronic urticaria (AICU) except for the provocation test in vivo. To identify disease markers for AICU, we investigated the single nucleotide polymorphism (SNP) of the promoter loci of high-affinity IgE receptor (FcεRIα) and CD203c expression level in Chinese patients with AICU. We studied two genotypic and allelic frequencies of rs2427827 (-344C/T) and rs2251746 (-66T/C) gene polymorphisms of FcεRIα in 20 patients with AICU, 52 subjects with airway hypersensitivity without aspirin intolerance, and 50 controls in a Chinese population. The results showed that the frequencies of two SNPs (-344C>T, -66C>T) were similar to the normal controls. The allele frequency of -344CC was significantly higher in the patients with AICU compared to those with airway sensitivity (p=0.019). We also studied both histamine release and CD203c expression on KU812 cells to assess aspirin-induced basophil activation. We found that the activity of basophil activation of AICU was significantly higher in the patients with AICU compared to those with airway hypersensitivity without aspirin intolerance. The mean fluorescence intensity of the CD203c expression were 122.5±5.2 vs. 103.3±3.3 respectively, (phistamine release were 31.3%±7.4% vs. -24.0%±17.5%, (phistamine release were significantly up-regulated by aspirin, they were not affected by anti-IgE antibodies. These results suggest that a single SNP of FcεRIα (-344C>T) is less likely to develop AICU and the basophil activation activity in the sera by measuring CD203c expression can be applicable to confirm the diagnosis of AICU.

  18. EFFECTIVENESS OF AUTOLOGOUS SERUM THERAPY IN CHRONIC URTICARIA: A PROSPECTIVE OBSERVATIONAL STUDY IN TERTIARY CARE HOSPITAL

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    Rakesh Kumar

    2016-02-01

    Full Text Available BACKGROUND Chronic urticaria is a challenging condition, both for patient and physician in a day-to-day practice. There is constant search for newer modality of treatment, which can provide prolong remission with less side effect. Autologous serum therapy have shown promising result in initial studies. AIM To evaluate effectiveness of Autologous Serum Therapy in chronic urticaria patients. MATERIALS AND METHODS A prospective observational study. Total 220 patients enrolled for study. Autologous serum skin test performed in all patients; 113 patients were given Autologous Serum Therapy along with oral levocetirizine on SOS basis weekly and 107 patients were given only oral levocetirizine on demand basis. Response to treatment assessed by urticaria activity score, urticaria total severity score, antihistamine score, dermatological quality of life index and Likert scale on 2 weekly interval for 10 weeks. RESULTS Autologous Serum Therapy shown significant improvement in both Autologous Serum Skin Test positive and Autologous Serum Skin Test negative patients as compared to non-Autologous Serum Therapy groups. Autologous Serum Therapy is more effective in Autologous Serum Skin Test positive patients. CONCLUSION Autologous Serum Therapy is effective in chronic urticaria patients.

  19. [Epidemiologic features in patients with antihistamine-resistant chronic urticaria].

    Science.gov (United States)

    Sánchez Borges, Mario; Tassinari, Stefano; Flores, Adriana

    2015-01-01

    Antecedentes: en la actualidad, la información disponible acerca de las características particulares de los pacientes que padecen urticaria crónica espontánea resistente a tratamiento es muy limitada. Objetivo: investigar las características demográficas y clínicas de los pacientes con urticaria crónica espontánea resistente a tratamiento. Material y método: estudio descriptivo, retrospectivo, de la información clínica y demográfica de pacientes que consultaron en los servicios de Alergología de dos hospitales de Caracas, Venezuela, que padecían urticaria espontánea de más de seis semanas de evolución y que no habían respondido a por lo menos un curso de tratamiento con antihistamínicos. Resultados: la urticaria crónica espontánea resistente a tratamiento fue más frecuente en pacientes de sexo femenino, de edades entre 20 y 59 años, de raza caucásica americana, con predominio de síntomas moderados, duración de las lesiones individuales de menos de tres horas y diámetro de los habones entre 1 y 3 cm. El angioedema solo o asociado con urticaria afectó a 14% de los pacientes. Las enfermedades asociadas con mayor frecuencia fueron: asma, rinitis y rinosinusitis, enfermedades tiroideas e hipertensión arterial. Conclusión: la urticaria crónica espontánea resistente a tratamiento constituye un subgrupo muy frecuente de urticaria crónica y representa un importante desafío terapéutico. En este estudio no se demostraron características diferenciales en comparación con las de los pacientes con urticaria crónica espontánea que responden al tratamiento con antihistamínicos.

  20. Pathology and classification of urticaria.

    Science.gov (United States)

    Greaves, Malcolm W

    2014-02-01

    Chronic urticaria is defined as daily or almost daily urticaria for more than 6 weeks. Chronic urticaria is normally subdivided into physical urticaria (wheals evoked by a physical stimulus such as pressure friction or cold contact) and spontaneous urticaria. A patient with a history of less than 6 weeks is traditionally designated as having acute urticaria. Patients with chronic spontaneous urticaria have an increased frequency of HLA-DR and HLA-DQ alleles characteristically associated with autoimmune disease. Some of these patients have functional anti-FceR1 and/or anti-IgE autoantibodies which are considered to be the cause of the urticaria.

  1. Chronic Idiopathic Intestinal Pseudo-obstruction.

    Science.gov (United States)

    Malagelada

    2000-08-01

    The definition of chronic idiopathic intestinal pseudo-obstruction (CIIP) is somewhat vague because it was based on clinical observations that preceded modern advances in the measurement of gut motility and neuromuscular integrity. Appropriate management of patients with CIIP requires an initial consideration, supported by pertinent diagnostic tests, of the tissue affected (muscle, nerves, both), extent and magnitude of gut propulsive failure, and extraintestinal disease.

  2. 胸腺五肽联合地氯雷他定治疗慢性特发性荨麻疹的临床观察%Clinical Observation of Thymopentin-5 Combined with Desloratadine in Treatment of Chronic Idiopathic Urticaria

    Institute of Scientific and Technical Information of China (English)

    晏勇; 余霞萍; 陈希林; 刘长山; 林应花

    2013-01-01

    目的:探讨胸腺五肽联合地氯雷他定治疗慢性特发性荨麻疹的临床疗效。方法:治疗慢性特发性荨麻疹患者180例,按照随机数字表法将其分为治疗组和对照组各90例。治疗组:口服地氯雷他定分散片5 mg,1次/d,同时胸腺五肽针1 mg加入0.9%氯化钠注射液250 mL,静脉滴注,1次/d;对照组:口服地氯雷他定片5 mg,1次/d。两组均连续用药4周后,随访观察12周,评定疗效并记录皮损变化和不良反应。结果:治疗组痊愈率为95.6%,总有效率为97.8%,对照组痊愈率为90%,总有效率为95.6%。两组短期症状控制效果都非常有效,差异无统计学意义(P>0.05)。两组痊愈患者复发情况观察结果显示,治疗组停药超过12周未复发(优等)病例52例(60.5%),对照组11例(13.6%);治疗组停药后4周以内复发(差等)病例9例(10.4%),对照组38例(46.9%),两组比较差异均有统计学意义(P0.05). The two group of patients relapse were observed. The results showed,the treatment group was more than 12 weeks in withdrawal recurrence(top)of 52 cases(60.5%),11 cases in the control group(13.6%),the treatment group 4 weeks after withdrawal recurrence within 9(low)cases(10.4%),38 cases in the control group(46.9%),and the difference of two indicates above between the two groups were no statistically significant(P<0.01).Conclusion:Thymopentin-5 combined with desloratadine in treatment of chronic idiopathic urticaria obvious curative effect,can effectively control the nettle rash and itching,little side effect,low recurrence rate,long-term effect is obviously higher than that of single desloratadine therapy.

  3. 嗜碱粒细胞组胺释放试验检测抗高亲和力IgE抗体及其受体%Significance of basophil histamine release assays in chronic urticaria

    Institute of Scientific and Technical Information of China (English)

    刘荣卿; 孙仁山

    2001-01-01

    Objective To Investigate the pathogenesis of chronic idiopathic urticaria.Methods Basophil histamine release assay was utilized.Result 15 of 32 cases(46.9%)had increased serum histamine releasing activities. This implied that anti-FcεR1 and anti-IgE autoantibodies existed in the sera of some patients with chronic idiopathic urticaria.Conclusion It suggested that autoimmunity might take part in the occurrence of some patients with chronic idiopathic urticaria.%目的 探讨慢性荨麻疹的发生机制。方法 用嗜碱粒细胞组胺释放试验,检测慢性特发性荨麻疹患者的血清组胺释放活性。结果 32例中,有15例(46.9%)患者血清组胺释放活性增高,提示抗FcεR1或抗IgE自身抗体的存在。结论 部分慢性荨麻疹的发生与自身免疫机制有关。

  4. A Disease Marker for Aspirin-Induced Chronic Urticaria

    Directory of Open Access Journals (Sweden)

    Chia-Wei Hsieh

    2014-07-01

    Full Text Available There are currently no diagnostic methods in vitro for aspirin-induced chronic urticaria (AICU except for the provocation test in vivo. To identify disease markers for AICU, we investigated the single nucleotide polymorphism (SNP of the promoter loci of high-affinity IgE receptor (FcεRIα and CD203c expression level in Chinese patients with AICU. We studied two genotypic and allelic frequencies of rs2427827 (–344C/T and rs2251746 (–66T/C gene polymorphisms of FcεRIα in 20 patients with AICU, 52 subjects with airway hypersensitivity without aspirin intolerance, and 50 controls in a Chinese population. The results showed that the frequencies of two SNPs (–344C>T, –66C>T were similar to the normal controls. The allele frequency of –344CC was significantly higher in the patients with AICU compared to those with airway sensitivity (p = 0.019. We also studied both histamine release and CD203c expression on KU812 cells to assess aspirin-induced basophil activation. We found that the activity of basophil activation of AICU was significantly higher in the patients with AICU compared to those with airway hypersensitivity without aspirin intolerance. The mean fluorescence intensity of the CD203c expression were 122.5 ± 5.2 vs. 103.3 ± 3.3 respectively, (p < 0.05, and the percentages of histamine release were 31.3% ± 7.4% vs. −24.0% ± 17.5%, (p < 0.05 respectively. Although the mean fluorescence intensity of CD203c expression and the percentage of histamine release were significantly up-regulated by aspirin, they were not affected by anti-IgE antibodies. These results suggest that a single SNP of FcεRIα (–344C>T is less likely to develop AICU and the basophil activation activity in the sera by measuring CD203c expression can be applicable to confirm the diagnosis of AICU.

  5. Association between Helicobacter pylori Infection and Chronic Urticaria: A Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Huiyuan Gu

    2015-01-01

    Full Text Available Background. Some studies have shown the possible involvement of Helicobacter pylori (H. pylori infection in chronic urticaria, but the relationship remains controversial. The aim of this meta-analysis was to quantitatively assess the association between H. pylori infection and chronic urticaria. Methods. Observational studies comparing the prevalence of H. pylori infection in patients with chronic urticaria and control subjects were identified through a systematic search in MEDLINE and EMBASE up to July 2014. H. pylori infection was confirmed by serological or nonserological tests. For subgroup analyses, studies were separated by region, publication year, and H. pylori detection method to screen the potential factors resulting in heterogeneity. Results. 16 studies involving 965 CU cases and 1235 controls were included. Overall, the prevalence of H. pylori infection was higher in urticarial patients than in controls (OR = 1.66; 95% CI: 1.12–2.45; P=0.01. This result persisted in subanalysis of nine high-quality studies (OR = 1.36; 95% CI: 1.03–1.80; P=0.03. Subgroup analysis showed that detection method of H. pylori is also a potential influential factor for the overall results. Conclusions. Our present meta-analysis suggests that H. pylori infection is significantly, though weakly, associated with an increased risk of chronic urticaria.

  6. Unmet clinical needs in chronic spontaneous urticaria. A GA(2) LEN task force report(1)

    DEFF Research Database (Denmark)

    Maurer, M; Weller, K; Bindslev-Jensen, Carsten

    2011-01-01

    autologous serum skin test (autoreactivity). Chronic spontaneous urticaria has major detrimental effects on quality of life, with sleep deprivation and psychiatric comorbidity being frequent. It also has a large impact on society in terms of direct and indirect health care costs as well as reduced...

  7. The Effectiveness and Safety of Acupuncture for Patients with Chronic Urticaria: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Qin Yao

    2016-01-01

    Full Text Available Background. Acupuncture might have effectiveness in relieving the symptoms of chronic urticaria. There are currently no systematic reviews of acupuncture for chronic urticaria published in English. Objective. We conducted a systematic review to assess the effectiveness and safety of acupuncture for chronic urticaria. Methods. A systematic review and meta-analysis of randomized, controlled trials were performed. The primary outcome was global symptom improvement. Results. We included 6 studies with 406 participants. Three trials showed significant difference between acupuncture and drugs in global symptom improvement (relative risk 1.37; 95% CI 1.11–1.70; P=0.003. As an adjuvant to medication, acupuncture was also beneficial for global symptom improvement (relative risk 1.77; 95% CI 1.41–2.22; P<0.01. There were no severe adverse events related to acupuncture. Limitations. Some methodological limitations were observed. The overall risk of bias in the 6 included trials was high and all included RCTs were conducted in China and published in Chinese. Besides, the lack of proper control groups and the use of different rating methods and cut-offs in the included trials also made the evidence of this review limited. Conclusions. Acupuncture might be effective and safe for chronic urticaria in relieving symptoms, based on a low level of evidence. To draw a reliable conclusion, more high quality trials are needed in the future. This trial is registered with PROSPERO CRD42015015702.

  8. [Angioedema and urticaria].

    Science.gov (United States)

    Boccon-Gibod, I; Bouillet, L

    2014-11-01

    Angiœdema (AE) is the clinical expression of urticaria (U) which occurs when urticaria is located within the subcutis. It is a syndrome characterized by a sudden and limited subcutaneous and/or submucous swelling. The updated classification of urticaria distinguishes acute and chronic urticaria. Chronic urticaria is spontaneous (CSU) or inducible (CIU). Angioedema in chronic urticaria is rarely allergic, but most of the time caused by a non-specific histamine release from activated mast-cell (non IgE mediated reaction). Angioedemas are recurrent, concomitant or not with wheals. They appear skin-coloured, sometimes slightly rosy, non-inflammatory, and more painful than itchy. They are transient, ephemeral, migrant, last most of the time a few hours (urticaria" and wheals "superficial urticaria". When AE or wheals last more than 6 weeks (with or without free intermission), it is called chronic urticaria. Angioedema can be elicited or worsened by physical factors (cold urticaria, exercise, heat, solar, vibratory, aquagenic, delayed pressure urticaria…) and /or drugs (as aspirin, nonsteroid anti-inflammatory drugs, morphine, antibiotics…). The treatment of histaminergic angioedemas of chronic urticaria is based on modern second generation antihistamines (anti H1). In allergic acute urticaria only, additional treatment for anaphylaxis can be used if needed (grade 2 to 4). In chronic urticaria, steroids should be avoided : they can make symptoms worse and long-lasting because of corticosteroid dependence.

  9. Correlation between the histopathology of chronic urticaria and its clinical picture*

    Science.gov (United States)

    Marques, Raquel Zappa Silva; Criado, Roberta Fachini Jardim; Machado Filho, Carlos D'Apparecida Santos; Tamanini, Juliana Milhomem; Mello, Cristina van Blarcum de Graaff; Speyer, Carolina

    2016-01-01

    BACKGROUND Chronic urticaria is characterized by transient, pruritic lesions of varying sizes, with central pallor and well-defined edges, with disease duration longer than six weeks. Its cellular infiltrate consists of neutrophils, lymphocytes and eosinophils. There is a subgroup of patients with eosinophilic or neutrophilic urticaria, resistant to the treatment with antihistamines, but that respond to a combination of antihistamine with other drugs. OBJECTIVE To evaluate the present infiltration in chronic urticaria biopsies and correlate it with the clinical disease activity and response to treatment. METHODS Forty-one patients with chronic urticaria were classified according to the score of severity of the disease, response to treatment and type of perivascular infiltrate. Inflammatory infiltrates were divided in eosinophilic (46.30%), neutrophilic and mixed. RESULTS An association was found between the eosinophilic infiltrate and clinical scores of greater severity (p = 0.002). CONCLUSION This association shows that the eosinophilic inflammatory infiltrates denote high clinical activity, which means more severe and exuberant clinical pictures of the disease. PMID:28099597

  10. [Systemic urticaria in 2014].

    Science.gov (United States)

    Doutre, M-S

    2014-11-01

    Systemic urticaria are defined as urticaria, most often chronic, associated with systemic diseases. At present time, urticarial vasculitis and neutrophilic urticarial dermatosis associated to autoinflammatory syndromes are not considered to be subtypes of chronic spontaneous urticaria due to their distinctly clinical and histological characteristics as well different pathomechanisms. Sometimes, chronic urticaria is associated to thyroid autoimmunity. However, the majority of cases of chronic spontaneous urticaria have no discernible cause and further investigations are not necessary, as already suggested by some authors and French consensus conference more than 10 years ago.

  11. Urticaria and infections

    Directory of Open Access Journals (Sweden)

    Wedi Bettina

    2009-12-01

    Full Text Available Abstract Urticaria is a group of diseases that share a distinct skin reaction pattern. Triggering of urticaria by infections has been discussed for many years but the exact role and pathogenesis of mast cell activation by infectious processes is unclear. In spontaneous acute urticaria there is no doubt for a causal relationship to infections and all chronic urticaria must have started as acute. Whereas in physical or distinct urticaria subtypes the evidence for infections is sparse, remission of annoying spontaneous chronic urticaria has been reported after successful treatment of persistent infections. Current summarizing available studies that evaluated the course of the chronic urticaria after proven Helicobacter eradication demonstrate a statistically significant benefit compared to untreated patients or Helicobacter-negative controls without urticaria (p

  12. Association of genome DNA methylation with pathogenesis of chronic urticaria%基因组甲基化与慢性荨麻疹发病机制间的关系的初探索

    Institute of Scientific and Technical Information of China (English)

    宋彪; 房思宁; 郑利雄; 梅忠喜; 黄小芳

    2013-01-01

    Objective To explore the association of genome methylation with the pathogenesis of chronic urticaria by detecting genome methylation level of chronic idiopathic urticaria and autoimmune urticaria.Methods 45 patients with chronic urticaria were divided into chronic idiopathic urticaria group and autoimmune urticaria group using ASST method.Serum TgAb,TPOAb,ANA,SAM,and SAH were detected.Results The positive rate of ASST was 46.7% in patients with chronic urticaria,as compared with 0% in control group.There was a statistical significance between the two groups.The positive rates of TgAb,TPOAb,and ANA were 23.80%,14.29%,and 14.29% in autoimmune urticaria group,4.16%,4.16%,and 0 in chronic idiopathic urticaria group,and 5%,0%,and 0% in the control group.TgAb differed significantly between autoimmune urticaria group and the other two groups,but not between chronic idiopathic urticaria group and the control group.TPOAb and ANA did not differ statistically between the two groups.SAM,SAH,and SAM/SAH did not differ significantly.Conclusions Autoimmune urticaria accounts for 46.7% in patients with chronic urticaria.TGAb is significantly higher in autoimmune urticaria patients than in those with chronic idiopathic urticaria.Further research should be done to confirm whether TGAb can be a kind of valuable clinical detection index of autoimmune urticaria.There is no statistical significance in SAM,SAH,and SAM/SAH between the two groups,which is likely to suggest that methylation is not involved in the pathogenesis of autoimmune urticaria.But this conclusion needs to be confirmed by bigger samples.%目的 通过检测慢性特发性荨麻疹和自身免疫性荨麻疹的基因组甲基化水平,初步探讨基因组甲基化与其发病机制间的关系.方法 采用ASST方法将45例慢性荨麻疹患者分为慢性特发性荨麻疹组和自身免疫性荨麻疹组.分离血清,分别检测血清中TgAb、TPOAb、ANA、SAM和SAH水平,并对

  13. Analysis of Circulating Vascular Endothelial Growth Factor and Its Soluble Receptors in Patients with Different Forms of Chronic Urticaria

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    Julia Jagodzinska

    2015-01-01

    Full Text Available Background. Vascular endothelial growth factor (VEGF is a powerful enhancer of vascular permeability and inflammatory response; however its significance in chronic urticaria is poorly recognised. Aim. To compare free circulating levels of VEGF and its soluble receptors (sVEGFR1 and VEGFR2 in patients with different forms of chronic urticaria. Methods. The concentrations of VEGF and its receptors in plateletpoor plasma (PPP/plasma were measured using enzyme-linked immunosorbent assay in chronic urticaria: (1 chronic spontaneous urticaria (CSU with positive autologous serum skin test (ASST, (2 CSU with negative response to ASST, (3 CSU with concomitant euthyroid Hashimoto’s thyroiditis (CSU/Hashimoto, (4 delayed pressure urticaria (DPU, and the healthy subjects. Results. There were no significant differences in VEGF concentration in PPP between CSU groups and the healthy subjects. Contrary, VEGF concentration was significantly higher in DPU and CSU/Hashimoto patients as compared with the healthy subjects and CSU groups. Furthermore, VEGF value in CSU/Hashimoto patients during the remission was similar to that of the active period and significantly higher than the healthy subjects; VEGF concentration was significantly correlated with TSH. Plasma concentrations of sVEGF1 and sVEGF2 were similar in chronic urticaria patients and the healthy subjects. Conclusions. Increased free circulating VEGF concentration may result from the urticarial process itself as well as concomitant Hashimoto’s thyroiditis.

  14. Vitamin D in atopic dermatitis, chronic urticaria and allergic contact dermatitis.

    Science.gov (United States)

    Quirk, Shannon K; Rainwater, Ellecia; Shure, Anna K; Agrawal, Devendra K

    2016-08-01

    Vitamin D influences allergen-induced pathways in the innate and adaptive immune system, and its potential immunomodulatory role in allergic skin disorders has been explored. This comprehensive review article provides an overview of the role of vitamin D in three common dermatologic conditions: atopic dermatitis (AD), chronic urticaria, and allergic contact dermatitis (ACD). Whereas the literature regarding vitamin D and AD has resulted in mixed findings, several studies have described an inverse relationship between vitamin D levels and AD severity, and improvement in AD with vitamin D supplementation. Similarly, several studies report an inverse relationship between vitamin D levels and severity of chronic urticaria. Although current research in humans remains limited, an increased likelihood of ACD has been demonstrated in vitamin D-deficient mice. Additional well-designed clinical trials will be necessary to determine whether vitamin D supplementation should be recommended for prevention or adjuvant treatment of these common dermatologic conditions.

  15. Chronic urticaria in adults: state-of-the-art in the new millennium.

    Science.gov (United States)

    Criado, Paulo Ricardo; Criado, Roberta Facchini Jardim; Maruta, Celina Wakisaka; Reis, Vitor Manoel Silva dos

    2015-01-01

    Chronic urticaria has been explored in several investigative aspects in the new millennium, either as to its pathogenesis, its stand as an autoimmune or auto-reactive disease, the correlation with HLA-linked genetic factors, especially with class II or its interrelation with the coagulation and fibrinolysis systems. New second-generation antihistamines, which act as good symptomatic drugs, emerged and were commercialized over the last decade. Old and new drugs that may interfere with the pathophysiology of the disease, such as cyclosporine and omalizumab have been developed and used as treatments. The purpose of this article is to describe the current state of knowledge on aspects of chronic urticaria such as, pathophysiology, diagnosis and the current therapeutic approach proposed in the literature.

  16. Pathogenic intracellular and autoimmune mechanisms in urticaria and angioedema.

    Science.gov (United States)

    Altman, Katherine; Chang, Christopher

    2013-08-01

    Urticaria and angioedema are common disorders. Chronic urticaria is defined as lasting longer than 6 weeks. Causes of chronic urticaria fall into the following categories: physical, allergic, hereditary, autoimmune, and idiopathic. Basophils and mast cells are the primary effector cells responsible for clinical symptoms and signs. These cells produce and secrete a variety of mediators including histamine, leukotrienes, prostaglandins, cytokines, chemokines, and other pro-inflammatory mediators. This leads to vasodilation, fluid exudation, increased vascular permeability, and accumulation of additional secondary inflammatory cells. Two mechanisms have been investigated as possibly contributing to the pathogenesis of chronic urticaria. One is the development of autoantibodies to FcεRI or IgE on mast cells and basophils. This appears to be responsible for 30-50 % of cases. The other is dysregulation of intracellular signaling pathways involving Syk, SHIP-1, or SHIP-2 in basophils and mast cells. The primary treatment for chronic urticaria is to treat the underlying pathology, if any can be identified. Otherwise, in idiopathic cases, H1 antihistamines, H2 antihistamines, antileukotrienes, and corticosteroids constitute the main pharmacologic treatment modalities. In severe and recalcitrant cases of chronic and autoimmune urticaria, immunosuppressive drugs have been used, most commonly cyclosporin. More recent experimental studies have also suggested that omalizumab, an anti-IgE therapy, may be of benefit. Currently, inhibitors of Syk are also being developed and tested in the laboratory and in animal models. As our understanding of the pathogenesis of idiopathic urticaria increases, development of additional drugs targeting these pathways may provide relief for the significant physical and psychological morbidity experienced by patients with this disorder.

  17. B淋巴细胞刺激因子对慢性特发性荨麻疹患者产生抗FcεRI抗体和抗IgE抗体的影响%Influence of B lymphocyte stimulator on the production of anti-FcεRI and anti-IgE antibodies by B lymphocytes from patients with chronic idiopathic urticaria

    Institute of Scientific and Technical Information of China (English)

    康尔恂; 李杰; 孙丽伟; 韩春玉; 闫丽萍; 杨建

    2013-01-01

    目的 探讨B淋巴细胞刺激因子(BlyS)能否刺激慢性特发性荨麻疹(CIU)患者B淋巴细胞产生抗FcεRI抗体或抗IgE抗体.方法 设CIU患者组和健康对照组.ELISA法测定血清中BlyS、抗FcεRI抗体和抗IgE抗体水平,分离培养受试者外周血B淋巴细胞,在培养液中加入BlyS,检测培养液中抗FcεRI抗体和抗IgE抗体水平,分析BlyS与抗FcεRI抗体和抗IgE抗体产生的相关性.结果 CIU患者血清BlyS水平显著高于健康对照组(t=3.04,P< 0.01),抗FcεRI抗体和抗IgE抗体水平均显著高于健康对照组(t=3.51,P<0.01;t=3.29,P< 0.01).CIU患者血清中抗FcεRI抗体和抗IgE抗体水平与BlyS水平呈正相关(r=0.93,P<0.01;r=0.91,P< 0.01);CIU患者外周血B淋巴细胞培养液中加入有效浓度BlyS后,B淋巴细胞培养液中抗FcεRI抗体和抗IgE抗体水平均显著高于不加BlyS的空白对照(t=3.67,P< 0.01;t=3.56,P< 0.01),2种抗体在培养液中的水平与BlyS浓度呈正相关(r=0.96,P< 0.01;r=0.91,P< 0.01);抗FcεRI抗体和抗IgE抗体在CIU患者血清与培养液中的检出符合率分别为94.76%和87.84%.结论 CIU患者血液中BlyS水平增高可刺激B淋巴细胞产生抗FcεRI抗体或抗IgE抗体,可能与CIU发病有关.%Objective To explore if B lymphocyte stimulator (BlyS) stimulates B lymphocytes from patients with chronic idiopathic urticaria (CIU) to produce anti-high affinity IgE receptor (FcεRI) or anti-IgE antibodies.Methods Totally,300 CIU patients and 300 health controls were enrolled in this study.Blood samples were obtained from these subjects.Peripheral blood B lymphocytes were isolated and cultured in vitro for 72 hours.Then,BlyS of various concentrations (2,4,8,16 ng/ml) was added to the culture medium of B lymphocytes followed by another 72-hour culture.Enzyme-linked immunosorbent assay was performed to determine the serum levels of BlyS,anti-FcεRI and anti-IgE antibodies,as well as the supernatant levels of anti

  18. Autologous Serum Skin Test versus Autologous Plasma Skin Test in Patients with Chronic Spontaneous Urticaria

    Directory of Open Access Journals (Sweden)

    Aysegul Alpay

    2013-01-01

    Full Text Available Previous studies indicate that 25–45% of chronic urticaria patients have an autoimmune etiology. Autologous serum skin test (ASST and autologous plasma skin test (APST are simple tests for diagnosing chronic autoimmune urticaria (CAU. However, there are still some questions about the specificity of these tests. This study consisted of 50 patients with chronic spontaneous urticaria (CSU and 50 sex- and age-matched healthy individuals aged 18 years, and older. A total of 31 (62% patients and 5 (10% control patients had positive ASST; 21 (42% patients and 3 (6% control patients had positive APST. Statistically significant differences were noted in ASST and APST positivity between the patient and control groups (ASST P<0.001; APST P<0.001. Thirteen (26% patients and 5 (10% control patients had antithyroglobulin antibodies or antithyroid peroxidase antibody positivity. No statistically significant differences were noted in thyroid autoantibodies between the patient and control groups (anti-TG P=0.317; anti-TPO P=0.269. We consider that the ASST and APST can both be used as in vivo tests for the assessment of autoimmunity in the etiology of CSU and that thyroid autoantibodies should be checked even when thyroid function tests reveal normal results in patients with CSU.

  19. Current challenges and controversies in the management of chronic spontaneous urticaria.

    Science.gov (United States)

    Asero, Riccardo; Pinter, Elena; Marra, Alessandro Maria; Tedeschi, Alberto; Cugno, Massimo; Marzano, Angelo Valerio

    2015-01-01

    Chronic spontaneous urticaria (CSU) is characterized by the recurrence of itchy wheals for at least 6 weeks, affects up to 1% of the general population and may severely impair quality of life. H1-antihistamines are the cornerstones of treatment, but in about 10% of cases they fail to control the disease even at higher than licensed doses. In these patients, short courses of oral steroids may induce a remission in about 50% of cases. Omalizumab, a monoclonal anti-IgE, is effective in antihistamine-unresponsive patients although optimal treatment duration needs to be defined. Immunosuppressive treatment with cyclosporine is also effective in the majority of antihistamine-resistant chronic spontaneous urticaria (CSU) patients, but its use is limited by potential side effects. In refractory patients, other approaches include intravenous immunoglobulin, rituximab, dapsone and anticoagulants. The present review looks with particular interest at the prevalence of treatment failures with the main third-level treatments (corticosteroids, omalizumab and cyclosporine) and discusses them in light of the possible different pathogenic mechanisms underlying chronic spontaneous urticaria.

  20. Effects of loratadine and cetirizine on serum levels of neuropeptides in patients with chronic urticaria.

    Science.gov (United States)

    Başak, Pinar Y; Vural, Huseyin; Kazanoglu, Oya O; Erturan, Ijlal; Buyukbayram, Halil I

    2014-12-01

    H1-receptor inhibiting drugs, namely loratadine and cetirizine, were frequently used in treatment of chronic urticaria. Urticarial weal and flare reactions, a neurogenic reflex due to neuropeptides, were reported to be more effectively inhibited by cetirizine than loratadine. The aim of this study was to determine and compare the effects of systemic loratadine and cetirizine treatments on serum levels of selected neuropeptides in chronic urticaria. Treatment groups of either systemic loratadine or cetirizine (10 mg/d), consisting of 16 and 22 patients, respectively, were included. Serum levels of stem cell factor (SCF), neuropeptide Y (NPY), calcitonin gene-related peptide (CGRP), nerve growth factor (NGF), vasoactive intestinal peptide (VIP), and substance P (SP) were detected before and after one week of treatment with antihistamines. Serum NPY and VIP levels were significantly decreased when compared before and after treatment with antihistamines (P neuropeptides. Systemic loratadine and cetirizine treatments in patients with chronic urticaria precisely caused variations in serum levels of neuropeptides. The predominant effect of cetirizine compared to loratadine on reducing serum SCF levels might be explained with anti-inflammatory properties of cetirizine.

  1. Autologous serum therapy in chronic urticaria: A promising complement to antihistamines

    Directory of Open Access Journals (Sweden)

    Panchami Debbarman

    2014-01-01

    Full Text Available Background: Chronic urticaria (CU is a vexing problem and patients of CU suffer from the morbidity that arise from irritable itch and weals and are also subjected to a huge antihistamine pill burden. The symptoms are more in autoreactive urticaria (AU where auto-antibodies in blood flares-up the condition. Search for newer effective modalities which can reduce pill burden is a felt need. Aims: This study evaluates the effectiveness of autologous serum therapy (AST in CU and also determines its usefulness in AU. Materials and Methods: Double blind, parallel group, randomized, controlled study. Fifty four patients were given AST and 57 patients were given injection normal saline (placebo, along with cetirizine in an on-demand basis in both groups. AST/Placebo was given weekly for nine weeks and followed-up for a total period of 24 weeks. AU was diagnosed by autologous serum skin test. Urticaria total severity score (TSS, Urticaria activity score (UAS, Dermatologic life quality index (DLQI was used as primary effectiveness variables. Safety parameters assessed were the spontaneously reported adverse events and laboratory parameters. Results: TSS showed significant improvement from baseline, 7 th week and 8 th week onwards in AST group and placebo group respectively. Group comparison showed significant improvement 4 th week onwards. UAS showed similar results. DLQI showed significant improvement in AST group compared to placebo at the end of study. Both AU and non-AU patients showed comparable improvement of TSS. Conclusion: AST shows promise in treatment of urticaria regardless of the autoreactive nature.

  2. Subtypes of chronic urticaria in patients attending allergy clinics in Venezuela.

    Science.gov (United States)

    Sánchez-Borges, M; Caballero-Fonseca, F; Capriles-Hulett, A

    2014-11-01

    Chronic urticaria (CU) is one of the most puzzling clinical entities confronted by the medical profession. It is a common motive for consultation, and in a sizable proportion of patients no identifiable cause is evident. Since there are relatively few publications regarding CU in developing countries, we performed a prospective 3-year study on the demographic and clinical features of patients with CU. Four hundred and twenty-three subjects were studied, 52 children and 371 adults, 295 females (69.7%), with a mean age of 38.4 ± 17.8 years. More often, wheals and angioedema (AE) were present on the head, upper and lower limbs and the trunk. AE was present in 162 patients (38.4%). The most frequent subtypes were chronic spontaneous urticaria, aspirin-exacerbated cutaneous disease, dermographic urticaria, and combinations of various subtypes. A better understanding of the characteristics of patients suffering CU is helpful for clinicians dealing with this ailment, and provides guidance for new investigations on its pathogenesis, which will hopefully result in a better management of this vexing condition.

  3. Efficacy of the eradication of Helicobacter pylori infection in patients with chronic urticaria. A placebo-controlled double blind study.

    Science.gov (United States)

    Gaig, P; García-Ortega, P; Enrique, E; Papo, M; Quer, J C; Richard, C

    2002-01-01

    Helicobacter pylori has been involved in the pathogenesis of chronic idiopathic urticaria (CIU) in patients suffering both CIU and H. pylori infection. We selected 49 patients with 13C urea breath test positive, long-lasting CIU and H. pylori infection; 20 remained symptomatic, had positive urease test or H. pylori histologic identification in gastric biopsy material and accepted to participate in a pacebo-controlled treatment trial. They were randomized for a 7-day, double-blind, placebo-controlled H. pylori eradication treatment with amoxicillin, clarithromycin and omeprazol or placebo. H. pylori eradication was assessed by a second 13C urea breath test six weeks after the end of treatment. We observed a significant improvement of more than 70 % of CIU; baseline clinical score was seen in 4 of the 9 (44 %) patients who eradicated H. pylori after active treatment and in 1 of the 7 (12,3 %) of those who did not (p = 0.19). No clinical differences in CIU characteristics were found between patients with and without improvement. No serious adverse effects were observed in either treatment group. We conclude that the eradication of H. pylori may be useful for patients suffering long-lasting CIU and H. pylori infection, although theses results did not reach statistical significance probably owing to the strict conditions of the recruitment.

  4. The Clinical Correlations of Helicobacter pylori Virulence Factors and Chronic Spontaneous Urticaria

    Directory of Open Access Journals (Sweden)

    Yi-Chun Chiu

    2013-01-01

    Full Text Available Background and Study Aims. The association between Helicobacter pylori (H. pylori and chronic spontaneous urticaria (CSU remains controversial. This study explored the role of H. pylori in CSU among different virulent genotypes patients. Patients and Methods. Patients infected by H. pylori were sorted into two groups as group A (with CSU and group B (without CSU. The tissue materials were taken via endoscopy for polymerase chain reaction study to determine virulence factors. After H. pylori eradication therapy, the eradication rate and response of urticaria were evaluated by using C13-UBT and a three-point scale (complete remission, partial remission, or no improvement. Results. The results were comparable between patients of groups A and B in terms of H. pylori infection rates and eradication rate. Longitudinal follow-up of 23.5 months showed complete remission of urticaria in 63.6% but no improvement in 36.4% of the patients after H. pylori eradication. H. pylori infected patients with different virulence factors such as cytotoxin-associated gene A, vacuolating cytotoxin gene A signal region and middle region have similar remission rates for CSU. Conclusions. Current study suggests that H. pylori may play a role in the development and disease course of CSU but may be irrelevant to different virulent genotypes.

  5. Phototesting In The Idiopathic Photodermatoses Among Indians

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    Bejoy P

    1998-01-01

    Full Text Available 50 patients with idiopathic photodermatoses were phototested using the solar simulator, with broad spectrum wavebands of the whole spectrum (WS and the whole spectrum â€" ultraviolet B (WS- UVB to determine the minimal erythema dose. Cases diagnosed as solar urticaria were further tested with visible light. Among the photodermatoses seen in this part of the country polymorphic light eruption (PLE was the commonest followed by chronic actinic dermatitis (CAD and solar urticaria. The UVB wavelengths appeared to be more responsible than UVA in PLE and CAD while the UVA and visible wavelengths were responsible for solar urticaria.

  6. Hives (Urticaria)

    Science.gov (United States)

    ... Loss Surgery? A Week of Healthy Breakfasts Shyness Hives (Urticaria) KidsHealth > For Teens > Hives (Urticaria) A A A ... prescribed an antihistamine to treat it. What Is Urticaria? The medical name for hives is urticaria . It's ...

  7. Accompanying conditions in patients with chronic spontaneous urticaria and urticarial vasculitis: Results of a retrospective study

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    Sevgi Akarsu

    2015-03-01

    Full Text Available Background and Design: Chronic spontaneous urticaria (CSU, the most common form of chronic urticaria, is characterized by spontaneous wheals and/or angioedema lasting longer than six weeks. Urticarial vasculitis (UV is a small vessel vasculitis; but is also included in the various classification systems of chronic urticaria by some authors. The aim of our study was to evaluate the frequency of accompanying conditions, and to compare the demographic, clinical and laboratory features of patients with CSU and UV. Materials and Methods: In this study, the files of CSU (n=146 and UV (n=43 patients who had been hospitalized between January 2010-December 2013 were retrospectively reviewed in terms of demographic data, disease-specific history, accompanying diseases, medications and laboratory findings. Results: When comparing between the two groups for statistical differences, it was found that the frequencies of personal atopy and angioedema were significantly higher in patients with CSU; however, the patients with UV had significantly higher rates for female gender and the presence of systemic symptoms compared to those with CSU. It was determined that the mean values for erythrocyte sedimentation rate and C-reactive protein, as well as the rates of antinuclear antibody positivity and hypocomplementemia were significantly higher in the UV group, compared with those in the CSU group. Accompanying factors were determined as infections, medications, autoimmune diseases and malignities in order of frequency in both CSU and UV groups, but only the frequency of autoimmune diseases was significantly higher in patients with UV group. Conclusion: Although various authors have reported that a large number (up to 40-60% of patients with UV may present only with wheals (clinically indistinguishable from CSU; we assumed that it would be more appropriate to be considered UV as a priority in patients especially who had systemic symptom, autoimmune disease

  8. Autologous serum therapy in chronic urticaria: Old wine in a new bottle

    Directory of Open Access Journals (Sweden)

    Bajaj A

    2008-01-01

    Full Text Available Background: Chronic urticaria (CU is one of the most challenging and frustrating therapeutic problems faced by a dermatologist. A recent demonstration of abnormal type 1 reactions to intradermal autologous serum injections in some CU patients has led to the characterization of a new subgroup of "autoimmune chronic urticaria". This has rekindled interest in the age-old practice of autologous blood injections as a theoretically sound treatment option in these patients. Aims: To evaluate the efficacy of repeated autologous serum injections (ASIs in patients with recalcitrant chronic urticaria. Methods: A cohort of 62 (32 females CU patients with a positive autologous serum skin test (ASST (group 1 was prospectively analyzed for the efficacy of nine consecutive weekly autologous serum injections with a postintervention follow-up of 12 weeks. Another group of 13 (seven females CU patients with negative ASST (group 2 was also treated similarly. In both groups, six separate parameters of disease severity and activity were recorded. Results: Demographic and disease variables were comparable in both groups. The mean duration of disease was 1.9 ± 0.3 years (range = 3 months to 32 years in group 1 and 1.5 ± 0.2 years (range = 3 months to 10 years in group 2. In the ASST (+ group, 35.5% patients were completely asymptomatic at the end of the follow-up while an additional 24.2% were markedly improved. In the ASST (− group, these figures were 23 and 23% respectively. The intergroup difference for complete subsidence was statistically significant (P < 0.05. In both groups, the most marked reduction was seen in pruritus and antihistamine use scores followed by the size and frequency of the wheals. Conclusion: Autologous serum therapy is effective in a significant proportion of ASST (+ patients with CU. A smaller but still substantial number of ASST (− patients also benefited from this treatment.

  9. Increased Level of Basophil CD203c Expression Predicts Severe Chronic Urticaria

    OpenAIRE

    Ye, Young-Min; Yang, Eun-Mi; Yoo, Hye-Soo; Shin, Yoo-Seob; Kim, Seung-Hyun; Park, Hae-Sim

    2013-01-01

    Increased FcεR1α expression with upregulated CD203c expression on peripheral basophils is seen in patients with chronic urticaria (CU). However, there has been no published report on the association between CD203c expression level and clinical disease activity in CU patients. To investigate whether the increase of basophil activation is associated with the disease activity of CU, we measured basophil CD203c expression using a tricolor flow cytometric method in 82 CU patients and 21 normal con...

  10. The Effect of Autologous Serum Therapy on Disease Severity in Patients with Chronic Urticaria

    Directory of Open Access Journals (Sweden)

    Farhad Abolnezhadian

    2016-08-01

    Full Text Available Limited evidence has been obtained concerning the beneficial effects of autologous serum therapy in treatment of skin disorders particularly chronic urticaria. In the present study, we have assessed the effect of this treatment method in patients with chronic urticaria (CU. This randomized single-blind controlled trial was performed on fifty consecutive patients with chronic urticaria. The patients were randomly assigned to receive autologous serum (as the case group, n=35 or normal saline (as the control group, n=15 and treated with monthly autologous serum therapy or normal saline for 6 months. The considered study endpoint was changes in total severity score (TSS at the 6 months follow-up visit. The TSS score was assessed at baseline as well as at the ninth week and the sixth month of interventions. The mean±SD of TSS at the ninth week of intervention was 10.94±3.92 in autologous serum therapy group and 11.67±2.72 in the normal saline group (p=0.458. Furthermore, the mean values of TSS at the sixth month of treatment in the study groups were 8.29±6.29 and 9.27±4.89 respectively (p=0.593. A downward trend in TSS, from baseline to the end of treatment, was seen in the case and control groups (p<0.001 for both, however the trend of this decline was insignificant between the two groups (p=0.592. The change in the trend of TSS after 6 months of treatment was independent from the administration of autologous serum when compared with normal saline administration (beta=-0.962, p=0.630. Multivariate linear regression model with the presence of baseline factors including gender, age, disease duration and history of atopy was performed to assess difference in TSS at six-month follow-up visit compared with the baseline value. Only young age was associated with more reduction of TSS (beta=0.163, p=0.023. We found no difference in the effects of autologous serum therapy and normal saline on the trend of the changes in disease severity in patients with

  11. The dynamics of histamine level in patients with chronic urticaria under the influence of different methods of treatment.

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    Dytyatkovska Ye.M.

    2014-11-01

    Full Text Available There was studied the efficiency of different methods of chronic urticaria treatment. All patients were divided into 2 groups depending on treatment scteme. The paper shows the dynamics of histamine level in blood plasma, intestine disbiosis in patients with chronic urticaria under the influence of different treatment complexes. It was proved that there exists the correlation between the serum histamine level and method of treatment. Intro¬ducing bionorm into the treatment allows to decrease histamine level and correspondingly to significantly improve clinical effect and patients’ life quality.

  12. 166 Assessment of Chronic Spontaneous Urticaria by Serum-Induced TNF & ALPHA; and MMP-9 Release

    OpenAIRE

    Falkencronec, Sidsel; Poulsen, Lars; Maurer, Marcus; Bindslev-Jensen, Carsten; Skov, Per Stahl

    2012-01-01

    Background Previous studies from our group have demonstrated that IgE-mediated basophil activation leads to release of TNFα that in turn can induce matrix metallo-proteinase-9 (MMP-9) release from monocytes. We wished to investigate if serum from chronic spontaneous urticaria-patients with auto-antibodies against IgE/IgE-receptor could induce TNFα and MMP-9 release from donor PBMCs, and if release levels could be used to assess severity and activity of chronic spontaneous urticaria (CSU). Met...

  13. [Urticaria: diagnosis and treatment].

    Science.gov (United States)

    Soria, A; Francès, C

    2014-09-01

    Urticaria is a common inflammatory skin disease. It is clinically defined as the occurrence of transient papular skin and/or mucosal lesions or subcutaneous lesions called angioedema. Chronic urticaria is defined as a clinical course over more than 6weeks. Different clinical forms of urticaria can coexist in the same patient. Urticaria results of mast cell activation. The diagnosis of urticaria is based on clinical examination. An allergic etiology for acute urticaria, although rare, is always to find and remove. Chronic urticaria is not allergic. Diagnosis is based on questioning and a careful clinical examination to rule out differential diagnoses. Few diagnostic tests are necessary for diagnosis and management, and are especially useful in case of doubtful diagnosis. The treatment of urticaria is symptomatic and based on anti-H1 second generation antihistamines as first-line therapy. In some chronic urticarial, antihistamines up dosing may be necessary. In the majority of patients, this treatment is sufficient to control chronic urticaria. In case of antihistamines failure, other treatment particularly immunomodulatory treatments can be offered in specialized departments.

  14. Efficacy and safety of omalizumab in patients with chronic urticaria who exhibit IgE against thyroperoxidase

    DEFF Research Database (Denmark)

    Maurer, Marcus; Altrichter, Sabine; Bieber, Thomas

    2011-01-01

    BACKGROUND: A subgroup of patients with chronic spontaneous urticaria (CU) exhibits IgE antibodies directed against autoantigens, such as thyroperoxidase (TPO). We conducted this study to investigate whether such patients with CU with IgE against TPO benefit from treatment with omalizumab, a huma...

  15. [Acquired angioedema with C1-INH deficiency and accompanying chronic spontaneous urticaria in a patient with chronic lymphatic B cell leukemia].

    Science.gov (United States)

    Klossowski, N; Braun, S A; von Gruben, V; Losem, C; Plewe, D; Homey, B; Meller, S

    2015-10-01

    Acquired angioedema due to C1 inhibitor deficiency (C1-INH-AAE) is characterized by recurrent edema of the subcutaneous and/or submucosal tissue without wheals and negative family history of angioedema. Here, we present the case of a patient with a chronic lymphatic B cell leukemia who suffered from both C1-INH-AAE and chronic spontaneous urticaria. Oral corticosteroids, antihistamines, and the anti-IgE antibody omalizumab were applied to treat the chronic urticaria in combination with the plasma-derived C1 esterase inhibitor concentrate Berinert® and the bradykinin B2 receptor antagonist icatibant, but the symptoms did not improved significantly. Thus, polychemotherapy targeting the slow-growing lymphoproliferative disease including rituximab was initiated, which resulted in remission of both the urticaria and the angioedema.

  16. Increased level of basophil CD203c expression predicts severe chronic urticaria.

    Science.gov (United States)

    Ye, Young-Min; Yang, Eun-Mi; Yoo, Hye-Soo; Shin, Yoo-Seob; Kim, Seung-Hyun; Park, Hae-Sim

    2014-01-01

    Increased FcεR1α expression with upregulated CD203c expression on peripheral basophils is seen in patients with chronic urticaria (CU). However, there has been no published report on the association between CD203c expression level and clinical disease activity in CU patients. To investigate whether the increase of basophil activation is associated with the disease activity of CU, we measured basophil CD203c expression using a tricolor flow cytometric method in 82 CU patients and 21 normal controls. The relationship between the percentage of CD203c-expressing basophils and clinical parameters was analyzed. The mean basophil CD203c expression was significantly higher in CU patients than in healthy controls (57.5% vs 11.6%, P basophil CD203c expression in severe CU patients was significantly higher than in non-severe CU (66.5% ± 23.3% vs 54.0% ± 23.3%, P = 0.033). Multiple logistic regression analysis indicated that both ≥ 72% basophil CD203c expression and urticaria activity score (UAS)≥ 13 were significant predictors of severe CU (P = 0.005 and P = 0.032, respectively). These findings suggest that the quantification of basophil activation with CD203c at baseline may be used as a potential predictor of severe CU requiring another treatment option beyond antihistamines.

  17. Wheat induced urticaria

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    Uppal Monica

    2004-09-01

    Full Text Available Wheat is widely consumed all over India in various forms - flour, daliya, maida, suji and wheat bran. Very few cases of wheat induced urticaria have been reported. This may be due to unusual features of wheat related hypersensitivity. A 35 year old female presented to us with history of chronic urticaria and angioedema. History revealed correlation between wheat intake and urticaria episodes. Prick testing was done with wheat antigen in the standard series and derivatives of raw wheat. Normal saline and histamine were used as controls. Prick testing was positive. Oral challenge induced urticaria within half an hour. This report discusses clinical features of wheat related hypersensitivity.

  18. Urticaria and angioedema in pregnancy and lactation.

    Science.gov (United States)

    Lawlor, Frances

    2014-02-01

    Urticaria is part of the management of pregnancy, labor, delivery, and the puerperium in some women. The urticaria can be acute, chronic, or physical, presenting with whealing, angioedema, or both. Contact urticaria can occur. Acquired angioedema, usually with urticaria, must be differentiated from hereditary angioedema. An approach to management of these conditions in pregnancy is proposed.

  19. Unravelling the incidence and etiology of chronic idiopathic axonal polyneuropathy

    NARCIS (Netherlands)

    Visser, N.A.

    2016-01-01

    Chronic idiopathic axonal polyneuropathy (CIAP) is a sensory or sensorimotor polyneuropathy that has a slowly progressive course without severe disability. CIAP is diagnosed in a significant proportion of patients with polyneuropathy, but precise figures on the incidence of polyneuropathy and CIAP w

  20. Chronic idiopathic intestinal pseudo-obstruction in an English bulldog.

    Science.gov (United States)

    Dvir, E; Leisewitz, A L; Van der Lugt, J J

    2001-05-01

    A case of chronic idiopathic intestinal pseudo-obstruction in an English bulldog is described. The dog was presented with chronic weight loss and vomiting. An intestinal obstruction was suspected based on clinical and radiological findings. A diagnosis of chronic idiopathic intestinal pseudo-obstruction was made on the basis of full thickness intestinal biopsies. The dog was refractory to any antiemetic therapy. Necropsy revealed marked atrophy and fibrosis of the tunica muscularis, together with a mononuclear cell infiltrate extending from the duodenum to the colon. This case was presented with clinical findings consistent with visceral myopathy in humans--namely, atony and dilatation of the whole gut--but the histological findings resembled sclerosis limited to the gastrointestinal tract.

  1. A rapid method of detecting autoantibody against FcεRIα for chronic spontaneous urticaria.

    Directory of Open Access Journals (Sweden)

    Mey-Fann Lee

    Full Text Available BACKGROUND: Chronic spontaneous urticaria (CU is a common skin disorder, with an estimated prevalence of 0.5-1.8% in most populations. Around 30-50% of CU patients have an autoimmune etiology, with autoantibodies (autoAbs against IgE, FcεRIα, and FcεRII/CD23. Although the in vivo autologous serum skin test (ASST and in vitro histamine release/activation assay are the most frequently used screening methods, these two have many limitations and do not directly measure susceptible autoAbs. This study aimed to establish an in vitro rapid screening test using recombinant autoantigen FcεRIα(rFcεRIα to improve the diagnosis of autoimmune urticaria. METHODS: Forty patients with CU and 20 healthy individuals were enrolled. After PCR-based cloning and the production of extracellular fragments of the FcεRIα protein using the E. coli expression system, serum autoAb to rFcεRIα was evaluated using in-house ELISA and rapid immunodot test. RESULTS: In ELISA-based detection, 14 out of 20 CU-ASST(+ patients exhibited anti- FcεRIα responses, whereas five of the 20 CU-ASST(- and two of the 20 non-CU patients showed autoantibody background in the assay. For the immunodot test, 55% (11/20 of the CU-ASST(+ sera exhibited anti-FcεRIα reactivity. There was no false positive among the CU-ASST(- and non-CU groups. Using clinical urticaria plus ASST(+ as the gold standard, in-house ELISA had 70% sensitivity, 82.5% specificity, and positive likelihood ratio of 4, while immunodot had 55% sensitivity, 100% specificity, and positive likelihood ratio >55. CONCLUSIONS: This study has developed a rapid immunodot method with high specificity for detecting autoAb to FcεRIαin patients with CU. Preliminary data indicates that this immunodot technique has the potential to be a routine diagnostic assay for autoimmune CU.

  2. Comparison of the in vivo autologous skin test with in vitro diagnostic tests for diagnosis of chronic autoimmune urticaria.

    Science.gov (United States)

    Altrich, Michelle L; Halsey, John F; Altman, Leonard C

    2009-01-01

    Previous studies indicate that 30-50% of chronic urticaria patients have an autoimmune etiology. Clinical diagnosis of autoimmune urticaria is supported with the autologous serum skin test. The purpose of this study was to compare two laboratory tests for measurement of IgG autoantibodies to IgE or IgE receptors and compare the results with the autologous serum and plasma skin tests. We performed skin tests and two functional in vitro tests, basophil histamine release, and CD63 up-regulation to detect autoantibodies relevant to autoimmune urticaria. Both sera and citrated plasma were evaluated in the autologous skin test and histamine release assay. Thyroid autoantibodies were also measured. Basophils were incubated with patient plasma, sera, buffer, or anti-IgE. The cells were analyzed for CD63 expression and the supernatants were recovered for histamine analysis. There was high correlation between CD63 up-regulation and histamine release assays, but histamine release was more sensitive. There was a high concordance between sera and citrated plasma for the skin test. Sera from chronic urticaria patients produced higher mean histamine release (23%) compared with citrated plasma (12%). Thirty-one percent of patients positive in the histamine release assay were also positive for thyroid autoantibodies. This compares with 12% who were negative in the histamine release assay. These data show that in vitro basophil histamine release can be used to measure antibodies to FceRI, FceRII/CD23, or IgE and identify patients with autoimmune urticaria.

  3. Assessment of chronic spontaneous urticaria by serum-induced tumor necrosis factor alpha and matrix metalloproteinase-9 release

    DEFF Research Database (Denmark)

    Falkencrone, Sidsel; Bindslev-Jensen, Carsten; Skov, Per Stahl;

    isolated with MACS Basophil Isolation Kit to 97-99% purity. Cells were pulsed 1 hour with/without anti-IgE or with sera from CSU-patients/healthy controls and incubated for a total of 21 h before protein analysis of supernatants. MMP-9 and TNFα in supernatants were measured with commercial ELISAs (R......BACKGROUND Previous studies from our group have demonstrated that IgE-mediated basophil activation leads to release of TNFα that in turn can induce matrix metallo-proteinase-9 (MMP-9) release from monocytes. We wished to investigate if serum from chronic spontaneous urticaria-patients with auto......-antibodies against IgE/IgE-receptor could induce TNFα and MMP-9 release from donor PBMCs, and if release levels could be used to assess severity and activity of chronic spontaneous urticaria (CSU). METHODS Peripheral blood mononuclear cells (PBMCs) were isolated from whole blood from healthy donors and basophils...

  4. A positive serum basophil histamine release assay is a marker for ciclosporin-responsiveness in patients with chronic spontaneous urticaria

    DEFF Research Database (Denmark)

    Iqbal, Kamran; Bhargava, Kapil; Skov, Per Stahl;

    2012-01-01

    ABSTRACT: The electronic records of 398 patients with chronic spontaneous urticaria (CSU) who had had a serum basophil histamine release assay (BHRA) performed as a marker of functional autoantibodies were audited. The BHRA was positive in 105 patients (26.4%). Fifty eight were treated with ciclo...... with ciclosporin because they were H1 anti-histamine unresponsive. CSU patients with a positive BHRA were more likely to respond clinically (P...

  5. Correlation of thyroid hormone levels and immune function state with the illness in patients with chronic urticaria

    Institute of Scientific and Technical Information of China (English)

    Xiao-Yan Sun; Guang-Zhong Yang; Qing-Xiang Li; Yao Wang

    2016-01-01

    Objective:To study the correlation of thyroid hormone level and immune function state with the illness in patients with chronic urticaria.Methods:A total of 54 patients with chronic urticaria treated in our hospital between May 2015 and October 2015 were selected as the chronic urticaria group (CU group) of the study, 50 healthy volunteers receiving physical examination in our hospital during the same period were selected as the negative control group (NC group) of the study, serum was collected to determine the content of immunoglobulins, complements, interleukins, thyroid hormone and autoantibodies.Results: Serum C3, C4 and IL-2 content of CU group were significantly lower than those of NC group while IgG, IgE, IL-4, IL-17, IL-18 and IL-33 content were significantly higher than those of NC group; serum TT3, TT4, FT3, FT4, TSAb, TGAb, TPOAb and TMAb content of CU group were significantly higher than those of NC group, negatively correlated with serum C3, C4 and IL-2 content, and positively correlated with serum IgG, IgE, IL-4, IL-17, IL-18 and IL-33 content;serum TSH content was significantly lower than that of NC group, positively correlated with serum C3, C4 and IL-2 content, and negatively correlated with serum IgG, IgE, IL-4, IL-17, IL-18 and IL-33 content.Conclusions: Thyroid autoantibody synthesis and thyroid hormone release increase in patients with chronic urticaria, and the change of thyroid hormone levels and immune function is closely related to the illness.

  6. LC/DAD determination of biogenic amines in serum of patients with diabetes mellitus, chronic urticaria or Hashimoto's thyroiditis

    Directory of Open Access Journals (Sweden)

    Trifunović-Macedoljan Jelena

    2016-01-01

    Full Text Available Biogenic amines are integral part of nearly every cell. In present study, we used method of acidic extraction of histamine (His, of polyamines putrescine (Put, spermidine (Spd and catecholamines epinephrine (Epi and norepinephrine (NE from human serum; precolumn derivatization with dansyl chloride, and LC/DAD analysis of the biogenic amines, in aim to monitor differences of their levels in patients with diabetes mellitus, chronic urticaria, and Hashimoto's thyroiditis, compared to healthy subjects, and to observe them as possible markers for immune mediated diseases. Method of retention times was used for determination of serum biogenic amines. We found statistically significant differences in putrescine and histamine levels in diabetes mellitus patients; putrescine, histamine, spermidine and epinephrine levels in chronic urticaria patients compared to healthy controls, and putrescine and spermidine levels in Hashimoto's thyroiditis patients, compared to controls. Norepinephrine was found only in serum of patients with chronic urticaria. The values of recovery, evaluated in controls, varied between 85.7% and 106.7%. The statistically significant changes in putrescine, histamine, spermidine and epinephrine levels in patients compared to healthy people reflects the existence of biochemical disturbances in mentioned immune-mediated diseases.

  7. Hyperlipidemia Is Associated with Chronic Urticaria: A Population-Based Study.

    Science.gov (United States)

    Chung, Shiu-Dong; Wang, Kuo-Hsien; Tsai, Ming-Chieh; Lin, Herng-Ching; Chen, Chao-Hung

    2016-01-01

    The etiology of chronic urticaria (CU) is diverse, with chronic infections and inflammation being reported as considerable contributing factors. Although the prevalence of metabolic syndrome was found to be significantly elevated in patients with CU, no one has specifically estimated the effects on CU following hyperlipidemia. This study aimed to examine the association between hyperlipidemia and CU using a population-based dataset in Taiwan. This study included 9798 adults with CU as cases and 9798 sex- and age-matched controls. These patients were examined for whether they had received a prior diagnosis of hyperlipidemia. We used conditional logistic regression analyses to calculate the odds ratio (OR) and its corresponding 95% confidence interval (CI) for having been previously diagnosed with hyperlipidemia between cases and controls. In total, 7066 (36.1%) patients had received a prior diagnosis of hyperlipidemia, including 4287 (43.8%) among CU cases and 2779 (28.4%) among controls. The conditional logistic regression revealed that the OR of prior hyperlipidemia for cases was 1.97 (95% CI: 1.85~2.09) compared to the controls. Furthermore, compared to patients without CU, patients with CU independently experienced a 1.65-fold (95% CI = 1.55~1.76; phyperlipidemia diagnosis, after adjustments were made. We concluded that CU was associated with having received a prior diagnosis of hyperlipidemia.

  8. Chronic Spontaneous Urticaria Is Characterized by Lower Serum Advanced Glycation End-Products

    Directory of Open Access Journals (Sweden)

    Alicja Grzanka

    2014-01-01

    Full Text Available Background. Chronic spontaneous urticaria (CSU is associated with activation of acute phase response. On the other hand, it is known that systemic inflammation may lead to increased formation of advanced glycation end-products (AGEs, associated with pathogenesis of various diseases. Aim. We aim to test whether chronic inflammation manifested by activated acute phase response may provide a mechanism for increased serum AGEs concentration in CSU. Methods. Concentrations of AGEs were measured spectrofluorimetrically in serum of CSU patients and the healthy subjects. Results. Serum AGEs and albumin concentrations in CSU patients were significantly lower as compared with the healthy subjects. Serum CRP concentration was significantly higher in patients with CSU than in the controls. Significant positive correlation was observed between AGEs and albumin concentrations in the subjects. Conclusions. CSU is not associated with increased circulating AGEs concentrations, despite the enhanced systemic inflammatory response. Paradoxical decrease of serum AGEs concentrations is probably a reflection of lower concentration of “negative acute phase proteins” such as albumin.

  9. The potential pharmacologic mechanisms of omalizumab in patients with chronic spontaneous urticaria.

    Science.gov (United States)

    Chang, Tse Wen; Chen, Christina; Lin, Chien-Jen; Metz, Martin; Church, Martin K; Maurer, Marcus

    2015-02-01

    In patients given a diagnosis of chronic spontaneous urticaria (CSU), there are no obvious external triggers, and the factors that initiate the clinical symptoms of wheal, flare, and itch arise from within the patient. Most patients with CSU have an autoimmune cause: some patients produce IgE autoantibodies against autoantigens, such as thyroperoxidase or double-stranded DNA, whereas other patients make IgG autoantibodies against FcεRI, IgE, or both, which might chronically activate mast cells and basophils. In the remainder of patients with CSU, the nature of the abnormalities has not yet been identified. Accumulating evidence has shown that IgE, by binding to FcεRI on mast cells without FcεRI cross-linking, can promote the proliferation and survival of mast cells and thus maintain and expand the pool of mast cells. IgE and FcεRI engagement can also decrease the release threshold of mast cells and increase their sensitivity to various stimuli through either FcεRI or other receptors for the degranulation process. Furthermore, IgE-FcεRI engagement potentiates the ability of mast cells to store and synthesize de novo inflammatory mediators and cytokines. Administration of omalizumab, by virtue of its ability to deplete IgE, attenuates the multiple effects of IgE to maintain and enhance mast cell activities and hence reduces the ability of mast cells to manifest inflammatory mechanisms in patients with CSU.

  10. 578 Comparison of the Modified Autologous Serum Skin Test and the Cd63 Basophil Activation Test in Chronic Urticaria

    OpenAIRE

    Irinyi, B; Gyimesi, E.; Garaczi, E.; Bata, Zs.; Hodosi, K.; Zeher, M; Remenyik, É.; Szegedi, A.

    2012-01-01

    Background The modified CD63 basophil activation test in the diagnosis of chronic autoimmun urticaria was first described in 2004 by Szegedi et al. We demonstrated that the strongly sensitized basophils of atopic donors can be successfully used without the addition of IL-3 for the in vitro evaluation of autoimmun urticaria. Positive correlation was found between the basophil CD63 expression test and the autolog serum skin test (ASST), and between the CD63 test and the gold standard histamine ...

  11. Clinicoepidemiologic features of chronic urticaria in patients having positive versus negative autologous serum skin test: A study of 100 Indian patients

    Directory of Open Access Journals (Sweden)

    Surbhi Vohra

    2011-01-01

    Full Text Available Background: Chronic urticaria patients who demonstrate autoantibodies against the high-affinity receptor of IgE (FceRI or IgE itself tend to have a high itch and wheal score, and systemic symptoms may have a significant bearing on their management in terms of super pharmacologic doses of antihistamines needed or use of immunomodulators. Most studies have used histamine release assays rather than autologous serum skin tests (ASSTs for correlating urticaria severity and histamine releasing activity. Methods: An ASST was performed in 100 (M:F, 31:69 chronic urticaria patients aged between 14 and 63 (mean, 32.69 ± 13 years with an objective to study the clinicoepidemiologic features like age, sex, age of onset and duration, frequency and distribution of wheals, urticaria severity, angioedema and systemic manifestations in ASST-positive and ASST-negative patients. Results: ASST was positive in 46% of the patients and negative in 54% of the patients, respectively. Both groups showed no statistically significant difference for epidemiological details. However, the ASST-positive patients had a higher mean urticaria activity score, frequent involvement of more body sites, particularly palms and soles, presence of throat angioedema and general constitutional, respiratory or gastrointestinal symptoms in comparison with the ASST-negative patients. Conclusions: Apparently, ASST-positive patients have more severe clinical manifestations of chronic urticaria. The knowledge will be useful for the treating dermatologists and patients alike in view of its therapeutic implications.

  12. Evidence-based diagnosis and treatment of chronic urticaria/angioedema.

    Science.gov (United States)

    Lang, David M

    2014-01-01

    Chronic urticaria/angioedema (CUA) continues to be a vexing condition for both patients and health care providers. Despite progress made in recent years to improve our understanding of the pathogenesis of CUA and its treatment, many patients continue to experience ongoing symptoms and impaired quality of life. In the overwhelming majority of cases, a definite etiology is not identified. Laboratory testing may be justified based on its "reassurance value"; however, extensive routine testing is not favorable from a cost-benefit standpoint and does not lead to improved patient care outcomes. The target for effective management is to control CUA with a combination of avoidance measures, lifestyle changes, and regular administration of medication. A step-care approach to pharmacologic management that is favorable from the standpoint of balancing the potential for benefit with the potential for harm can lead to substantial improvement in quality of life. This article will focus on achieving improved outcomes for patients with CUA based on evidence-directed recommendations for diagnosis and management.

  13. Association of HLA-DRB1, DQB1 Alleles with Chronic Urticaria

    Institute of Scientific and Technical Information of China (English)

    CHEN Jing; TAN Zhijian; LI Jiawen; XIONG Ping

    2005-01-01

    Summary: In order to investigate the association of genotypes of HLA-DRB1 and HLA-DQB1 alleles with the genetic susceptibility of chronic urticaria (CU), genotypes of HLA-DRB1 and HLA-DQB1 genes were detected by polymerase chain reactions with sequence-specific primers (PCR-SSP) in 42 patients with CU (19 men and 23 women, mean age 30.67±12.45 y old as well as 193 racially matched healthy persons in ethnic Han from Hubei provinece. Gene frequencies of HLA-DRB1*12, *0901 (RR=3.11, χ2=7.579, P=0.006; RR=2.47, χ2=5.684, P=0.017) were significantly increased in CU patients as compared with that in healthy people. Gene frequencies of HLA-DQB1*05 (RR=0.26, χ2=6.683, P=0.01) were significantly decreased in CU patients. It was suggested that CU was found strongly associated with HLA-DRB1*12, *0901 and HLA-DQB1*05, the former might be the genetic markers for susceptibility to CU, but the latter might play a resistive role.

  14. [Pathophysiology of urticaria].

    Science.gov (United States)

    Nosbaum, A; Augey, F; Nicolas, J-F; Bérard, F

    2014-11-01

    Urticaria is a dermal edema resulting from vascular dilatation and leakage of fluid into the skin in response to molecules released from mast cells. The major mediator responsible for urticaria is histamine. However, the clinical spectrum and pattern of lesions indicate that other molecules, including prostaglandins, leukotrienes, cytokines, and chemokines, produced at different times after mast cell activation contribute to the polymorphism of this symptom and the variable evolution of this disease. It is a common practice to distinguish immunological and nonimmunological urticaria. Immunological urticaria is a hypersensitivity reaction mediated by antibodies and/or T-cells that results in mast cell activation. Although immunoglobulin (Ig) E-mediated type I hypersensitivity (HS) was long postulated to be the major immunological pathway associated with mast cell activation, interaction between IgEbound mast cells and allergens is unlikely to be the mechanism by which urticaria develops in most patients. It is now well established that urticaria may result from the binding of IgG auto-antibodies to IgE and/or to the receptor for IgE molecules on mast cells, thus corresponding to a type II HS reaction. These auto-immune urticarias represent up to 50 % of patients with chronic urticaria. Mast cell activation can also result from type III HS through the binding of circulating immune complexes to mast cell-expressing Fc receptors for IgG and IgM. Finally, under certain circumstances, T-cells can induce activation of mast cells, as well as histamine release (type IV HS). Nonimmunological urticarias result from mast cell activation through membrane receptors involved in innate immunity (e.g., complement, Toll-like, cytokine/chemokine, opioid) or by direct toxicity of xenobiotics (haptens, drugs). In conclusion, urticaria may result from different pathophysiological mechanisms that explain the great heterogeneity of clinical symptoms and the variable responses to treatment.

  15. Russian version of CU-Q2oL questionnaire for estimation of quality of life of patients with chronic urticaria

    Directory of Open Access Journals (Sweden)

    Nekrasova Е.Е.

    2010-09-01

    Full Text Available The research objective is to work out the creation of Russian-language questionnaire for assessing quality of life of patients with chronic urticaria by adapting the questionnaire «Chronic Urticaria Quality of Life Questionnaire» (CU-Q2oL to Russian conditions. The study involved 150 patients aged 18 to 50 years (32,41±6,02 with chronic urticaria. Cultural and linguistic adaptation of the questionnaire was conducted according to international methodology. Evaluation of reliability was conducted by calculating Cronbach's б-coefficient, constructive validity -the method of «known groups» and the identification of mutual correlations with the scales of the SF-36 questionnaire, sensitivity-by comparing the quality of life before and after the treatment. High values of Cronbach's б-coefficient (>0.72 were obtained, the dependence of quality of life on the severity of chronic urticaria was proved to be significant, as well as the sensitivity of the questionnaire to clinical changes. The research findings confirmed good psychometric properties of Russian version of the questionnaire. The developed version of the questionnaire is a reliable, valid and sensitive device for assessing the quality of life in patients with chronic urticaria, and may be used in scientific and clinical research.

  16. Multiple H1-antihistamine-induced urticaria.

    Science.gov (United States)

    Inomata, Naoko; Tatewaki, Satoko; Ikezawa, Zenro

    2009-04-01

    H(1)-antihistamines are widely used in the treatment of various allergic diseases. Particularly, a cornerstone of the management of chronic idiopathic urticaria is treatment with H(1)-antihistamines. However, a few cases of H(1)-antihistamine-induced urticaria have been reported. A 34-year-old woman presented with a 4-month history of recurrent urticaria, which was prominently exacerbated by the administration of H(1)-antihistamines. The patient consented to a provocation test of fexofenadine among drugs including cetirizine and hydroxyzine, which were suspected of inducing severe symptoms in episodes. One hour after challenge with 12 mg fexofenadine (one-fifth of the therapeutic dose), a urticarial reaction rapidly developed on nearly the entire body with remarkably increased levels of plasma histamine (190 nmol/L) and plasma leukotriene B4 (150 pg/mL). In challenge tests with other antihistamines, generalized urticaria occurred 5 and 1 h after intake of 10 mg loratadine and 10 mg bepotastine, respectively, whereas challenges with chlorpheniramine, mequitazine and azelastine were all negative. Skin prick tests with H(1)-antihistamines used in the challenges were all negative, indicating that the urticarial reactions after challenges with the causative drugs might not be immunoglobulin E-mediated. Among the causative drugs in our case, cetirizine and hydroxyzine are the piperazine derivatives, whereas fexofenadine, bepotastine, ebastine and loratadine are the piperidine derivatives. The chemical structures of both derivatives are very similar. Therefore, in this case, H(1)-antihistamine-induced urticaria may have been due to cross-reactivity between metabolites of these drugs, but not to drugs before metabolization. Hypersensitivity to H(1)-antihistamines should be considered when urticarial lesions worsen after H(1)-antihistamine treatment.

  17. Urticaria pigmentosa

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/001466.htm Urticaria pigmentosa To use the sharing features on this page, please enable JavaScript. Urticaria pigmentosa is a skin disease that produces patches ...

  18. Idiopathic chronic hypertrophic craniocervical pachymeningitis: case report.

    Science.gov (United States)

    Botella, C; Orozco, M; Navarro, J; Riesgo, P

    1994-12-01

    A 55-year-old woman with a unique form of chronic hypertrophic pachymeningitis involving the posterior fossa and upper cervical spine is reported. Unlike other cases previously described, the clinical picture was dominated by signs of increased intracranial pressure, lower cranial nerve disorders, and a progressive cervical radiculomyelopathy. The diagnosis was made by means of a contrast-enhanced magnetic resonance imaging scan and confirmed by histological examination of the excised dura. Surgical treatment with removal of the hypertrophic dura provided temporary relief, although the natural history of the disease was not modified. Exhaustive bacteriological and histopathological studies failed to identify a specific cause for this diffuse hypertrophy of the cranial and cervical dura. The literature is reviewed, and other histologically documented cases are discussed.

  19. Cold Urticaria

    Science.gov (United States)

    Diseases and Conditions Cold urticaria By Mayo Clinic Staff Cold urticaria (ur-tih-KAR-e-uh) is a skin reaction to cold. Skin that has ... in contact with cold develops reddish, itchy welts (hives). The severity of cold urticaria symptoms varies widely. ...

  20. A perspective for pediatric surgeons: chronic idiopathic intestinal pseudoobstruction.

    Science.gov (United States)

    Shaw, A; Shaffer, H; Teja, K; Kelly, T; Grogan, E; Bruni, C

    1979-12-01

    Chronic idiopathic intestinal pseudoobstruction (CIIP) is a disorder of alimentary tract motility with onset of symptoms in adolescence or young adulthood, characterized by recurring attacks of abdominal pain, distention, vomiting, and constipation often leading to malnutrition and death. Starting with an adolescent patient, treated for a succession of life-threatening attacks of pseudoobstruction, the authors have identified CIIP in four generations of a Virginia family. Studies show characteristic dilation and diminished motility of the esophagus and intestine. Surgery's role in CIIP is palliative, and operation should only be offered when medical measures have failed to control symptoms.

  1. Toxocara Canis IgG Seropositivity in Patients with Chronic Urticaria

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    Mehmet Burak-Selek

    2015-10-01

    Full Text Available We aimed to investigate IgG antibody levels specific to Toxocara canis (T. canis, a parasite which subsists in dog’s intestine, on serum samples obtained from patients with chronic urticaria (CU to evaluate effective risk in CU etiopathogenesis.In this study, 73 patients diagnosed with CU and 109 healthy individuals as control group, were included. Various factors such as sex, age, education and income, daily hand washing habits, history of dog owning and soil eating were questioned in patient anamnesis. T. canis IgG antibodies were detected using an enzyme linked immunosorbent assay (ELISA kit prepared with T. canis larval excretory-secretory antigens. Positive results were confirmed with western blot (WB WB test.We found T. canis IgG positivity in 17.8% (n=13 of patients (n=73 with CU. But we did not observe any T. canis IgG positivity in healthy controls (n=109. Low molecular weight bands (24-35 kDa were observed in 11 samples in WB analyses while two of the samples were weakly positive. It is revealed that dog owning history increases T. canis seropositivity12.9 times while insufficient daily hand washing habit (less than six times a day increasesseropositivity 20.7 times. Our study showed that T. canis may trigger CU since we found17.8% seropositivity in 73 patients with CU and none in 109 healthy individuals.Moreover, various socio-demographic characteristics have been shown to affect T. canisseropositivity in patients with CU. 

  2. Toxocara Canis IgG Seropositivity in Patients with Chronic Urticaria.

    Science.gov (United States)

    Burak Selek, Mehmet; Baylan, Orhan; Kutlu, Ali; Özyurt, Mustafa

    2015-08-01

    We aimed to investigate IgG antibody levels specific to Toxocara canis (T. canis), a parasite which subsists in dog's intestine, on serum samples obtained from patients with chronic urticaria (CU) to evaluate effective risk in CU etiopathogenesis. In this study, 73 patients diagnosed with CU and 109 healthy individuals as control group, were included. Various factors such as sex, age, education and income, daily hand washing habits, history of dog owning and soil eating were questioned in patient anamnesis. T. canis IgG antibodies were detected using an enzyme linked immunosorbent assay (ELISA) kit prepared with T. canis larval excretory-secretory antigens. Positive results were confirmed with western blot (WB) WB test. We found T. canis IgG positivity in 17.8% (n=13) of patients (n=73) with CU. But we did not observe any T. canis IgG positivity in healthy controls (n=109). Low molecular weight bands (24-35 kDa) were observed in 11 samples in WB analyses while two of the samples were weakly positive. It is revealed that dog owning history increases T. canis seropositivity 12.9 times while insufficient daily hand washing habit (less than six times a day) increases seropositivity 20.7 times. Our study showed that T. canis may trigger CU since we found 17.8% seropositivity in 73 patients with CU and none in 109 healthy individuals. Moreover, various socio-demographic characteristics have been shown to affect T. canis seropositivity in patients with CU.

  3. 慢性荨麻疹中医治疗概况%Profile of the treatment of chronic urticaria by Traditional Chinese Medicine

    Institute of Scientific and Technical Information of China (English)

    仲亚平; 闵仲生

    2014-01-01

    The literature of TCM treatment of chronic urticaria were summarized, and it pointed out that Traditional Chinese Medicine, integrated Chinese and western medicine, Chinese medicine external treatment methods had good curative effect on chronic urticaria.%对近年文献报道有关慢性荨麻疹中医治疗方法及进展进行综述,指出通过中药治疗、中西医结合、中医外治等方法治疗慢性荨麻疹可取的较好疗效。

  4. Positive associations between infections of Toxoplasma gondii and seropositivity with Anisakis simplex in human patients suffering from chronic urticaria.

    Science.gov (United States)

    Fernández-Fígares, V; Rodero, M; Valls, A; De Frutos, C; Daschner, A; Cuéllar, C

    2015-11-01

    Toxoplasma gondii is a food-borne and orofecal microorganism which produces chronic infection, and attempts have been made to prove its negative association with atopy in the context of the hygiene hypothesis. Anisakis simplex is a fish parasite associated with chronic urticaria (CU) in endemic regions. We analysed the relationship between both infectious agents in CU. We included 42 patients with chronic urticaria (18 patients with CU associated with A. simplex sensitization and 24 not sensitized CU patients). Patients were assessed for atopy by a skin prick test (SPT) against common aeroallergens and for respiratory symptoms. Anisakis simplex sensitization was assessed by SPT and specific IgE by CAP fluoro-enzyme immunoassay (CAP-FEIA). Anti-T. gondii IgG levels were measured by enzyme-linked immunosorbent assay (ELISA). CU patients were analysed with respect to T. gondii seropositivity, A. simplex sensitization, atopy and immigrant status. The seroprevalence of T. gondii was 40.5% in CU patients and 42.1% in the control group. Immigrants were more frequently infected by T. gondii (41.2% versus 12%; P =0.036). Anti-T. gondii IgG antibodies were associated with past A. simplex parasitism (odds ratio 6.73; P =0.03) and independently with atopic sensitization (odds ratio 5.85; P =0.04). In CU patients, T. gondii has no protective effect on atopic sensitization or A. simplex sensitization.

  5. Nomenclatuur en scoresystemen chronische urticaria

    NARCIS (Netherlands)

    Urgert, M. C.; Van Den Elzen, M. T.; Tupker, R. A.; Franken, S. M.; Van Zuuren, E. J.; Knulst, A. C.

    2015-01-01

    The Dutch Guideline on urticaria is currently being developed. Whilst awaiting the guideline, this article already discusses the classification and score system. Chronic urticaria is defined as the occurrence of spontaneous wheals, angioedema or both for a period of at least six weeks. In the curren

  6. Managing urticaria in primary care.

    Science.gov (United States)

    Tidman, Michael J

    2015-02-01

    Urticaria is characterised by transient wheals that consist of a swollen palpable centre often surrounded by an erythematous flare, associated with itching or, less commonly, a burning sensation. Individual wheals usually disappear within 1 to 24 hours leaving normal skin. Wheals may be accompanied by angioedema, a more deep-seated flesh-coloured or erythematous swelling of skin or mucous membrane, which may last longer than 24 hours. Urticaria is classified as acute when it resolves within six weeks and chronic when its duration exceeds six weeks. Chronic urticaria is now sub-classified into chronic spontaneous urticaria (CSU) and chronic inducible urticaria. The prognosis for eventual recovery from spontaneous and inducible urticaria is excellent. However, the time course is unpredictable and may extend to years, often following a relapsing and remitting course. Urticaria results from the release of inflammatory mediators from dermal mast cells, resulting in vasodilatation, plasma extravasation, recruitment of immunologically active cells and sensory nerve stimulation. The cause of urticaria cannot usually be precisely identified for most affected individuals. IgE-mediated food allergy is rarely the cause of CSU in patients with the daily appearance of urticarial lesions, although it should be considered in CSU patients with intermittent symptoms. For patients with CSU a differential full blood count and inflammatory markers are all that are routinely recommended. It is also reasonable to test thyroid function and check for circulating thyroid autoantibodies as there is an association between CSU and thyroid autoimmunity.

  7. A randomized placebo-controlled double-blind pilot study of methotrexate in the treatment of H1 antihistamine-resistant chronic spontaneous urticaria

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    Vinod K Sharma

    2014-01-01

    Full Text Available Background: Chronic urticaria not responsive to antihistamines is a difficult disease to manage. Methotrexate has been used in difficult chronic urticarias with some benefit. Objective: To evaluate the efficacy of methotrexate in the treatment of chronic spontaneous urticaria poorly responsive to H1 antihistaminics. Methods: In a randomized double-blind trial at the Department of Dermatology and Venereology of a tertiary care centre, 29 patients with chronic spontaneous urticaria not responding well to H1 antihistaminics were recruited. Patients were randomly allocated to receive either a weekly dose of oral methotrexate 15 mg or placebo (calcium carbonate for a total duration of 12 weeks, after which treatment was stopped and patients were followed up for relapse of urticaria. Each group also received levocetrizine 5 mg once daily for symptom control. Primary outcome measured was a reduction by >2/3 rd of baseline urticaria scores after 12 week therapy. Secondary outcome was a reduction in antihistamine requirement after stopping therapy. Results: Fourteen patients were randomized to the methotrexate group and fifteen patients to the placebo group. Out of 17 patients who completed therapy, the primary outcome was achieved by 3.5 ± 1.9 (out of 10 patients in the methotrexate group and by 3.67 ± 1.03 (out of 7 patients in the placebo group (P > 0.05. Ten patients followed up, after stopping therapy, for a mean period of 3.5 ± 2.4 months; 3 remained in remission and 7 had relapsed. One patient had uncontrollable nausea and vomiting after taking methotrexate and was withdrawn from the study. The placebo group did not experience any side effects. Conclusions: Methotrexate 15 mg weekly for 3 months did not provide any additional benefit over H1 antihistamines in this study but an adequately powered study with longer follow up is required to assess its utility.

  8. Autologous serum skin test as an indicator of chronic autoimmune urticaria in a tertiary care hospital in South India

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    Adaikalampillai Ganapathy Vikramkumar

    2014-01-01

    Full Text Available Background: Autologous serum skin test (ASST is a simple in-vivo clinical test for the detection of basophil histamine releasing activity and to diagnose chronic autoimmune urticaria (CAU among chronic spontaneous urticaria (CSU patients. Diagnosing these patients is also important as they may need high doses of antihistamines and systemic corticosteroids during acute exacerbations. Aims and Objectives: The aim of this study is to study the prevalence of CAU among cases of CSU by using ASST. Materials and Methods: This was a cross-sectional study done among 48 patients presenting with CSU. Detailed history, physical examination and routine investigations were recorded for all patients. ASST was done on all the 48 patients. Results: Of the 48 patients included in the study, 20 patients (41.6% were ASST positive, while the remaining 28 (58% were ASST negative. The median duration of disease in both ASST positive and negative patients was 1 year. ASST positivity was higher (66.6% among patients with a history of round shaped weals, though not statistically significant. ASST positivity was seen in 5 (71.4% out of seven patients with systemic involvement, which was again not statistically significant. Conclusion: Our study did not show any significant difference between patients with and without antibodies regarding mean age and sex distribution, clinical morphology of individual weals, duration, severity, systemic symptoms, angioedema, atopy, and association with other autoimmune conditions.

  9. Analysis of Drug Utilization for Acute Urticaria and Chronic Urticaria in Our Hospital%我院治疗急性与慢性荨麻疹的药物使用情况分析

    Institute of Scientific and Technical Information of China (English)

    周敏华; 吴晓玲

    2013-01-01

    目的:了解我院治疗荨麻疹的用药情况,比较慢性及急性荨麻疹的用药特点.方法:选取我院2012年1-10月门诊诊断为急性或慢性荨麻疹的处方各600张,采用回顾性分析方法,调查急性荨麻疹与慢性荨麻疹不同处方药物类别使用频次、具体使用药物构成比排序、不合理用药情况.结果:抗组胺药在荨麻疹的治疗中共被使用2 085次,用药频次最高;糖皮质激素在急性荨麻疹的治疗中共被使用303次,作用较突出;部分新型抗过敏药物已逐渐应用于慢性荨麻疹的治疗;荨麻疹不合理用药率为33.0%,不合理用药主要存在于抗组胺药联用、抗菌药物、糖皮质激素类药及中成药的使用等方面.结论:抗组胺药仍是荨麻疹治疗的首选药物;临床医师应严格掌握抗组胺药联用、抗生素、糖皮质激素类药及中成药的使用原则,避免滥用.%OBJECTIVE:To investigate the drug utilization for urticaria in our hospital,and to compare the medication characteristics of chronic urticaria and acute urticaria.METHODS:A total of 1 200 prescriptions which included 600 samples diagnosed as the acute urticaria and the remaining 600 as chronic urticaria were selected from our hospital during Jan.-Oct.2012.The frequency of different category of drugs,constituent ratio sorting of drug used and irrational drug use were investigated in those prescriptions.RESULTS:In the treatment of urticaria,antihistamine showed the highest frequency of drug use,which was used for 2 085 times; the effect of glucocorticoid which was used for 303 times was prominent in the treatment of acute urticaria; part of new type anti-allergic drugs was gradually applied for chronic urticaria; the rate of irrational drug use was 33.0%,which mainly existed in the combined use of antihistamines,antibiotics,glucocorticoids and Chinese patent drug.CONCLUSIONS:Antihistamines still are the preferred drugs for urticaria; clinicians should

  10. 慢性荨麻疹与凝血机制的研究进展%Chronic urticaria and blood coagulation mechanism

    Institute of Scientific and Technical Information of China (English)

    王朵勤; 唐慧; 徐金华

    2011-01-01

    Blood coagulation plays an important role in the pathogenesis of chronic urticaria. Both the intrinsic and extrinsic pathways of the coagulation cascade are activated in chronic urticaria, which in turn induce the generation of thrombin. Thrombin, as the agonist of proteinase-activated receptors, can induce histamine release from mast cells, and then cause the development of urticaria. The severity of urticaria is parallel to the quantity of coagulation factors. Anticoagulants and protease inhibitors have shown certain efficacy in the treatment of some refractory urticaria. This paper summarizes recent progress in the development of blood coagulation-targeting strategies for the treatment of chronic urticaria.%凝血机制在慢性荨麻疹的发病中起着重要的作用。内、外源性凝血途径同时被激活,产生凝血酶。凝血酶是一种蛋白酶激活受体激动剂,可诱导肥大细胞释放组胺,从而诱发荨麻疹的发生。其病情严重性随着凝血因子数量的增高而加重。抗凝药物及蛋白酶抑制剂对部分难治性荨麻疹有一定疗效。概述近几年针对凝血机制治疗慢性荨麻疹的研究进展。

  11. Inhibition of ileal bile acid transporter: An emerging therapeutic strategy for chronic idiopathic constipation.

    Science.gov (United States)

    Mosińska, Paula; Fichna, Jakub; Storr, Martin

    2015-06-28

    Chronic idiopathic constipation is a common disorder of the gastrointestinal tract that encompasses a wide profile of symptoms. Current treatment options for chronic idiopathic constipation are of limited value; therefore, a novel strategy is necessary with an increased effectiveness and safety. Recently, the inhibition of the ileal bile acid transporter has become a promising target for constipation-associated diseases. Enhanced delivery of bile acids into the colon achieves an accelerated colonic transit, increased stool frequency, and relief of constipation-related symptoms. This article provides insight into the mechanism of action of ileal bile acid transporter inhibitors and discusses their potential clinical use for pharmacotherapy of constipation in chronic idiopathic constipation.

  12. A Study of Anorectal Manometry in Patients with Chronic Idiopathic Constipation

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    To study the changes of anorectal motility in patients with chronic idiopathic constipation, anorectal motility was investigated by water-perfused manometric system in 30 patients with chronic idiopathic constipation and 18 healthy subjects. Our results showed that there was no significant difference between the constipation group and the control group in anal sphincteric resting pressure and anal maximal squeezing pressure. The minimum relaxation volume, the rectal defecatory threshold, the rectal maximal tolerable volume and the rectal compliance in the patients were significantly higher than those in the controls (P< 0. 01 or P< 0. 05). It is concluded that patients with chronic idiopathic constipation have anorectal motility disturbances.

  13. Urticaria and angioedema.

    Science.gov (United States)

    Spickett, G

    2014-01-01

    Urticaria, also known as hives, and angioedema, where the swelling occurs below the skin instead of on the skin, are extremely common but there is a misconception that the most likely cause is an allergic reaction. Chronic urticaria in particular is rarely due to allergy. Equally for angioedema, many will consider the exceptionally rare hereditary angioedema (HAE), but in fact other medical causes are the most likely, in particular the use of angiotensin-converting enzyme inhibitor (ACE-I) drugs. Approximately 3-5% of patients receiving ACE-I will develop angioedema at some time in the course of their treatment.1 Stress is a major contributor to both chronic urticaria and recurrent angioedema. Treatment needs to focus on the use of long-acting, non-sedating, antihistamines. Corticosteroids may be used acutely but not long term.

  14. Exploration and analysis of chronic urticaria treated with replenishing qi and nourishing blood to expel wind method%益气养血祛风法治疗慢性荨麻疹探析

    Institute of Scientific and Technical Information of China (English)

    闫学文

    2012-01-01

    Chronic urticaria is a common and frequently encountered disease in the department of dermatology. Chronic urticaria is usually induced by deficient qi and blood invasion by pathogenic wind in Traditional Chinese medicine. The curative effect of chronic urticaria with replenishing qi and nourishing blood to expel wind method is satisfactory.%慢性荨麻疹是皮肤科常见病、多发病,中医认为病因是气血虚弱,风邪外邪引起;使用益气活血祛风法治疗取得满意疗效.

  15. Symptomatic dermographism (factitious urticaria)--passive transfer experiments from human to monkey.

    Science.gov (United States)

    Murphy, G M; Zollman, P E; Greaves, M W; Winkelmann, R K

    1987-06-01

    Passive transfer experiments were carried out on three species of monkey, Macaca mulatta, Macaca nemestrina and Macaca fascicularis, using human serum from patients affected with severe symptomatic dermographism (factitious urticaria), cholinergic urticaria, chronic idiopathic urticaria and normal subjects. The monkeys were tested for dermographism by means of a calibrated dermographometer 24 h after intradermal injection of the serum, using Evans blue as a marker. Positive responses were seen initially in the M. nemestrina. Four sites injected with serum from patients with severe symptomatic dermographism gave positive responses, one site injected with serum from a normal subject produced a faint response. One of the four responses was reproduced one month later in M. fascicularis. These results indicate that passive transfer of dermographism is possible from human to monkey.

  16. Comparative efficacy of bilastine, levocetirizine and desloratadine updosing in chronic urticaria

    Directory of Open Access Journals (Sweden)

    Staevska MT

    2016-11-01

    Full Text Available Maria T Staevska Clinical Center of Allergology, Medical University, Sofia, Bulgaria As a group of allergists who treat both allergic rhinitis and urticaria patients on a daily basis, and involved in clinical research, we read with particular interest the review paper “Treatment of allergic rhinitis and urticaria: a review of the newest antihistamine drug bilastine”,1 published in your journal. Although the group of distinguished authors from the Asia Pacific Region provide an interesting insight into the burden of allergic diseases in this fast developing part of the world, no new data or insights are offered for the treatment of these diseases. Our attention was particularly drawn by Figure 9, which is partly based on data generated in a clinical study performed and published by our group.The original article article by Wang et al.

  17. Maintenance of remission with low-dose olopatadine hydrochloride for itch in well-controlled chronic urticaria

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    Makino T

    2012-09-01

    Full Text Available Teruhiko Makino,1 Yoshiaki Takegami,1 Mati Ur Rehman,1 Yoko Yoshihisa,1 Waka Ishida,2 Takashi Toyomoto,3 Tadamichi Shimizu11Department of Dermatology, University of Toyama, Toyama, Japan; 2Department of Dermatology, Niigata Central Hospital, Joetsu, Japan; 3Department of Dermatology, Saiseikai Takaoka Hospital, Takaoka, JapanBackground: The long-term follow-up of chronic urticaria (CU is important to ensure the adequate treatment of patients. Olopatadine hydrochloride is one of the second-generation nonsedating antihistamines.Methods: This study was designed to assess the optimal dose of olopatadine to suppress symptoms of chronic urticarial itch in well-controlled patients. After CU patients were treated with 10 mg olopatadine, patients having a visual analogue scale (VAS itch score of less than 20 were randomly allocated into one of three groups: 10 mg/day (n = 35, 5 mg/day (n = 30, or no medication (n = 32.Results: The suppressive effects of both the 5 mg and 10 mg olopatadine treatments on the VAS itch score were more significant and longer lasting over a period of 4 weeks than the no-medication treatment. Both the 5-mg group and the 10-mg group showed improved urticarial symptoms and maintained their VAS itch score within normal limits compared to the no-medication group. The differences between the 5-mg and 10-mg groups were not significant.Conclusion: These results demonstrate that treatment with olopatadine at a dose of 5 mg once daily is effective and safe for the management and prevention of CU symptoms for itch in well-controlled patients.Keywords: chronic urticaria, olopatadine, dose, antihistamine, itch, histamine

  18. Solar urticaria

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    Srinivas C

    1995-01-01

    Full Text Available A 35-year-old female and a 41-year-old male presented with clinical features suggestive of solar urticaria. The diagnosis of solar urticaria and the effectiveness of a combination of H1 and H2 blocking antihistamines were confirmed by phototesting with a solar simulator

  19. H1-antihistamine up-dosing in chronic spontaneous urticaria: patients' perspective of effectiveness and side effects--a retrospective survey study.

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    Karsten Weller

    Full Text Available BACKGROUND: The guidelines recommend that first line treatment of chronic spontaneous urticaria should be second generation non-sedating H(1-antihistamines with a positive recommendation against the use of old sedating first generation antihistamines. If standard dosing is not effective, increasing the dosage up to four-fold is recommended. The objective of this study was to obtain the chronic spontaneous urticaria-patient perspective on the effectiveness and unwanted effects of H(1-antihistamines in standard and higher doses. METHODOLOGY/PRINCIPAL FINDINGS: This was a questionnaire based survey, initially completed by 368 individuals. 319 (248 female, 71 male, median age 42 years had a physician-confirmed diagnosis of chronic spontaneous urticaria and were included in the results. Participants believed standard doses (manufacturers recommended dose of second generation antihistamines to be significantly (P<0.005 more effective than first generation drugs. Furthermore, they believed that second generation drugs caused significantly (P<0.001 fewer unwanted effects and caused significantly (P<0.001 less sedation than first generation antihistamines. Three-quarters of the patients stated that they had up-dosed with antihistamines with 40%, 42% and 54% reporting significant added benefit from taking 2, 3 or 4 tablets daily respectively. The number of reports of unwanted effects and sedation following up-dosing were not significantly different from those reported for standard doses. CONCLUSIONS: This survey supports the urticaria guidelines recommendations that the first line treatment for chronic spontaneous urticaria should be second generation rather than first generation H(1-antihistamines and that, if standard dosing is not effective, the dosage should be increased up to four-fold.

  20. Richtlijn Chronische urticaria

    NARCIS (Netherlands)

    Urgert, M. C.; Knulst, A. C.

    2015-01-01

    The development of the new Dutch guideline on chronic urticaria started in 2014. In this multidisciplenary guideline, initiated by the NVDV, evidence for predefined outcomes were assessed using the EBRO and GRADE approach. This guideline discusses the nomenclature of CSU. In addition the guideline r

  1. Urticaria crónica con alteraciones de la función tiroidea y anticuerpos antiperoxidasa tiroidea Chronic urticaria with alterations of the thyroid function and thyroid peroxidase antibodies

    Directory of Open Access Journals (Sweden)

    Diego S. Fernández Romero

    2005-06-01

    Full Text Available La urticaria crónica es una enfermedad frecuente, caracterizada por la presencia de ronchas y/o angioedema con una duración superior a las 6 semanas. En un número importante de pacientes se comporta como una enfermedad autoinmune asociada frecuentemente con alteraciones en la función tiroidea y con la presencia de anticuerpos antitiroideos. Presentamos una serie de 70 pacientes consecutivos con diagnóstico de urticaria crónica a los cuales les investigamos la función tiroidea y la presencia de anticuerpos antiperoxidasa tiroidea. Siete (10% tenían diagnóstico de enfermedad tiroidea previa al momento de la consulta. A los 63 pacientes restantes se les estudió los niveles de tirotrofina sérica, 11 de los cuales (17% presentaron valores anormales, que sumados a los 7 con enfermedad previa llegan a 18 (26% con función tiroidea alterada. A 61 pacientes se les investigó anticuerpos antiperoxidasa tiroidea, 22 (36% fueron positivos. De 57 pacientes sin diagnóstico de patología tiroidea previa al momento de la consulta por urticaria, a los que se les estudió tanto los niveles de tirotrofina sérica como la presencia de anticuerpos antiperoxidasa tiroidea, 24 (42% presentaron alguno de los estudios alterados. El alto porcentaje de alteraciones tiroideas en nuestra serie de pacientes resalta la necesidad de estudiar la función tiroidea y la presencia de anticuerpos antiperoxidasa tiroidea en pacientes con urticaria crónica.Chronic urticaria is a frequent pathology, characterized by the presence of hives and/or angioedema lasting longer than 6 weeks. In an important number of patients it behaves as an autoimmune illness, frequently associated with alterations in thyroid function and thyroid antibodies. We herein describe a consecutive series of 70 patients with a diagnosis of chronic urticaria. Seven (10% had a diagnosis of thyroid illness previous to their first consultation. Thyroid function and thyroid antibodies were studied in the

  2. [Interest of allergy tests in urticaria].

    Science.gov (United States)

    Mathelier-Fusade, P

    2014-11-01

    Urticaria is a common skin disease that may affect 20 % of the general population. Most of the time, urticaria is an acute disorder that rarely can be chronic. The difficulty in urticaria is not the clinical diagnosis because the rash is characteristic, but the underlying causes and treatment that result. Urticaria is a benign disease when chronic and potentially dangerous when acute and associated with allergy. This allergy risk, needs an allergy exploration, based on skin tests and / or specific IgE assays. Because allergy is unusual in chronic urticaria, no allergy tests should be performed. By contrast, these tests must be undertaken in case of acute urticaria with a strong suspicion of IgE-mediated reaction because of the risk of severe anaphylaxis in case of allergenic re-exposure.

  3. [Usefulness of studies looking for autoimmunity in patients with spontaneous chronic urticaria].

    Science.gov (United States)

    Rojo-Gutiérrez, María Isabel; Flores-Ruvalcaba, Christian Nataly; Mellado-Ábrego, Jaime; Castillo-Narváez, Gloria; Ramírez-Rojo, Danika Pammela

    2015-01-01

    Antecedentes: la urticaria crónica espontánea es una enfermedad común en los adultos, sobre todo entre las mujeres; esta entidad con frecuencia está relacionada con padecimientos autoinmunitarios. Objetivo: evaluar, mediante estudios de laboratorio, si los pacientes con urticaria crónica espontánea tuvieron signos de autoinmunidad. Material y método: estudio transversal de 35 pacientes del área de Alergia e Inmunología del Hospital Juárez de México, diagnosticados con urticaria crónica espontánea. Se les realizó biometría hemática completa, anticuerpos antitiroideos (antiperoxidasa y tiroglobulina), anticuerpos antinucleares, factor reumatoide, anticoagulante lúpico, células LE, prueba cutánea de suero autólogo (Autologus Serum Skin Test, ASST), complemento (C3 y C4); como estudios adicionales se les realizó prueba de Helicobacter pylori, perfil tiroideo (T3,T4, TSH) y dímero D. Resultados: evaluamos 35 pacientes adultos, 27 eran mujeres. La prueba ASST fue positiva en cuatro pacientes, los anticuerpos antinucleares fueron negativos en todos los casos, pero los anticuerpos antitiroideos resultaron positivos en cuatro pacientes. Las células LE, anticoagulante lúpico, complemento, dímero D, perfil tiroideo y Helicobacter pylori fueron normales o negativos y el factor reumatoide fue positivo en un paciente. Todos los pacientes antitiroideos positivos eran mujeres y de ellas, 26 tuvieron ASST negativa. La correlación entre ASST y AAT no fue significativa. Conclusiones: en nuestro estudio, la mayoría de los pacientes con urticaria crónica espontánea eran mujeres y sólo cuatro tuvieron la prueba ASST positiva, pero esto no se correlaciona con existencia de anticuerpos antitiroideos. La mayor parte de los estudios realizados resultaron normales, por lo que sugerimos no hacer estudios de laboratorio innecesarios en esta afección.

  4. Nederlandse richtlijn Chronische urticaria - Behandeling met omalizumab

    NARCIS (Netherlands)

    Van Den Elzen, M. T.; Urgert, M. C.; Van Doorn, M. B A; Tupker, R. A.; Knulst, A. C.; Van Zuuren, E. J.

    2015-01-01

    The Dutch guideline Chronic Urticaria aims to present a stepped-care model for the treatment of chronic spontaneous urticaria (CSU). In this manuscript omalizumab is discussed as a treatment option. Omalizumab is a humanized monoclonal antibody that selectively binds to immunoglobulin E (IgE). We ha

  5. Nederlandse richtlijn Chronische urticaria - Behandeling met cyclosporine

    NARCIS (Netherlands)

    Van Doorn, M. B A; Urgert, M. C.; Van Den Elzen, M. T.; Tupker, R. A.; Knulst, A. C.; Van Zuuren, E. J.

    2015-01-01

    The Dutch guideline Chronic Urticaria aims to introduce a stepped-care model for the treatment of chronic spontaneous urticaria (CSU). In this manuscript ciclosporin is discussed as potential treatment option. Ciclosporin is a systemic calcineurin inhibitor with immunosuppressive properties. We have

  6. What are the effects of omalizumab in refractory chronic spontaneous urticaria?

    Directory of Open Access Journals (Sweden)

    Mario López

    2015-12-01

    Full Text Available La urticaria crónica espontánea es una enfermedad mediada por degranulación de mastocitos, caracterizada por la aparición de ronchas y/o angioedema por más de seis semanas, con o sin un gatillante conocido. El manejo de primera y segunda línea son los antihistamínicos, pero existen casos refractarios que requieren otras alternativas terapéuticas, dentro de las cuales destaca el omalizumab. Utilizando la base de datos Epistemonikos, la cual es mantenida mediante búsquedas en 30 bases de datos, identificamos cuatro revisiones sistemáticas que en conjunto incluyen cinco estudios aleatorizados. Realizamos un metanálisis y tablas de resumen de los resultados utilizando el método GRADE. Concluimos que el uso de omalizumab disminuye los síntomas y mejora la calidad de vida en pacientes con urticaria crónica espontánea.

  7. Changes in splenic microcirculatory pathways in chronic idiopathic thrombocytopenic purpura.

    Science.gov (United States)

    Schmidt, E E; MacDonald, I C; Groom, A C

    1991-09-15

    The spleen plays a central role in the pathogenesis of chronic idiopathic thrombocytopenic purpura (ITP); it produces massive quantities of antiplatelet antibodies, leading to accelerated phagocytosis of platelets. Lymphoid hyperplasia typically occurs in the spleen, characterized by large numbers of lymphatic nodules with active germinal centers. Whether changes in splenic microcirculatory pathways also occur is not known. We have studied this question by scanning electron microscopy of corrosion casts, comparing spleens removed from patients with ITP with normal spleens obtained from organ transplant donors. The casts demonstrate two major changes in microcirculatory pathways in ITP. Firstly, a striking proliferation of arterioles and capillaries is found in the white pulp and marginal zone (MZ), seen as extensive vascularization in 92.3% of lymphatic nodules (n = 191) versus 0.6% (n = 224) in normal spleens. Secondly, the marginal sinus, a series of flattened, anastomosing vascular spaces between the white pulp and MZ, is absent in 89.4% of lymphatic nodules versus 4.9% in normal spleens. The cause of these microcirculatory changes, which may not be exclusive to ITP, is presently unknown. Absence of the marginal sinus may affect distribution of blood flow through the MZ such that platelets spend increased amounts of time in the proximity of macrophages. In the presence of antiplatelet antibodies found in ITP spleens, this delayed transit would lead to greatly increased platelet destruction.

  8. Urticaria crónica: Evolución clínica, prueba del suero autologo, recuento y activación de basofilos Chronic urticaria: Follow up, autologous serum skin test, basophil count and activation

    Directory of Open Access Journals (Sweden)

    N. Galassi

    2003-01-01

    Full Text Available Recientes estudios sugieren que algunos pacientes con urticaria crónica tienen autoanticuerpos dirigidos contra la IgE o a la cadena alfa de su receptor de alta afinidad FceRIa. La detección de éstos se realiza in vivo mediante la prueba del suero autólogo (PSA o in vitro mediante una variedad de técnicas. Describimos aquí nuestra experiencia con 37 pacientes, 28 mujeres y 9 varones con una relación femenino/masculino de 3.1 y edad promedio de 36.5 años (16-78. La PSA fue positiva en 25 (68% y negativa en 12 (32%. El suero indujo una pápula significativamente más grande que el plasma (122 ± 78 mm² vs 57 ± 66 mm², pRecent advances on the pathogenesis of chronic urticaria have defined a group of patients with autoantibodies directed to the IgE or to the alpha chain of the Fc high affinity receptor of IgE, FceRIa. These antibodies are detected in vivo through the autologous serum test (AST and in vitro with a variety of techniques. We here describe 37 patients with chronic urticaria, 28 female and 9 male, with a f/m ratio of 3.1. Mean age at onset was 36.5 years (range 16-78. AST was positive in 25 (68% of 37 patients. Serum induced a wheal significantly larger than plasma (122 ± 78 mm² vs 57 ± 66 mm², p<0.05. Median persistence of the chronic urticaria, estimated by Kaplan-Meyer analysis, was 437 days, with no difference between AST(+ and AST(- patients (437 vs. 369, p=0.18. Mean IgE concentration was 157 ± 173 IU/mL, as expected in an unselected population. Basophil count was lower in patients compared with controls (17 ± 12 cel/mL vs. 43 ± 27 cel/mL, p< 0.008. Only sera from 2/7(28.6% patients AST (+ and very low basophil count consistently induced expression of CD63. This effect was abrogated in non-releasing basophils, confirming the presence of antibodies directed to the FceRIa-IgE . We conclude that functional antibodies are present in only a minority of patients and that their identification does not predict the outcome.

  9. Estudo da qualidade de vida nos pacientes com urticária crônica Quality of life assessment in patients with chronic urticaria

    Directory of Open Access Journals (Sweden)

    Ana Paula Fusel de Ue

    2011-10-01

    Full Text Available FUNDAMENTOS: A urticária crônica compromete o doente por interferir nas atividades diárias, prejudicar a autoestima e as relações interpessoais. Os profissionais de saúde subestimam seu impacto na qualidade de vida dos doentes. OBJETIVOS: Avaliar a qualidade de vida com questionário específico e genérico. Compará-la entre os tipos clínicos de urticária crônica e avaliar se o angioedema piora a qualidade de vida. MÉTODOS: Participaram 62 doentes com urticária crônica, com sinais e sintomas da doença até 7 dias da consulta, que foram divididos em urticária crônica comum, urticária crônica física e urticária crônica mista. RESULTADOS: Observou-se predominância de mulheres (72,6%, idade média de 39,8 anos, angioedema associado em 75,8% dos doentes. Apresentaram mais angioedema doentes com urticária crônica comum (p=0,011 e mulheres (p=0,024. Quanto aos tipos clínicos, 32,3% apresentaram urticária crônica comum, 27,4% urticária crônica física e 40,3% urticária crônica mista. O escore médio total do questionário específico foi 10,4. No questionário específico, os domínios mais comprometidos foram "Sintomas e sentimentos" e "Atividades diárias", e, no SF-36, "Aspectos físicos" e "Vitalidade". Houve comprometimento da qualidade de vida nas mulheres, nos doentes com até 30 anos, em primeira consulta, nos mais escolarizados, naqueles com até 1 ano de doença e naqueles com angioedema. CONCLUSÃO: A urticária crônica compromete a qualidade de vida medida pelos questionários específico e genérico. Não houve diferença estatisticamente significante na qualidade de vida entre os tipos clínicos. A presença do angioedema conferiu pior qualidade de vida aos doentes. Houve correlação estatisticamente significante entre os escores do questionário específico e do questionário genérico.BACKGROUND: Chronic urticaria affects patients by interfering with their daily activities, damaging their self-esteem and

  10. Comparison of efficacy, safety and cost-effectiveness of rupatadine and olopatadine in patients of chronic spontaneous urticaria: A randomized, double-blind, comparative, parallel group trial

    Directory of Open Access Journals (Sweden)

    Ganesh N Dakhale

    2016-01-01

    Full Text Available Objective: To compare efficacy, safety and cost-effectiveness of rupatadine and olopatadine in patients of chronic spontaneous urticaria. Materials and Methods: A 6-week, single-centered, randomized, double blind, parallel group comparative clinical study was conducted on patients with chronic spontaneous urticaria. Following inclusion and exclusion criteria, 60 patients were recruited and were randomized to two treatment groups and received the respective drugs for 6 weeks. At follow-up, parameters assessed were mean total symptom score (MTSS calculated by adding the mean number of wheals (MNW and the mean pruritus score (MPS, number of wheals, size of wheal, scale for interference of wheals with sleep (SIWS. Results: Both the drugs significantly reduced the MTSS, number of wheals, size of wheal, scale for interference of wheals with sleep, but olopatadine was found to be superior. In olopatadine group, there was significantly higher reduction in MTSS (p = 0.01, Number of wheals (P < 0.05, Size of wheals (p < 0.05, Scale for intensity of erythema (p < 0.05 and change in eosinopils count (p = 0.015 than that of rupatadine. Incidence of adverse effects was found to be less in olopatadine group when compared with rupatadine group. Cost effectiveness ratio was less in olopatadine group as compared to rupatadine group throughout the treatment. Conclusions: Olopatadine is a better choice in chronic spontaneous urticaria in comparison to rupatadine due to its better efficacy, safety and cost effectiveness profile.

  11. [The idiopathic hypereosinophilic syndrome and chronic eosinophilic leukemia].

    Science.gov (United States)

    Chrobák, L; Voglová, J

    2005-12-01

    Idiopathic hypereosinophilic syndrome is a heterogenous group of hematological disorders characterized by eosinophilia (> 1.5 x 10(9)/l) persistent for more than 6 months, exclusion of reactive eosinophilia from other causes, such as parasitic infections or allergy, and evidence of end-organ damage. According to World Health Organization the exclusion includes all neoplastic disorders in which eosinophils are part of the neoplastic clone. Excluded should be also T cell population with aberant phenotype and abnormal cytokine production, recently considert also as "lymphocytic" variants of the HES [42]. HES has to be reclassified as chronic eosinophilic leukemia (CEL) when there is evidence for clonality based on the presence of chromosomal abnormalities or inactivation of X-chromosome in female patients. The successful empiric treatment of patients with tyrosine kinase inhibitor imatinib (Glivec) suggested the presence of an imatinib-sensitive tyrosine kinase inhibitor. The identification of a specific intersticial chromosome deletion del(4)(q12;q12) creating the FIP1L1-PDGFRA fusion gene confirmed this hypothesis. Patients carrying this gene should be reclassified as CEL and detection of this gene is a positive predictor for response to imatinib therapy. Effective doses of imatinib are 100 mg/day. The side effects are minimal. The only exception is an acute left ventricular dysfunction which has been reported in three patients within the first week of treatment with imatinib. Imatinib has been successfully used also in some patients with the constitutively activated thyrosine kinase ETV6-PDGFRbeta [1] and in systemic mast cell disease associated with eosinophilia. Other therapeutical options for HES/CEL have been mentioned. The resistence to imatinib and the possibilities how to overcome it are discussed.

  12. Treatment of Idiopathic Chronic Orchialgia with Transcutaneous Electrical Nerve Stimulation (TENS):A Preliminary Result

    OpenAIRE

    2016-01-01

    Purpose: Unilateral or bilateral testicular pain lasting more than 3 months is called as chronic orchialgia. Aproximately 25-50% of chronic orchialgia is idiopatic origin. This study aimed the effectiveness of Transcutaneous Electrical Nerve Stimulation (TENS) therapy due to Idiopathic Chronic Orchialgia (ICO). Methods: Five patients were included into this study with ICO that diagnosed with physical examination, urine analyses, urinary system x-ray film, and scrotal doppler ultrasound. Me...

  13. Pediatric urticaria.

    Science.gov (United States)

    Tsakok, Teresa; Du Toit, George; Flohr, Carsten

    2014-02-01

    Although urticaria is not a life-threatening disease, its impact on quality of life in children should not be overlooked. A systematic search of online databases, including Medline, was performed to inform a review aiming to equip clinicians with an evidence-based approach to all aspects of pediatric urticaria. This review hinges on an illustrative case and includes a summary table of studies pertaining to disease management in children. The multiple issues faced by patients, their families, and treating clinicians are highlighted, and the current literature on the presentation, natural history, investigation, and management of this poorly understood condition is assessed.

  14. Position statement for the use of omalizumab in the management of chronic spontaneous urticaria in Indian patients

    Directory of Open Access Journals (Sweden)

    Kiran Godse

    2016-01-01

    Full Text Available Chronic spontaneous urticaria (CSU affects 1% of the world population and also their quality of life, and 50% of these patients are refractory to H1-antihistamines. Omalizumab is a humanized monoclonal anti-IgE antibody that binds with free IgE antibodies and reduces the circulating levels of free IgE. This reduction in free IgE prevents mast-cell degranulation. The EAACI/GA2LEN/EDF/WAO guidelines recommend omalizumab as the third-line of therapy as an add-on to antihistamines. The recommended dose of omalizumab is 300 mg, 4 weekly in the management of CSU refractory to standard of care with H1-antihistamines in adults and adolescents ≥12 years of age. In some patients, a dose of 150 mg may be acceptable. Omalizumab has a good safety profile. However, due to the biologic nature of the drug, all patients administered omalizumab must be observed for 2 h after administration for anaphylactoid reactions. There have been no studies on the effect of impaired renal or hepatic function on the pharmacokinetics of omalizumab. While no particular dose adjustment is recommended, omalizumab should be administered with caution in these patients.

  15. Refractory chronic spontaneous urticaria and permanent atrial fibrillation associated with dental infection: Mere coincidence or something more to it?

    Science.gov (United States)

    Kasperska-Zajac, Alicja; Grzanka, Alicja; Kowalczyk, Jacek; Wyszyńska-Chłap, Magdalena; Lisowska, Grażyna; Kasperski, Jacek; Jarząb, Jerzy; Misiołek, Maciej; Kalarus, Zbigniew

    2016-03-01

    Controversy surrounds the role of dental infection/inflammation in the oral cavity in chronic spontaneous urticaria (CSU) and atrial fibrillation (AF), which is mainly due to scarce literature in this area. Therefore, this case report and review of literature illustrate a possible association between the acute-phase response (APR) and clinical conditions, such as CSU and dental infection/inflammation of oral cavity and AF.We describe a 36-year-old man with an 8-year history of difficult-to-treat, uncontrolled CSU, co-existent with dental infection/inflammatory processes of oral cavity and permanent atrial fibrillation (AF). In the presented case, the most likely triggering or aggravating/maintaining factor of the symptoms was the inflammation/dental infection of the oral cavity because of rapid reduction of the urticarial symptoms, drug doses, and serum CRP levels after the dental therapy. Dental treatment may have a beneficial effect on the systemic inflammatory response, reducing/normalizing the circulating levels of APR markers. APR activation appears to worsen CSU course, early identification and treatment of infectious/inflammatory foci in the oral cavity would form the mainstay of supportive therapy for CU probably through reduction of the systemic inflammatory burden. APR associated with infectious/inflammatory foci in the oral cavity could be taken into account as a predisposing agents to AF.

  16. Coagulation mechanisms are involved in the pathogenesis of chronic urticaria: an update%凝血机制参与慢性荨麻疹发病的研究进展

    Institute of Scientific and Technical Information of China (English)

    刘佳; 农祥

    2016-01-01

    凝血机制与慢性荨麻疹有关.内外凝血途径均参与其发病,同时被激活产生凝血酶.凝血酶不仅可以直接作用于血管内皮细胞,增加血管通透性,还可以间接使肥大细胞脱颗粒释放组胺,从而诱发荨麻疹.慢性荨麻疹患者检测出的一些凝血标记物也间接证明凝血机制参与其发病.在慢性荨麻疹发病过程中,凝血机制与炎症反应机制、自身免疫机制和血管机制密切相关.对于抗组胺治疗无效的顽固性荨麻疹患者,抗凝血治疗提供了新的思路和方向.%Recent studies have suggested that coagulation mechanisms are associated with chronic urticaria.Both the intrinsic and extrinsic pathways of blood coagulation are involved in the pathogenesis of chronic urticaria, which are activated simultaneously followed by the generation of thrombin.Thrombin can not only directly act on vascular endothelial cells and increase vascular permeability, but also can indirectly induce mast cells to degranulate and release histamine, and then cause the development of urticaria.Some coagulation markers have been found in patients with chronic urticaria, which indirectly suggests the involvement of coagulation mechanisms in the pathogenesis of chronic urticaria.In the development of chronic urticaria, coagulation mechanisms are closely related to inflammatory response mechanisms, autoimmune mechanisms and vascular mechanisms.Anti-coagulation treatments have provided new ideas and directions for the treatment of intractable urticaria unresponsive to antihistamines.

  17. Evaluation of Three Kinds of Antihistamines Curative Effect for the Treatment of Chronic Idiopathic Urticarial%评价3种抗组胺药治疗慢性特发性荨麻疹的疗效

    Institute of Scientific and Technical Information of China (English)

    陈海兵

    2015-01-01

    目的:评价3种抗组胺药治疗慢性特发性荨麻疹的疗效。方法选取于我院就诊的慢性特发性荨麻疹患者90例作为研究对象,随机分为三组,每组各30人,分别给予西替利嗪药物治疗、氯雷他定药物治疗、依巴斯丁药物治疗。结果第7天、14天、28天三组有效率为:氯雷他定组分别为70.00%、83.33%、93.33%;西替利嗪组分别为66.67%、86.67%、90.00%;依巴斯丁组分别为76.67%、86.67%、96.67%。结论三种抗组胺药物在临床治疗慢性特发荨麻疹上都具有较好的效果,具有临床应用价值。%Objective To evaluate three kinds of antihistamines curative effect for the treatment of chronic idiopathic urticaria. Methods 90 patients with chronic idiopathic urticaria were selected from our hospital as research object, randomly dividing into three groups (30 people a group). Cetirizine group was given cetirizine medication, loratadine group was given loratadine drug therapy, by buss butyl group was given by buss butyl drug therapy. Results 7 days, 14 days, the effective rate of 28 days three groups:loratadine group was 70.00%, 83.33%and 70.00%respectively. Cetirizine group was 66.67%, 86.67%and 66.67%respectively. By bass butyl group 76.67%, 86.67, 96.67, respectively. Conclusion The three kinds of antihistamines in clinical treatment of chronic idiopathic urticaria had good effect, had clinical application value.

  18. Familial progressive neuronal disease and chronic idiopathic intestinal pseudo-obstruction.

    Science.gov (United States)

    Steiner, I; Steinberg, A; Argov, Z; Faber, J; Fich, A; Gilai, A

    1987-06-01

    Chronic idiopathic intestinal pseudo-obstruction (CIIP) is characterized by recurrent episodes of bowel obstruction without mechanical cause. In five members of two Jewish-Iranian families, CIIP was associated with progressive neuronal disease, starting before age 30, with ophthalmoplegia, sensorimotor peripheral neuropathy, and hearing loss. There was no evidence of CNS involvement. The pattern suggested autosomal recessive inheritance.

  19. Long-term outcomes of combined chemotherapy in chronic refractory idiopathic thrombocytopenic purpura

    Institute of Scientific and Technical Information of China (English)

    TAO Jie; HUANG Ying; LI Hong-qiang; WANG Ting-ting; WANG Xiao-yan; JI Lin-xiang; YANG Ren-chi

    2007-01-01

    @@ Adult idiopathic thrombocytopenic purpura (ITP) is a chronic acquired organ-specific autoimmune hemorrhagic disease characterized by the production of auto-antibodies against antigens on the membranes of platelet, resulting in enhanced Fc-mediated destruction of the platelets by macrophages in the reticuloendothelial system.

  20. Coexistence of chronic renal failure, hashimoto thyroiditis and idiopathic hypoparathyroidism: a rare case report.

    Science.gov (United States)

    Yildiz, Saliha; Soyoral, Yasemin; Demirkiran, Davut; Ozturk, Mustafa

    2014-04-01

    Hypoparathyroidism is an uncommon disease and its coexistence with chronic renal failure is quite rare. Hypocalcemia and hyperphosphatemia are seen in both diseases. Diagnosis of hypoparathyroidism may be overlooked when parathormone response is not evaluated in patients with chronic renal failure. A 19-year-old female patient who had been receiving hemodialysis for 3 years because of chronic renal failure was diagnosed as idiopathic hypoparathyroidism and hashimoto thyroiditis. When her medical records on the first admission and medical history were evaluated, hypoparathyroidism and hashimoto thyroiditis were seen to be present also when she was started hemodialysis. Idiopathic hypoparathyroidism should be suspected in case as absence of parathormone response to hypocalcemia in patients with chronic renal failure. It should be taken into consideration that hashimoto thyroiditis may accompany and required analysis should be done.

  1. Efficacy of the Treatment of Chronic Urticaria With the Combination of the Western and Western for the Treatment of Chronic Urticaria%左西替利嗪联合卡介菌多糖核酸治疗慢性荨麻疹疗效观察

    Institute of Scientific and Technical Information of China (English)

    张艳玲; 张曦予

    2015-01-01

    Objective To investigate the efficacy of the treatment of chronic urticaria by the combination of the treatment of the treatment of chronic urticaria with the combination of the western and western. Methods 84 cases of chronic urticaria hospital patients were divided into two groups, left-cetirizine treatment, observation group left cetirizine joint BCG nucleic acid treatment. Results The total effective rate was 92.86%, the total efficiency of the control group was 71.42%, compared to a significant difference. Conclusion The patients with chronic urticaria left cetirizine joint card PSN treatment, can significantly improve the therapeutic effect.%目的:探讨左西替利嗪联合卡介菌多糖核酸治疗慢性荨麻疹的疗效。方法将我院84例慢性荨麻疹患者分为两组,对照组采用左西替利嗪治疗,观察组采用左西替利嗪联合卡介菌多糖核酸治疗。结果观察组治疗总有效率是92.86%,对照组治疗总有效率是71.42%,对比差异显著。结论慢性荨麻疹患者采用左西替利嗪联合卡介菌多糖核酸治疗,能够明显提高治疗效果。

  2. Effects observation on treating chronic urticaria in the integrative medicine%中西医结合治疗慢性荨麻疹效果探讨

    Institute of Scientific and Technical Information of China (English)

    王晓丽

    2014-01-01

    Objective:To investigate the integrative clinical effect in treating chronic urticaria. Methods:60 patients with chronic urticaria were randomly divided into two groups of 30 cases for each. The control group were treated with western medicine, the observation group were treated in the integrative therapy. Results: The effective rate of the observed group was 96.67%, in the control group patients effective rate 66.67%, significant different (P0.05). Conclusion:The integrative therapy for chronic urticaria has significant clinical effect, fewer complications, should be widely applied.%目的:探讨中西医结合治疗慢性荨麻疹的临床效果。方法:将60例慢性荨麻疹患者随机分为两组,每组30例,分别标记为对照组、观察组。对照组患者给予西医治疗,观察组患者给予中西医结合治疗,比较两组患者治疗效果。结果:观察组患者治疗有效率为96.67%,对照组患者治疗有效率为66.67%,两组间差异具有统计学意义(P0.05)。结论:中西医结合治疗慢性荨麻疹临床效果显著,并发症少,值得推广应用。

  3. Solar urticaria successfully treated with intravenous immunoglobulin.

    LENUS (Irish Health Repository)

    Hughes, R

    2012-02-01

    Idiopathic solar urticaria (SU) is a rare, debilitating photodermatosis, which may be difficult to treat. First-line treatment with antihistamines is effective in mild cases, but remission after phototherapeutic induction of tolerance is often short-lived. Other treatment options include plasma exchange, photopheresis and cyclosporin. We present two cases of severe, idiopathic SU, which were resistant to conventional treatment. Both patients achieved remission after administration of intravenous immunoglobulin (IVIg) and have remained in remission at 13 months and 4 years, respectively. There are only two case reports of successful treatment of solar urticaria with IVIg. In our experience IVIg given at a total dose of 2 g\\/kg over several 5-day courses about a month apart is an effective treatment option for severe idiopathic SU. It is also generally safe, even if certainly subject to significant theoretical risks, such as induction of viral infection or anaphylaxis.

  4. Diagnosis of urticaria.

    Science.gov (United States)

    Schoepke, Nicole; Doumoulakis, Georgios; Maurer, Marcus

    2013-05-01

    Acute urticaria do not need extensive diagnostic procedures. Urticaria activity score is a useful tool for evaluation of urticaria. Complete blood count, Erythrocyte sedimentation rate and C reactive protein are important investigations for diagnosis of infections in urticaria. Autologous serum skin test is a simple office procedure for diagnosis of auto reactive urticaria. Closed ball point pen tip is a simple test to diagnose dermographism.

  5. Diagnosis of urticaria

    Directory of Open Access Journals (Sweden)

    Nicole Schoepke

    2013-01-01

    Full Text Available Acute urticaria do not need extensive diagnostic procedures. Urticaria activity score is a useful tool for evaluation of urticaria. Complete blood count, Erythrocyte sedimentation rate and C reactive protein are important investigations for diagnosis of infections in urticaria. Autologous serum skin test is a simple office procedure for diagnosis of auto reactive urticaria. Closed ball point pen tip is a simple test to diagnose dermographism.

  6. Diagnosis of urticaria

    OpenAIRE

    Nicole Schoepke; Georgios Doumoulakis; Marcus Maurer

    2013-01-01

    Acute urticaria do not need extensive diagnostic procedures. Urticaria activity score is a useful tool for evaluation of urticaria. Complete blood count, Erythrocyte sedimentation rate and C reactive protein are important investigations for diagnosis of infections in urticaria. Autologous serum skin test is a simple office procedure for diagnosis of auto reactive urticaria. Closed ball point pen tip is a simple test to diagnose dermographism.

  7. 幽门螺杆菌感染与慢性荨麻疹的相关性研究进展%Progress in the research of Helicobacter pylori and chronic urticaria

    Institute of Scientific and Technical Information of China (English)

    廖理超; 胡白

    2011-01-01

    慢性荨麻疹是一种常见的过敏性皮肤病,病因复杂,治疗棘手.机体内存在的慢性感染如幽门螺杆菌感染可能参与了慢性荨麻疹的发生与发展,针对幽门螺杆菌的治疗能够缓解部分患者的症状,关于两者之间相关性的研究较多,但结果尚存争议.本文对近年来有关幽门螺杆菌感染与慢性荨麻疹的相关性研究进展作一综述.%Chronic urticaria is a common allergic skin diseases with complex causes and intractable. Chronic infections such as Helicobacter pylori in body may be involved in the occurrence and development of chronic urticaria. The radical treatment against Helicobacter pylori can relieve symptoms in some patients. There are disputes on the research of the correlation between Helicobacter pylori and chronic urticaria.This article reviews the research works about the relationship between Helicobacterpylori and chronic urticaria in recent years.

  8. Ginecomastia induzida por anti-histamínicos no tratamento da urticária crônica Antihistaminic-induced gynecomastia in chronic urticaria treatment

    Directory of Open Access Journals (Sweden)

    Ana Paula Fusel de Ue

    2007-06-01

    Full Text Available Os anti-histamínicos são drogas muito usadas na prática do dermatologista, sendo a primeira escolha no tratamento da urticária crônica. Os efeitos colaterais mais comuns são os relacionados ao sistema nervoso central. A ginecomastia é decorrente de várias causas, entre elas a indução por drogas. Apresenta-se caso de ginecomastia induzida por anti-histamínico H1,em paciente em tratamento de urticária crônica. A investigação laboratorial e radiológica descartou outras causas para a ginecomastia, que involuiu com a retirada da medicação. Objetiva-se discutir os efeitos colaterais dos anti-histamínicos e apresentar caso de ginecomastia induzida por drogas.Antihistaminic drugs are very commonly used in dermatological practice, and are the first-line therapy to chronic urticaria. The commonest side effects are related to the central nervous system. Gynecomastia, in turn, may be due to a myriad of disorders, including the use of medication. The case of H1 antihistaminic-induced gynecomastia in a patient undergoing chronic urticaria treatment is reported. Radiological and laboratorial investigations discarded other possible causes for the gynecomastia, which disappeared after removal of the medication. Antihistaminic-related side effects, including gynecomastia, are discussed.

  9. Management of difficult urticaria

    Directory of Open Access Journals (Sweden)

    Yadav Sudha

    2009-01-01

    Full Text Available Chronic urticaria, a major health problem causing patient′s distress, induces often physicians′ dilemma while dealing with its etiology, investigations and management. Clinical approach of such cases should include apart from clinical history and physical examination laboratory investigations like routine blood test, thyroid profile, etc. as well as sometimes special test like autologous serum skin test. Management includes reassurance, avoidance of precipitating factors, treatment of underlying disorders, and non-pharmacological approach along with pharmacotherapy. First line drug therapy comprises non-sedative and sedative antihistamines, second line doxepin, nifedipine, leukotriene-inhibitors, sulfasalazine, etc. and third line cyclosporine, dapsone, colchicin, etc.

  10. Clinical epidemiological characteristics of chronic urticaria: report of 535 cases%535例慢性荨麻疹临床流行病学特征分析

    Institute of Scientific and Technical Information of China (English)

    罗婕; 郝飞; 宋志强; 钟华; 尹锐; 黄秀英; 李垚莹; 程良金; 向明明; 王莉

    2011-01-01

    目的 了解慢性荨麻疹(chronic urticaria,CU)临床流行病学特征.方法 以2010年1月1日至9月30日,对临床确诊为CU的535例患者进行问卷调查.调查数据录入EpiData数据库,运用SPSS 13.0统计软件进行分析.结果 共收到有效问卷535例,其中男性204例,女性331例,年龄(34.4±14.0)岁,初发年龄(30.6±14.8)岁,以20~40岁多见.诱发因素中物理因素94例(17.6%),药物23例(4.3%),食物29例(5.4%),精神因素39例(7.3%),工作压力9例(1.7%),蚊虫叮咬24例(4.5%),其他54例(10.0%),无明显诱因263例(49.2%).临床分型中最常见是慢性自发性荨麻疹(chronic spontaneous urticaria,CSU)294例(55.0%),其次皮肤划痕症120例(22.4%),未发现延迟压力性、震动性和运动诱发性荨麻疹.CU伴血管性水肿105例(19.6%),其中,女性70例(21.1%),CSU 76例(25.9%).自体血清皮肤试验(ASST)总阳性率为49.6%.结论 CU发病以青壮年为主,临床表现形式多样,伴发血管性水肿并非少见.关注CU的临床流行病学特征,有利于指导临床治疗.%Objective To investigate clinical epidemiological charateristics of chronic urticaria (CU). Methods A survey was conducted to clinically diagnosed CU patients in our hospitals from January to September 2010. All these subjects received physical examination by dermatologists and were required to fulfill the self-report questionnaires. EpiData and SPSS 13.0 were utilized for statistical analysis. Results Totally, there were 535 valid questionnaires returned in this survey. Of them, 204 were male and 331 were female with a mean age of 34.4 ± 14.0. The average age of these subjects at first onset was 30.6 ± 14.8. The prevalence of CU peaked in patients aging from 20 to 40 years. The self-reported eliciting factors of urticaria were as follows: physical stimuli 94 ( approximately 17. 6% ), drugs 23 (4. 3% ) , foods 29 (5. 4% ) , mental factor 39 (7. 3% ), working pressure 9 (1.7%), mosquito 24 (4. 5

  11. Urticaria: impact on quality of life and economic cost.

    LENUS (Irish Health Repository)

    O'Donnell, Brigid F

    2014-02-01

    Patients with urticaria suffer itch, swellings, fatigue caused by sleep disturbance and the side effects of medication, and disruption of many facets of their lives. Much progress has been made in formally evaluating the degree of quality-of-life (QoL) impairment suffered by patients with urticaria. This review focuses on QoL in chronic urticaria (>6 weeks duration) and examines QoL measures, including the chronic urticaria-quality of life questionnaire (CU-Q2oL). Patients with urticaria have difficulty identifying and coping with their emotions. The psychiatric comorbidity and the financial burden on the patient and society because of chronic urticaria, is also examined.

  12. Lubiprostone: a new drug for the treatment of chronic idiopathic constipation.

    Science.gov (United States)

    Baker, Danial E

    2007-01-01

    Lubiprostone offers an additional alternative for patients with chronic idiopathic constipation. Lubiprostone is more efficacious than placebo in the treatment of chronic idiopathic constipation. In placebo-controlled clinical trials, lubiprostone therapy was generally well tolerated and was not associated with severe adverse effects; however, the high incidence of nausea may be problematic for some patients. The nausea may be alleviated or minimized by administering the dose with food, and some patients may require a dosage reduction to 24 mug once daily. The key limitations of the placebo-controlled clinical trials include the absence of information regarding the duration of the constipation and previous types of therapies that had been used to treat the constipation and the absence of an active control group. Comparative studies with other therapies (eg, saline laxatives, polyethylene glycol) used for constipation are necessary to determine the clinical and economic value of this agent relative to other forms of therapy.

  13. Autologous serum skin test response in chronic spontaneous urticaria and respiratory diseases and its relationship with serum interleukin-18 level.

    Science.gov (United States)

    Kurt, Emel; Aktas, Ayse; Aksu, Kurtulus; Keren, Metin; Dokumacioglu, Ali; Goss, Christopher H; Alatas, Ozkan

    2011-11-01

    Autologous serum skin test (ASST) is mostly used in chronic spontaneous urticaria (CSU) to show autoreactivity. Interleukin-18 (IL-18) has also been shown to be involved in autoimmune conditions. To investigate the role of autoreactivity assessed by ASST in CSU and respiratory diseases and to investigate whether this autoreactive state is related to IL-18 level or other clinical covariates. Fifty-five patients with CSU (mean age: 40.3 ± 12.3 years), 70 patients with persistent asthma (mean age: 43.7 ± 9.6 years), 21 patients with seasonal allergic rhinitis (SAR) (mean age: 35.5 ± 11.8 years) and 20 normal controls (mean age: 37.7 ± 9.8) were included. All subjects underwent a laboratory examination and skin prick test. ASST was performed and serum IL-18 levels were measured in all subjects. Positive response to ASST and serum IL-18 levels were higher in CSU patients than those with respiratory diseases (asthma and SAR) (P = 0.034 and 0.002, respectively) and normal controls (P = 0.004 and 0.031, respectively). Considering all patients, IL-18 levels were higher in patients with positive ASST (301.8 ± 194.4 vs. 241.8 ± 206.3 pg/ml, P = 0.036) than ASST negative patients. ASST response was associated with disease severity in CSU (P = 0.037) and asthma patients (P = 0.001). Multivariate analysis showed that positive response to ASST was significantly associated with diagnosis of CSU (OR: 3.13, 95% CI: 1.25-7.87) and female gender (OR: 3.98, 95% CI: 1.19-13.38). ASST response could be related with activity of the disease. A positive ASST response found in respiratory diseases patients suggests that it may occur as a result of some inflammatory events during the diseases' process.

  14. [Chronic cough and worsening dyspnea: a case of idiopathic tracheal stenosis].

    Science.gov (United States)

    Conti, Valentina; Calia, Nunzio; Pasquini, Claudio; Zardi, Silvia; Finetti, Cinzia; Stomeo, Francesco; Ravenna, Franco

    2013-04-01

    We report a case of idiopathic tracheal stenosis in a 75-year-old woman, who presented to our observation with a diagnosis of asthmatic bronchitis characterized by cough and exertional dyspnea, later complicated by the appearance of tirage. Biopsy of the lesion showed focal squamous metaplasia of the epithelium lining, multiple sclerosis and chronic inflammatory infiltration of the corium. The patient was treated with endoscopic destruction via rigid bronchoscopy, through the combined action of YAG laser and mechanical debulking.

  15. Small bowel volvulus in a patient with chronic idiopathic intestinal pseudo-obstruction

    OpenAIRE

    Youssef, Haney; Rashid, Sidi H; Cellador, Enrique Collantes; Baragwanath, Phil

    2009-01-01

    Chronic idiopathic intestinal pseudo-obstruction (CIIP) is a rare syndrome of ineffectual gut motility associated with clinical, endoscopic and radiological exclusion of mechanical causes, as well as evidence of air–fluid levels in distended bowel loops. A case of small bowel volvulus in a patient with an established diagnosis of CIIP is presented. The case is illustrated by images of operative findings and computed tomography scan reconstruction, showing the classical appearances of small bo...

  16. The impact of chronic urticaria on the quality of life in Indian patients

    Directory of Open Access Journals (Sweden)

    A V Pherwani

    2012-01-01

    Full Text Available Backgound : Besides the relief of symptoms, the main purpose of any treatment must be to ensure a better quality of life (QOL. Mere recording of symptoms reveals their severity and frequency, but gives scant information on its effect on QOL. Aim: The study was designed to assess QOL in Indian patients with chronic urticaia (CU. Subjects and Methods: We used the validated CU-QOL by Bairadani et al., consisting of five domains and each domain consisting of several items. Each item was scored from 1 to 5 (score 5 = most affected, score 1 = not affected. Criteria for Inclusion: Patients having symptoms of rash and pruritis on most of the days for at least 6 weeks were enrolled. Criteria for Exclusion: If the individuals had CU secondary to any other disease, they were excluded. Results: We enrolled 48 patients. The means of the domains, the items, and the frequency of occurrence of an item were tabulated. The highest mean scores were in the domains of symptoms, followed by sleep disturbances, life activities, looks, and limits. The highest mean scores for the items were for pruritis and wheals followed by sleep disturbances, mood changes, nervousness, embarrassment, fatigue, loss of concentration, reduced work, and social relationships. We also observed a significant relationship among individual items. It is possible that they may have an additive effect. Conclusions: Even though CU significantly affected many items, patients were rarely aware of them. There was a significant inter-item correlation, suggesting that items might be aggravating each other. It is important to address the issues regarding QOL along with symptoms for better management of CU.

  17. Idiopathic erythrocytosis in a patient on chronic hemodialysis

    Directory of Open Access Journals (Sweden)

    Dong Hyun Lee

    2015-03-01

    Full Text Available A 78-year-old man on hemodialysis presented to our hospital with erythrocytosis. He had started hemodialysis 4 years previously, with a hemoglobin level of 9.8 g/dL, and was administered erythropoiesis stimulating agents and ferrous sulfate. Two years previously, his hemoglobin level increased to 14.5 g/dL and the treatment for anemia was discontinued. He continued hemodialysis thrice weekly; however, the hemoglobin level had increased to 17.0 g/dL at the time of presenting to our hospital. His serum erythropoietin level was 31.4 mIU/mL (range, 3.7–31.5 mIU/mL, carboxyhemoglobin level was 0.6% (range, 0–1.5%, and oxygen saturation in ambient air was 95.4%. The JAK2 V617F mutation was not observed and other bone marrow abnormalities were not identified. The patient was diagnosed with bladder cancer and a transurethral resection was performed. Eight months after the treatment of bladder cancer, his hemoglobin level was 15.1 g/dL, and he was diagnosed with idiopathic erythrocytosis.

  18. Diagnostic Value of Plasma Tumor Necrosis Factor-α Concentration for Chronic Urticaria%血浆TNF-α浓度对慢性荨麻疹的诊断价值

    Institute of Scientific and Technical Information of China (English)

    雷素珍

    2012-01-01

    Objective To investigate the changes of plasma necrosis factor-α concentration in patients with chronic urticaria and analyze its diagnostic value. Methods 86 patients with chronic urticaria and 86 healthy controls were enrolled in this study. Determining plasma tumor necrosis factor-α (TNF-α) concentration with ELISA. Statistical analysis was taken. Results Plasma TNF-α concentration was significantly higher in patients than those of healthy controls (4.2 ±1.8 ng/ml vs 1.8 ±0.7)ng/ml, P2.8 ng/ml) that dignosed chronic urticaria with high sensitivity (83.1% ) and specificity (79. 1% ) respectively. Conclusion TNF-α may be involved in pathogenesis of chronic urticaria, and its concentration can effectively in diagnosis of chronic urticaria.%目的:揭示慢性荨麻疹患者血浆肿瘤坏死因子-α(TNF-α)浓度的变化,分析其对慢性荨麻疹的诊断价值.方法:选取门诊治疗的慢性荨麻疹患者及健康体检者各86例,ELISA检测血浆TNF-α浓度,对数据进行统计分析.结果:慢性荨麻疹患者血浆TNF-α浓度(4.2±1.8)ng/ml显著高于对照组(1.8±0.7)ng/ml(P2.8 ng/ml),对诊断慢性荨麻疹有较高的灵敏度(83.7%)和特异度(79.1%).结论:TNF-α可能参与慢性荨麻疹的发病机制,其浓度可有效诊断慢性荨麻疹.

  19. 579 The Frequency of Positivity in Autologous Serum Skin Test in Patients with Chronic Idiopatic Urticaria

    OpenAIRE

    Filho, Silvio Lima

    2012-01-01

    Background Describe the frequency of positive results in autologus serum skin test among patients with cronic urticaria. Methods Trans-sectional study of patients with CIU refered to traitment in policlínica geral do Rio de Janeiro, brazil. Autologus serum intradermal injections were used to estabilished the sensitivity. Negative and positive controls were made with 0.9% intradermal saline solution and skin prick test with histamina 1:100 solution. Autoreactivity was considered positive when ...

  20. Expression of complement receptor type 1 on erythrocytes and its correlation with immunoglobulin E,complement C3 and C4 expressions in patients with chronic urticaria%慢性荨麻疹患者红细胞补体受体1分子表达及外周血IgE和补体C3、 C4水平的相关性研究

    Institute of Scientific and Technical Information of China (English)

    罗颖; 晏洪波; 周凌; 杨李; 夏罡

    2012-01-01

    目的 探讨红细胞补体受体1(CR1)在慢性荨麻疹发病机制中的作用及意义.方法 慢性荨麻疹患者59例,其中含人工划痕症14例,慢性特发性荨麻疹45例,采用流式细胞仪检测外周血红细胞CR1的表达,并采用双抗体夹心酶联免疫吸附法(ELISA)检测外周血补体C3、C4、CH50及IgE水平.29例健康人作为对照组.利用ONE-WAY ANOVA进行三组样本间均数比较,两组均数的比较采用独立样本t检验,相关分析采用Pearson相关分析法.结果 外周血红细胞CR1的表达水平人工划痕症组为35.06±2.06(10 000个红细胞表面的荧光强度)、慢性特发性荨麻疹组为29.17±1.53,均高于健康对照组(20.46±2.57),t值分别为4.20、3.33,P值均<0.05,人工划痕症组与慢性特发性荨麻疹组间差异无统计学意义(P>0.05).外周血IgE水平人工划痕症组为(769.89±123.06) μg/L,慢性特发性荨麻疹组为(340.09±29.74) μg/L,均高于健康对照组(107.63±88.79μg/L),t值分别为5.58、5.85,P值均<0.05,人工划痕症组高于慢性特发性荨麻疹组(t=3.49,P< 0.05).慢性荨麻疹患者中IgE为0~240 μg/L的22例患者CR1水平(24.45±10.83)与IgE为500 μg/L以上的17例患者CR1水平(33.09±11.86)差异有统计学意义(t=3.33,P<0.05).血清总IgE与CR1水平呈显著正相关(r=0.27,P< 0.05),与C3(r=0.16,P> 0.05)、C4(r=-0.08,P> 0.05)均无相关性.C3与C4具有正相关(r=0.54,P< 0.01).3组C3、C4和CH50水平经ONE-WAY ANOVA检验,差异均无统计学意义(P>0.05).结论 红细胞CR1在慢性荨麻疹患者中的表达存在异常.%Objective To investigate the role of erythrocyte complement receptor type 1 (CR1) in the pathogenesis of chronic urticaria.Methods Venous blood samples were collected from 59 patients with chronic urticaria (including 14 cases of dermatographism and 45 chronic idiopathic urticaria) and 29 healthy human controls.Flow cytometry was carried out to quantify the expression level of CR1,and

  1. Prolonged idiopathic gastric dilatation following revascularization for chronic mesenteric ischemia.

    Science.gov (United States)

    Gauci, Julia L; Stoven, Samantha; Szarka, Lawrence; Papadakis, Konstantinos A

    2014-01-01

    A 71-year-old female presented with nausea, emesis, early satiety, and abdominal distension following revascularization for chronic mesenteric ischemia. Computed tomography angiogram showed gastric dilatation. Esophagogastroduodenoscopy, small bowel follow through, and paraneoplastic panel were negative. Gastric emptying was delayed. Despite conservative management, she required a percutaneous endoscopic jejunostomy. The development of a prolonged gastroparetic state has not been previously described.

  2. Huang Yaozhou's Experiences in the Treatment of Chronic Urticaria%黄尧洲治疗慢性荨麻疹经验

    Institute of Scientific and Technical Information of China (English)

    曲韵; 付中学

    2015-01-01

    文章介绍黄尧洲教授治疗慢性荨麻疹的临证经验。慢性荨麻疹是一种常见病多发病,现代医学认为其发病原因较为复杂,以对症治疗为主,常用抗组胺药等药物。黄尧洲教授认为慢性荨麻疹的发生多与先天禀赋不足、脏腑功能失调、感受外邪有关,外感邪气、服用药物、饮食不节等是发病的主要诱因。提出镇心安神、疏风止痒是治疗的主要大法,临床遣方用药以重镇药物为主,辅以疏风止痒之品。常用药物包括生龙骨、煅牡蛎、防风、仙鹤草、麻黄根等,再根据不同发病诱因进行加减,常取得良效。%In the paper,Prof. Huang Yaozhou's experiences in the clinical treatment of chronic urti-caria were introduced. Chronic urticaria is a common highly - attack disease. The modern medicine thinks that the causative factors of the disease are complicated and the symptomatic treatment is commonly applied with antihistaminics. Prof. Huang believes that chronic urticaria is relevant with congenital insufficiency,dysfunc-tion of zangfu organs and invasion of exogenous factors. The invasion of exogenous factors,medication and im-proper diet are the main inducing factors. The major principles of treatment are tranquilizing the mind,disper-sing wind and stopping itching. The drugs for tranquilization are the main ones,assistant with the drugs for dispersing wind and stopping itching. The common drugs are os draconis,concha ostreae,radices sileris,agri-monia pilosa and radix ephedra. The formula is modified according to the inducing factors. The good efficacy is achieved.

  3. Urticaria y angioedema

    OpenAIRE

    Serrano Reyes Carlos Daniel; Fundación Valle de Lili

    2007-01-01

    ¿Por qué se produce la urticaria y el agioedema?/¿Cuáles son los tipos y las causas de urticaria y angioedema?/¿Qué se debe hacer para tratar de aclarar la causa?/¿Cómo se tratan las urticarias y angioedema?

  4. 地氯雷他定治疗慢性荨麻疹临床观察%Desloratadine for chronic urticaria

    Institute of Scientific and Technical Information of China (English)

    杨亚胜

    2012-01-01

    目的 观察地氯雷他定治疗慢性荨麻疹( chronic urticaria)的临床疗效及安全性.方法 将92例慢性荨麻疹患者随机分为治疗组和对照组,各46例.治疗组口服地氯雷他定片5 mg,1次/d,连续治疗28 d;对照组口服西替利嗪片10 mg,1次/d,连续治疗28 d.采用症状和体征总积分法评估疗效.结果 治疗后第28天,治疗组痊愈率和总有效率分别为82.61%和95.65%,对照组痊愈率和总有效率分别为60.87%和80.43%,两组疗效比较差异有统计学意义(Uc=6.0922,P=0.0136).治疗组1例患者出现嗜睡,对照组16例出现嗜睡,两组不良反应发生率比较差异有统计学意义(x2=14.5607,P<0.01).结论 地氯雷他定治疗慢性荨麻疹是安全有效的.%Objective To investigate the efficacy and safety of desloratadine in the treatment of chronic urticaria.Methods Nity-two adult patients with chronic urticaria were randomly divided into study group and control group,46 for each group.The study group received 10 mg desloratadine orally once daily for 28 days,while the control group received cetirizin orally.The efficacy was assessed by the total scores for symptoms and signs.Results 28 days after treatment,the cure rate was 82.61% and the total effectiveness rate was 95.65% in the study group; and they were 60.87% and 80.43% in the control group,respectively.The efficacy differed significantly between the two groups ( Uc =6.0922,P=0.0136 ).Hypersomnia occurred in one patient in the study group but in sixteen patients in the control group.There were significant differences in adverse reactions between the two groups ( x2=14.5607,P < 0.01 ).Conclusions Desloratadine is effective and safe in the treatment of chronic urticaria.

  5. Acceptance and Commitment Therapy in the Rehabilitation of a Girl with Chronic Idiopathic Pain: Are We Breaking New Ground?

    Science.gov (United States)

    Asmundson, Gordon J. G.; Hadjistavropolous, Heather D.

    2006-01-01

    Wicksell and colleagues (2005) addressed the important and currently understudied realm of chronic idiopathic musculoskeletal pain treatment in children. They presented a brief overview of empirically supported treatments for children with chronic pain, detailed their case and intervention strategy, and offered conclusions regarding the potential…

  6. Caffeine as a cause of urticaria-angioedema

    Directory of Open Access Journals (Sweden)

    Linda Tognetti

    2014-01-01

    Full Text Available We report the case of a young woman presenting with recurrent urticaria. The episodes occurred both in and out of the workplace. On three occasions it presented as urticaria-angioedema, requiring emergency care on one occassion. A thorough clinical history along with serological and allergological tests allowed a diagnosis of caffeine-induced urticaria-angioedema. We advised the patient to follow a caffeine-free diet and to avoid all caffeine or methylxanthine-containing drugs. After two years of caffeine abstinence, she had not experienced any further episodes of urticaria-angioedema. Only a few cases of caffeine-induced urticaria and/or anaphylaxis have been reported till date, with varying outcomes in allergologic investigations. Moreover, several cases are probably undiagnosed or misdiagnosed as idiopathic urticaria or as occupational allergy. We speculate that hypersensitivity to caffeine rather than autoimmine reaction may be the probable cause of urticaria. Caffeine should considered as a potential urticaria-inducing agent and should be included in the allergological test series.

  7. Linaclotide in Chronic Idiopathic Constipation Patients with Moderate to Severe Abdominal Bloating: A Randomized, Controlled Trial.

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    Brian E Lacy

    Full Text Available Abdominal bloating is a common and bothersome symptom of chronic idiopathic constipation. The objective of this trial was to evaluate the efficacy and safety of linaclotide in patients with chronic idiopathic constipation and concomitant moderate-to-severe abdominal bloating.This Phase 3b, randomized, double-blind, placebo-controlled clinical trial randomized patients to oral linaclotide (145 or 290 μg or placebo once daily for 12 weeks. Eligible patients met Rome II criteria for chronic constipation upon entry with an average abdominal bloating score ≥5 (self-assessment: 0 10-point numerical rating scale during the 14-day baseline period. Patients reported abdominal symptoms (including bloating and bowel symptoms daily; adverse events were monitored. The primary responder endpoint required patients to have ≥3 complete spontaneous bowel movements/week with an increase of ≥1 from baseline, for ≥9 of 12 weeks. The primary endpoint compared linaclotide 145 μg vs. placebo.The intent-to-treat population included 483 patients (mean age=47.3 years, female=91.5%, white=67.7%. The primary endpoint was met by 15.7% of linaclotide 145 μg patients vs. 7.6% of placebo patients (P<0.05. Both linaclotide doses significantly improved abdominal bloating vs. placebo (P<0.05 for all secondary endpoints, controlling for multiplicity. Approximately one-third of linaclotide patients (each group had ≥50% mean decrease from baseline in abdominal bloating vs. 18% of placebo patients (P<0.01. Diarrhea was reported in 6% and 17% of linaclotide 145 and 290 μg patients, respectively, and 2% of placebo patients. AEs resulted in premature discontinuation of 5% and 9% of linaclotide 145 μg and 290 μg patients, respectively, and 6% of placebo patients.Once-daily linaclotide (145 and 290 μg significantly improved bowel and abdominal symptoms in chronic idiopathic constipation patients with moderate-to-severe baseline abdominal bloating; in particular

  8. Neuroendoscopic treatment of idiopathic occlusion of unilateral foramen of Monro presenting as chronic headache

    Directory of Open Access Journals (Sweden)

    Dhaval Shukla

    2016-01-01

    Full Text Available Asymmetric ventriculomegly due to idiopathic occlusion of the foramen of Monro is rare. Such patients present with clinical features of raised intracranial pressure (ICP. Presentation as chronic headache has not been previously described. In the absence of raised ICP, pursuing surgical treatment raises a clinical dilemma as the headache may be a primary headache with no improvement after surgery. A 21-year-old woman presented with chronic headache. She was found to have asymmetric ventriculomegaly due to the occlusion of the foramen of Monro. She underwent endoscopic septostomy and widening of the foramen of Monro. Her headache subsided after surgery. At 15 months of follow-up, she was free from headache without medications. Unilateral occlusion of the foramen of Monro can present with asymmetric ventriculomegaly resulting in chronic headache. Though the symptoms of raised ICP may not be present, still endoscopic relief of ventriculomegaly leads to cure of headache.

  9. Chronic idiopathic intestinal pseudo-obstruction treated with jejunostomy: case report and literature review

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    Carlos Renato dos Reis Lemos

    Full Text Available CONTEXT: Chronic idiopathic intestinal pseudo-obstruction is a very rare condition. CASE REPORT: This study describes a male patient who had presented obstructive symptoms for 24 years. He had been treated clinically and had undergone two previous operations in different services, with no clinical improvement or correct diagnosis. He was diagnosed with intestinal obstruction without mechanical factors in our service and underwent jejunostomy, which had a significant decompressive effect. The patient was able to gain weight and presented improvements in laboratory tests. Jejunostomy is a relatively simple surgical procedure that is considered palliative but, in this case, it was resolutive.

  10. Evaluation of autologous serum skin test and skin prick test reactivity to house dust mite in patients with chronic spontaneous urticaria.

    Directory of Open Access Journals (Sweden)

    Zhiqiang Song

    Full Text Available BACKGROUND: Chronic spontaneous urticaria (CSU is a common skin disorder with etiology that is not well understood. METHODS: In this study, we evaluated the prevalence of autologous serum skin test (ASST and skin prick testing (SPT to house dust mite (HDM in 862 CSU cases in China. Clinical features, courses and treatment responses were also recorded. RESULTS: The prevalence of positive ASST was 46.3%, and patients aged 30-39 years had the highest positive rate (52.1%. Positive SPT to HDM was seen in 153 patients (17.7% with the highest positive rate (34.2% in patients aged 20 or less. Patients with positive ASST had higher urticaria activity scores (UAS (4.18±0.65 vs. 3.67±0.53 but lower positive rates of HDM (24.6% vs. 37.6%, as compared with those with negative ASST (odds ratio (OR 1.84, 95% CI 1.38-2.47. Patients could be categorized into four groups based on the results of ASST and SPT to HDM and patients with positive ASST and positive SPT to HDM had the highest disease activity scores, experienced higher frequencies of angioedema, diseases duration, and required higher dosage of loratadine every month, compared with other subgroups (P<0.0001. CONCLUSIONS: Patients with CSU showed varied responses of positive ASST and varied sensitivity to HDM, Patients with positive ASST and/or positive SPT had more disease activity compared with patients with negative ASST and/or negative SPT. Further classification can be made based on the result of SPT and ASST.

  11. Validation of basophil histamine release against the autologous serum skin test and outcome of serum-induced basophil histamine release studies in a large population of chronic urticaria patients

    DEFF Research Database (Denmark)

    Platzer, M H; Grattan, C E H; Poulsen, Lars K.

    2005-01-01

    Endogenous histamine-releasing factors (HRFs) are involved in 30-60% of patients with chronic urticaria (CU). Evidence for their existence comes from in vivo studies of autoreactivity with the autologous serum skin test (ASST), in vitro immunoassays demonstrating autoantibodies against the immuno......Endogenous histamine-releasing factors (HRFs) are involved in 30-60% of patients with chronic urticaria (CU). Evidence for their existence comes from in vivo studies of autoreactivity with the autologous serum skin test (ASST), in vitro immunoassays demonstrating autoantibodies against...... the immunoglobulin E (IgE) or the high affinity IgE receptor (FcepsilonRI) and serum-induced histamine release (HR) from basophils and mast cells. We have examined the correlation between the ASST and a new basophil histamine-releasing assay (the HR-Urtikaria test) in a group of well-characterized CU patients...

  12. Does chronic idiopathic dizziness reflect an impairment of sensory predictions of self-motion?

    Directory of Open Access Journals (Sweden)

    Joern K Pomper

    2013-11-01

    Full Text Available Most patients suffering from chronic idiopathic dizziness do not present signs of vestibular dysfunction or organic failures of other kinds. Hence, this kind of dizziness is commonly seen as psychogenic in nature, sharing commonalities with specific phobias, panic disorder and generalized anxiety. A more specific concept put forward by Brandt and Dieterich (1986 states that these patients suffer from dizziness because of an inadequate compensation of self-induced sensory stimulation. According to this hypothesis self-motion-induced reafferent visual stimulation is interpreted as motion in the world since a predictive signal reflecting the consequences of self-motion, needed to compensate the reafferent stimulus, is inadequate. While conceptually intriguing, experimental evidence supporting the idea of an inadequate prediction of the sensory consequences of own movements has as yet been lacking. Here we tested this hypothesis by applying it to the perception of background motion induced by smooth-pursuit eye movements. As a matter of fact, we found the same mildly undercompensating prediction, responsible for the perception of slight illusory world motion („Filehne illusion in the 15 patients tested and their age-matched controls. Likewise, the ability to adapt this prediction to the needs of the visual context was not deteriorated in patients. Finally, we could not find any correlation between measures of the individual severity of dizziness and the ability to predict. In sum, our results do not support the concept of a deviant prediction of self-induced sensory stimulation as cause of chronic idiopathic dizziness.

  13. Transanal Irrigation for Refractory Chronic Idiopathic Constipation: Patients Perceive a Safe and Effective Therapy

    Science.gov (United States)

    Minty, Ian; Bain, Iain M.; Cundall, Jeremy; Yiannakou, Yan

    2017-01-01

    Background. Transanal irrigation (TAI) can successfully treat neurogenic bowel dysfunction (NBD), but patient perception of its use in chronic idiopathic constipation (CIC) is unknown. Objective. To evaluate patient perceptions of the efficacy and safety of TAI for CIC and whether there are predictive factors of perceived treatment response. Methods. Prospective data collection of baseline physiology and symptom severity; retrospective evaluation of efficacy and safety perceptions using a snapshot survey. All patients fulfilling the Rome III criteria for functional constipation with chronic idiopathic aetiology were included. The main outcome measure was the duration of patients' usage of TAI. Results. 102 patients reported 21,476 irrigations over 119 patient years, with a mean duration of therapy use of 60.5 weeks [SD 73.2 : SE 7.3]. Overall symptom improvement included general well-being (65%), rectal clearance (63%), bloating (49%), abdominal pain (48%), and bowel frequency (42%). 68 patients (67%) were “moderately better” or “very much better” on a satisfaction question. Reported complications were minor. No correlation was demonstrated between duration of therapy use and baseline measures. Conclusion. A significant proportion of CIC sufferers use TAI as a long-term or bridging therapy and perceive it as safe. This therapy demands a prospective investigation of efficacy and safety. PMID:28115930

  14. Multiple cycles of recombinant human thrombopoietin therapy in a patient with chronic refractory idiopathic thrombocytopenic purpura.

    Science.gov (United States)

    Hua, Baolai; Zou, Nong; Wang, Shujie; Zhu, Tienan; Zhao, Yongqiang

    2005-06-01

    We describe a 41-year-old woman with chronic idiopathic thrombocytopenic purpura who received recombinant human thrombopoietin (rhTPO) therapy. rhTPO was administrated subcutaneously at a dosage of 1.0 mug/kg daily for a maximum of 14 days until the platelet count was more than 50 x 10/l. The patient received three cycles (six, 13, and eight doses each) of rhTPO, each initiated when the platelet counts was less than 10 x 10/l. The platelet count increased to above 50 x 10/l on days 5, 11 and 8, and peaked at 456 x 10/l, 130 x 10/l and 82 x 10/l on days 9, 15 and 13 in the three respective cycles, each followed by a gradual decline. The durations of platelet counts at more than 50 x 10/l in the three cycles were 13, 7 and 10 days, respectively. rhTPO was well tolerated with no adverse event observed. Antibodies to rhTPO by enzyme-linked immunosorbent assay were not detected. Our observations suggested that rhTPO could transiently increase the peripheral platelet count in patients with chronic refractory idiopathic thrombocytopenic purpura. The reasons why the peak platelet counts decreased and the duration of response shortened after successive cycles of treatment were unclear.

  15. Treatment of Idiopathic Chronic Orchialgia with Transcutaneous Electrical Nerve Stimulation (TENS:A Preliminary Result

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    Ekrem Akdeniz

    2016-01-01

    Full Text Available Purpose: Unilateral or bilateral testicular pain lasting more than 3 months is called as chronic orchialgia. Aproximately 25-50% of chronic orchialgia is idiopatic origin. This study aimed the effectiveness of Transcutaneous Electrical Nerve Stimulation (TENS therapy due to Idiopathic Chronic Orchialgia (ICO. Methods: Five patients were included into this study with ICO that diagnosed with physical examination, urine analyses, urinary system x-ray film, and scrotal doppler ultrasound. Medical history revealed that multiple conservative therapy attempts failed to alleviate the pain. Two of the patients had right sided ICO. Traditional TENS device is placed to the most painful points. TENS applied 3 times in a week with duration 30 minutes for 4 weeks. Before and after TENS application, patients were evaluated by using Visual Analog Scale (VAS at first and third months. Results: Median age of patients was 26.20±2.38 (22-30. Mean VAS value was 6.52 ± 0.89 before the procedure. After 1 month VAS value was 3.82 ± 0.83 (p0.05. None of the patients needed any analgesics after during the one month. No complications, hyperemia or hypoesthesia of the scrotal or penile skin, occurred after the procedure. Conclusion: TENS reduces pain by increasing endorphin release in the spinal cord dorsal horn. TENS is very effective method for first 1 month in patients with ICO but its effect reduces by the time. There is no standard therapeutic protocol for idiopathic chronic orchialgia. Therefore TENS may be an alternative for patients who do not benefit from medical therapy and do not want invasive procedures. Short-term use of TENS and low number of the patients are the limitations of this study. Randomized, placebo-controlled, and longer follow-up period studies are needed to better assess the efficacy of TENS for ICO.

  16. Efficacy of Qingfeng Decoction and Setastine Hydrochloride in the Treatment of Chronic Urticaria%“清风汤”联合盐酸司他斯汀对慢性荨麻疹的治疗效果观察

    Institute of Scientific and Technical Information of China (English)

    孙胜军

    2015-01-01

    目的:研究“清风汤”联合盐酸司他斯汀治疗慢性荨麻疹的疗效。方法将我院80例慢性荨麻疹患者随机分成对照组与观察组(n=40),对照组单独应用盐酸司他斯汀治疗,观察组应用“清风汤”联合盐酸司他斯汀治疗。结果观察组总治疗有效率与复发率均优于对照组,P<0.05。结论应用“清风汤”联合盐酸司他斯汀治疗慢性荨麻疹患者疗效显著。%Objective To study the efficacy of qingfeng decoction and setastine hydrochloride in the treatment of chronic urticaria.Methods 80 patients with chronic urticaria in our hospital were randomly divided into control group and observation group(n=40),control group used alone setastine hydrochloride treatment,observation group application qingfeng decoction and setastine hydrochloride therapy.ResultsObservation group total treatment efficient and recurrence rate were better than the control group,P<0.05.ConclusionThe application of qingfeng decoction and setastine hydrochloride therapy of chronic urticaria patients curative effect is remarkable.

  17. The Therapeutic Effect of Sublingual Immunotherapy for chronic urticaria%舌下含服粉尘螨滴剂脱敏治疗慢性荨麻疹疗效分析

    Institute of Scientific and Technical Information of China (English)

    任小丽; 陈晋广; 胡雅玉; 陈健; 陈祥恩

    2012-01-01

    Objective To investigate the clinical efficacy of sublingual dermato phagoides farinae for chronic urticaria. Methods Two hundred and fourty cases of chronic urticaria were randomly devided into treatment group and control group, each 120 cases. The treatment group were given sublingual dermato phagoides farinae,and the control group were given antihistamine. Results Total efficiency in the treatment and control group was 67.50% and 54. 17% respectively, Lreatment group significantly better than control groups(P <0. 05). Conclusion Sublingual dermato phagoides farinae for chronic urticaria is effective.%目的 探讨舌下含服粉尘螨滴剂特异性脱敏治疗慢性荨麻疹的疗效.方法 将入选的240例患者随机分为两组,各120例.治疗组舌下含服粉尘螨滴剂脱敏治疗,对照组仅口服抗组胺药物.结果 治疗组和对照组有效率分别为67.50%和54.17%,差异有统计学意义(P<0.05).结论 舌下含服粉尘螨滴剂特异性脱敏治疗慢性荨麻疹疗效肯定.

  18. Allergen Analysis of 1145 Cases of Chronic Urticaria and Chronic Eczema Patients in Donggang District%慢性湿疹和慢性荨麻疹患者1145例过敏原检测结果分析

    Institute of Scientific and Technical Information of China (English)

    姜启君; 曹娜; 宫振波; 于华; 魏庆宇

    2011-01-01

    目的 了解沿海地区慢性湿疹和慢性荨麻疹患者的过敏原分布情况,探讨预防过敏性疾病发生的有效措施.方法 采用皮肤点刺试验,对沿海地区1 145例慢性荨麻疹和慢性湿疹患者进行过敏原检测.结果 慢性荨麻疹和慢性湿疹患者的主要致敏原分别为牛奶(54.61%)、鸡蛋(52.34%)和鸡蛋(60.04%)、粉尘螨(58.97%).东港市本地父母辈和子女辈的过敏原皮肤反应强度指数差异无统计学意义(P>0.05);父母辈为内地居民,而子女辈出生于东港市的二代之间对鱼虾蟹贝等海产品皮肤反应强度指数差异有统计学意义(P<0.001).复习国内几个代表地区的过敏原检测情况,发现与本研究结果有相同趋势.结论 沿海地区慢性荨麻疹和慢性湿疹患者的过敏原中鱼虾等海产品呈低敏感性,提示早期接触过敏原对预防过敏反应发生有重要意义.%Objective To investigate the methods of preventing the occurrence of allergic disease by studying the allergen distribution of chronic urticaria and chronic eczema patients from coastland. Methods Skin prick test to 1 145 cases of chronic urticaria and chronic eczema patients from couastland were used. Results The main allergens of chronic urticaria and chronic eczema patients were milk (54.61%), chicken (52.34%) and eggs (60.04%), Dermatophagoides farinae (58.97%), respectively. No difference was identified between the mothers and their children who were all born in Donggang district, however, there was significant difference between the mothers born in hinterland and their children born in Donggang district on classic seafood allergens ( t = 5. 0, P = 0. 001 ). Conclusion Seafood allergens on chronic urticaria or chronic eczema in patients from coastland show low sensitivity, and to contact with allergens early was a potentially effective way to prevent allergic disease.

  19. Anaphylaxis and urticaria.

    Science.gov (United States)

    Williams, Kelli W; Sharma, Hemant P

    2015-02-01

    Anaphylaxis and urticaria are common presenting allergic complaints. Affecting up to 2% of the population, anaphylaxis is a serious, life-threatening allergic reaction. Although not life-threatening, urticaria is a rash of transient, erythematous, pruritic wheals that can be bothersome and affects up to 25% of the population. All cases of anaphylaxis warrant thorough clinical evaluation by the allergist-immunologist, although most cases of urticaria are self-limited and do not require specialist referral. This article offers an overview of our current knowledge on the epidemiology, pathogenesis, triggers, diagnosis, and treatment of anaphylaxis and urticaria.

  20. 穴位注射治疗慢性荨麻疹的临床研究现状%Current status of clinical researches of acupoint injection treatment of chronic urticaria

    Institute of Scientific and Technical Information of China (English)

    赵菊花; 苏青; 何启敏

    2013-01-01

    通过对穴位注射治疗慢性荨麻疹的文献分析,而总结出该治疗方法主要选取的穴位、常用注射药物和有效性。通过检索数据库,对近10余年来穴位注射有效治疗慢性荨麻疹进行综述,总结其选取穴位、注射药物的原则。穴位注射治疗慢性荨麻疹多选取足阳明胃经、足太阴脾经、手阳明大肠经、足太阳膀胱经等所属腧穴。其中足三里、三阴交、血海、曲池是治疗慢性荨麻疹的要穴。注射药物多单用可用于注射的抗组胺药、免疫调节剂、益气补血和有类固醇激素样作用的中药注射制剂和其他药物。穴位注射疗法应用于慢性荨麻疹的治疗,疗效确切,可减少复发率,值得临床推广应用,但应加强机理研究。%Through analyzing the literature on acupoint injection treatment of chronic urticaria,to summarize the main acupoints,commonly used injection drugs and effectiveness. Through searching the database,the literature on effective acupoint injection treatment of chronic urticaria in the recent 10 years had been reviewed and the principles of selected acupoints and injection drugs were summarized.The acupoint injection treatment of chronic urticaria mainly selects stomach meridian,spleen meridian,hand Yangming large intestine meridian and bladder meridian. Zusanli,sanyinjiao,Xuehai and Quchi are important acupoints for the treatment of chronic urticaria.The main selected injection drugs are antihistamine drugs,immunomodulators,injectable traditional Chinese medicine injections and other drugs that have qi replenishing and blood enriching and sterioid hormone-like effect.In the treatment of chronic urticaria, acupoint injection therapy has accurate efficacy and can reduce the relapse rate,thereby worthy of clinical promotion and application,but mechanism research should be strengthened.

  1. 甲状腺自身抗体与慢性荨麻疹的关系及其临床意义的探讨%The correlation between thyroid autoantibodies and chronic urticaria and its clinical significance

    Institute of Scientific and Technical Information of China (English)

    区洪光; 陈智明; 吴继红; 林颜玉; 王荣辉

    2015-01-01

    Objective To investigate the correlation between thyroid auto - antibodies [anti - thyroid globulin antibody (TGA)and anti-thyroid peroxidase antibody(TPO)]and chronic urticaria,and to observe the efficacy of thyroid tablets in treatment of patients with chronic urticaria complicated with thyroid auto-an-tibodies. Methods January 2013~December 2014 ninety-two cases of chronic urticaria outpatients cared at our hospital received thyroid autoantibodies test by using radioimmunoassay,according to the results of the test all the cases were divided into two sub-groups,positive-TGA and -TPO group and negative-TGA and -TPO group,compared with 45 cases of healthy thyroid auto-antibodies at the same period,observation of thy-roid function,28 cases of patients with positive antibody detection having the same baseline data as 20 cases of negative antibody patients both were treated with thyroid tablets for 2 weeks,curative effect was evaluated. Results Comparison of RT3,T4,FT3,TSH levels between the chronic urticaria group and the control group showed no statistically significant differences (P >0.05).Chronic urticaria group in thyroid auto-antibodies TGA,TPO levels were higher than those in the control group(P 0.05)。慢性荨麻疹组甲状腺自身抗体 TGA、TPO 水平均高于对照组(P <0.01)。慢性荨麻疹组 TGA、TPO 阳性率为30.43%,对照组 TGA 阳性率为2.22%,慢性荨麻疹组 TGA、TPO 阳性率高于对照组(χ2=14.41,P <0.001)。给予甲状腺素片治疗2周后,阳性组总有效率为89.29%,阴性组总有效率0%,两组总有效率比较差异具有统计学意义(χ2=37.26,P <0.0001)。结论慢性荨麻疹与甲状腺自身抗体有一定的关系,对于抗组胺药物治疗无效的患者可进行甲状腺自身抗体检测,阳性患者给予甲状腺素片治疗可提高疗效。

  2. A Meta-analysis on the relations between Helicobacter pylori infection and chronic urticaria%幽门螺杆菌感染与慢性荨麻疹相关性的Meta分析

    Institute of Scientific and Technical Information of China (English)

    唐路得; 张沿君; 高晓萌; 董瑞; 张喜凤; 谷鸿喜; 商庆龙

    2014-01-01

    目的 探讨幽门螺杆菌(HP)感染与慢性荨麻疹发生的病因学关系.方法 以HP、慢性荨麻疹为检索词,检索维普学术期刊数据库、中国期刊全文数据库、万方学术期刊数据库和PubMed数据库,筛选后纳入相关病例对照研究文献进行Meta分析,通过Stata软件计算合并OR值及其95%CI.结果 入选研究共37项,累计慢性荨麻疹病例2 909人,对照组1 873人,数据表现为异质性.与对照组比较,HP感染增加慢性荨麻疹的发生风险(OR=3.20,95% CI:2.31~4.43).回归分析显示检测方法和地区分布是结论的重要影响因素.结论 HP感染与慢性荨麻疹发生存在相关性.研究结果与分右地区和检测方法有关.%Objective To investigate the relationship between Helicobacter pylori (HP) infection and the development of chronic urticaria.Methods Published case-control studies which concerned HP infection related chronic urticaria were searched in Wanfang,CNKI,CQVIP Chinese databanks and PubMed.Meta-analysis was applied to analyze the pooled odds ratio (OR) and 95% confidence interval (CI).Results 37 studies which comprised 2 909 cases of chronic urticaria and 1 873 persons served as controls were enrolled.When compared with the controls,HP infection significantly increased the risk of chronic urticaria development with a pooled OR of 3.20 (95%CI:2.31-4.43).Results from Meta-regression analyses showed that the distribution of residential areas and detection method being used were potential influential factors.Conclusion HP infection seemed to be associated with an increased risk of developing the chronic urticaria.

  3. Study of relationship between the incidence and constitution of TCM of chronic urticaria%慢性荨麻疹的发病与中医体质相关性研究

    Institute of Scientific and Technical Information of China (English)

    张剑; 邓永琼; 杨茜; 叶田; 杨春艳; 胡祥宇; 姚丽萍

    2012-01-01

    目的:观察慢性荨麻疹患者的中医体质类型分布特点,初步探讨影响其发病的体质相关因素.方法:收集200例患者,对其进行体质分型和体质相关因素的调查.结果:七种体质类型中,慢性荨麻疹患者以气虚质最为多见,各型的分布比率分别为:正常质占9.5%,阴虚质占19.5%,阳虚质占6.5%,痰湿质占2.0%,湿热质占8.0%,气虚质占46.5%,瘀血质占7.5%.结论:慢性荨麻疹的发病与性别、饮食、睡眠、性格等因素关系均较密切.将中医体质学说应用于慢性荨麻疹病因病机探讨,为慢性荨麻疹的治疗开创了新思路.%Objective;To observed the distribution of types of constitution of TCM,and primarily discuss the relative factors which has contributed to the incidence of chronic urticaria. Methods: Gathering 200 cases of chronic urticaria,and classify their constituents and survey the related constitutional factors according to the authoritative method of constitutional differentiation. Results: Among the seven types of constitution of patients suffering from chronic urticaria, constitution of Qi-deficiency is the most important. The ratio of each type are as follows:the normal type took 9.5%,Yin-deficiency 19.5%,Yang-deficiency 6.5%,phlegm and dampness 2.0% ,Qi-deficiency 46.5% ,heat-dampness 8.0% ,and blood-stasis 7.5%. Meanwhile,the incidence of chronic urticaria was closely correlated to gender,diet customs,temper,sleep and so on. Conclusions:It is a new ideas for treatment of chronic urticaria by using the theory of constitution of TCM in etiology and pathogenesis of this disease.

  4. Allergen detection result analysis of 1062 patients with chronic urticaria in Anhui province%安徽省1062例慢性荨麻疹过敏原检测结果分析

    Institute of Scientific and Technical Information of China (English)

    周海林; 胡白; 蒋法兴; 廖理超; 姚秀华

    2012-01-01

    目的 了解安徽省慢性荨麻疹患者的食入性与吸入性过敏原情况,为该病的预防和治疗提供依据.方法 采用酶联免疫分析法,对1062例慢性荨麻疹患者进行吸入性过敏原和食入性过敏原特异性lgE抗体检测.结果 1062例慢性荨麻疹患者过敏原阳性检出率为48.78%(518例),吸入组过敏原的阳性率明显高于食入组,其中粉螨、尘螨 (34.56%)、屋尘(10.73%)为主要过敏原.结论 安徽省慢性荨麻疹患者吸入性过敏原的检出率明显高于食入性,过敏原以尘螨、粉螨和屋尘多见,找出致病因素对临床治疗慢性荨麻疹有较好的指导意义.%Objective To investigate Anhui province patients with chronic urticaria in ingestion and inhalation allergen conditions respectively, in order to provide evidence for prevention and treatment. Methods Enzyme immunoassay method was used to test 1 062 patients with chronic urticaria in allergen-specific lgE antibodies. Results The testing results of 1 062 cases showed that the total of the positive reaction rates reached 48. 78% (518 positive cases). Inhalation allergen positive rate was significantly higher than that of ingestion allergen group. The positive reaction rates of the mites and the house dust reached 34. 56% and 10. 37% respectively, which were the first and the second in the allergens tested. Conclusion Both ingestion allergens and inhalation allergens are contributing causes to chronic urticaria. The mites and the house dust were perhaps the ordinary pathogenic allergens for the patients with chronic urticaria in Anhui province. Identifying the causative factors is of instructive significance for the clinical treatment of chronic urticaria.

  5. Analysis of Food Specific IgE,IgG in Patients with Chronic Urticaria%慢性荨麻疹患者血清特异性IgE、IgG检测结果分析

    Institute of Scientific and Technical Information of China (English)

    许志萍; 王蓉

    2013-01-01

    Objective To discuss the relationship of food al ergens specific IgE and IgG with chronic urticaria,and to provide evidence for the clinical diagnosis and treatment of food al ergy. Methods 7 kinds of specific IgE and 14 kinds of specific IgG were detected in serum of 146 cases with chronic urticaria and 30 cases of healthy controls test by enzymelinked immunosorbent assay. Results The overal positive rate of specific IgE was 40.4%and the overal positive rates of specific IgG was 82.2% with chronic urticaria. The mainly al ergen in serum with chronic urticaria were egg,milk and shrimp,crab. Conclusion Combined detection of specific IgE and specific IgG could be an important means for the prevention and treatment with chronic urticaria.%目的探讨血清食物特异性IgE、IgG抗体与慢性荨麻疹的关系,为食物过敏的诊断和治疗提供依据。方法采用酶联免疫法检测146例慢性荨麻疹患者7种食物特异性IgE和14种食物特异性IgG,同时设立健康对照组。结果慢性荨麻疹患者血清食物特异性IgE的总阳性率为40.4%,血清食物特异性 IgG的总阳性率为82.2%,主要食物过敏原都是鸡蛋、牛奶和虾蟹。结论联合测定血清中食物特异性IgE和特异性IgG抗体是防治慢性荨麻疹的有效方法。

  6. Spirulina did not ameliorate idiopathic chronic fatigue in four N-of-1 randomized controlled trials.

    Science.gov (United States)

    Baicus, Cristian; Baicus, Anda

    2007-06-01

    Idiopathic chronic fatigue is an exclusion diagnosis established when no chronic disease is found. Spirulina platensis is an alga with a rich content of proteins, vitamins, minerals and amino acids and is considered as a bioactive additive with multiple effects, among them being effects against fatigue. However, despite the worldwide utilization of Spirulina, there are only a few quality studies with it and none concerning fatigue. The N-of-1 randomized trials are made on one patient, and by this kind of study the efficacy of a treatment on that particular patient can be assessed. A series of four N-of-1 double-blind, randomized trials were performed on four physicians who complained of chronic fatigue. Each patient was his own control and received three pairs of treatments comprising 4 weeks of spirulina and 4 weeks of placebo. Spirulina platensis was administered in a dose of 3 g/day. For each pair, the order of treatments was randomized. Outcome measures were severity of fatigue measured on a 10-point scale. The scores of fatigue were not significantly different between spirulina and placebo. Spirulina administered in a dose of 3 g/day did not ameliorate fatigue more than the placebo in any of the four subjects, and possibly it has no effect on chronic fatigue.

  7. Does Helicobacter pylori play a role in the pathogenesis of childhood chronic idiopathic thrombocytopenic purpura?

    Science.gov (United States)

    Maghbool, Maryam; Maghbool, Masood; Shahriari, Mehdi; Karimi, Mehran

    2009-06-08

    Idiopathic thrombocytopenic purpura (ITP) is an acute self-limited bleeding disorder that can progress to chronic form in 10-15% of the cases. Helicobacter pylori (H. pylori) infection is a possible cause of chronic ITP. We studied 30 children with resistant chronic ITP for H. pylori infection based on the detection of H. pylori fecal antigen. This retrospective study was based on data obtained from medical records of 30 children aged between five and 17 years (median age at ITP diagnosis was ten years). A specially-designed data sheet was used to record information on age, sex, duration of disease, family history of bleeding disorders, previous treatments and median platelet count. In patients with H. pylori infection, antimicrobial treatment consisted of amoxicillin, metronidazol and omeprazol. Response was assessed every month for one year and defined as complete (platelet count >150×10(9)/L) or partial (platelet count between 50 and 150×10(9)/L). We detected H. pylori infection in 5 patients. In 4 of them increased platelet count was seen during one year of follow-up and in one patient the platelet count was acceptable during six months. Although the pathological mechanism of H. pylori-induced thrombocytopenia was unclear in our patient sample, the assessment of H. pylori infection and use of eradication therapy should be attempted in chronic and resistant ITP patients.

  8. Does Helicobacter pylori play a role in the pathogenesis of childhood chronic idiopathic thrombocytopenic purpura?

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    Maryam Maghbool

    2009-07-01

    Full Text Available Idiopathic thrombocytopenic purpura (ITP is an acute self-limited bleeding disorder that can progress to chronic form in 10-15% of the cases. Helicobacter pylori (H. pylori infection is a possible cause of chronic ITP. We studied 30 children with resistant chronic ITP for H. pylori infection based on the detection of H. pylori fecal antigen. This retrospective study was based on data obtained from medical records of 30 children aged between five and 17 years (median age at ITP diagnosis was ten years. A specially-designed data sheet was used to record information on age, sex, duration of disease, family history of bleeding disorders, previous treatments and median platelet count. In patients with H. pylori infection, antimicrobial treatment consisted of amoxicillin, metronidazol and omeprazol. Response was assessed every month for one year and defined as complete (platelet count >150x109/L or partial (platelet count between 50 and 150x109/L. We detected H. pylori infection in 5 patients. In 4 of them increased platelet count was seen during one year of follow-up and in one patient the platelet count was acceptable during six months. Although the pathological mechanism of H. pylori-induced thrombocytopenia was unclear in our patient sample, the assessment of H. pylori infection and use of eradication therapy should be attempted in chronic and resistant ITP patients.

  9. 581例慢性荨麻疹皮肤点刺试验阳性患者临床特征分析%A clinical characteristics analysis of 581 chronic urticaria patients with positive skin prick test

    Institute of Scientific and Technical Information of China (English)

    李健; 张燕芹; 吴飞; 成戌; 朱坤举; 昂正斌

    2014-01-01

    Objective To perform an association analysis between the number of positive skin prick test (SPT)responses and chro-nic urticaria clinical characteristics.Methods A total of 581 individuals with chronic urticaria underwent SPT with a panel of 21 biologically standardized aeroallergens,and these data were analyzed retrospectively.Results Skin scratch test positive patients with chronic urticaria held a higher average number of positive SPT responses than that of the patients with skin scratch test negative (P=0.002);the frequency of skin scratch test positive patients with chronic urticaria with poly-sensitization was significantly higher than that of the patients with skin scratch test negative (P=0.03).Similarly,patients with concomitant allergic diseases (asthma,allergic rhinitis,allergic conjunctivitis)held a higher average number of positive SPT responses than that in those without concomitant allergic diseases (P=0.03),and the frequency of patients with concomitant allergic diseases with poly-sensitization was also significantly higher than those with only chronic urticaria (P=0.04).Conclusion The number of positive SPT responses (≥4)may associate with skin scratch test positive and concomitant allergic dis-eases (asthma,allergic rhinitis,allergic conjunctivitis)in chronic urticaria,which helps to assess the clinical features of chronic urticaria.%目的:探讨皮肤点刺试验阳性数目与慢性荨麻疹临床特征之间的关系。方法分析21种变应原检测的581例慢性荨麻疹皮肤点刺试验阳性患者的资料。结果皮肤划痕试验阳性患者的变应原阳性数目高于皮肤划痕试验阴性者(P=0.00),对多种变应原致敏的皮肤划痕试验阳性患者频率高于皮肤划痕试验阴性患者(P=0.03);伴发其他过敏性疾病(过敏性鼻炎、哮喘、过敏性结膜炎)患者的变应原阳性数目高于单纯的慢性荨麻疹患者(P=0.03),对多种变应原致敏的伴发其

  10. Dentoalveolar trauma in a patient with chronic idiopathic thrombocytopenic purpura: a case report.

    Science.gov (United States)

    Finucane, David; Fleming, Padraig; Smith, Owen

    2004-01-01

    A case is presented of a 13-year-old boy with chronic idiopathic thrombocytopenic purpura (ITP) who sustained traumatic labial luxation of both lower central incisors, with partial alveolar fracture resulting in displacement of the labial alveolar plate. Intravenous immunoglobulin (Fleibogamma, 1 g/kg body weight x 2 days) was administered, resulting in the patient's platelet count rising from 15,000/mm3 to 70,000/mm3. Under general anesthesia, the displaced lower labial alveolus and luxated teeth were repositioned and splinted 2 days following trauma. Healing was uneventful. Subsequently, both lower central incisors became nonvital and were endodontically treated. The dental treatment of this patient with ITP is discussed in terms of emergency management, and subsequent care.

  11. [Splenectomy in chronic idiopathic thrombopenic purpura in adults. Apropos of 49 cases].

    Science.gov (United States)

    Melki, J; Dauce, J P; Kunlin, A; Tilly, H; Julien, J P; Monconduit, M; Piguet, H

    1989-01-01

    The authors reviewed the case files of 49 adult patients undergoing splenectomy for chronic idiopathic thrombocytopenic purpura at the Centre Henri Becquerel between 1970 and 1987. Although the postoperative course was straightforward in 83.7% of cases, one reoperation for subphrenic abscess was necessary and there was one postoperative death. Remission from thrombocytopenia was obtained in 87.5% of the patients, but only transiently in 8.5% of them. No preoperative predictive factors could be demonstrated. An early postoperative rise in the platelet count to more than 500 G/litre appears to ensure a good subsequent result. Secondary infectious complications are not exceptional and can be fatal (one death in our series); they require prophylaxis by anti-pneumococcal vaccination. The place of prophylactic antibiotic therapy has yet to be defined.

  12. Small bowel volvulus in a patient with chronic idiopathic intestinal pseudo-obstruction.

    Science.gov (United States)

    Youssef, Haney; Rashid, Sidi H; Cellador, Enrique Collantes; Baragwanath, Phil

    2009-01-01

    Chronic idiopathic intestinal pseudo-obstruction (CIIP) is a rare syndrome of ineffectual gut motility associated with clinical, endoscopic and radiological exclusion of mechanical causes, as well as evidence of air-fluid levels in distended bowel loops. A case of small bowel volvulus in a patient with an established diagnosis of CIIP is presented. The case is illustrated by images of operative findings and computed tomography scan reconstruction, showing the classical appearances of small bowel volvulus. The patient recovered well after surgery and is maintained on parenteral nutrition. CIIP is a heterogeneous disorder in which the primary aims of management are nutrition, pain control and the avoidance of unnecessary repeated laparotomies. However, even in the presence of an established diagnosis of CIIP, surgeons should be vigilant to the possibility that an operable mechanical obstruction may still occur.

  13. The Turkish Guideline for the Diagnosis and Management of Urticaria-2016

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    Emek Kocatürk Göncü

    2016-09-01

    Full Text Available Background and Design: Albeit an easily recognized disease, urticaria features many diverse approaches which rationalize the need for an algorithm for the diagnosis, classification, etiopathogenesis, diagnostic evaluation and therapeutic approach. Therefore, authors from Dermatoallergy Working Group of the Turkish Society of Dermatology and the Turkish Dermatoimmunology and Allergy Association aimed to create an urticaria guideline for the diagnosis, treatment and followup of urticaria. Materials and Methods: Each section of the guideline has been written by a different author. The prepared sections were evaluated in part by e-mail correspondence and have taken its final form after revision in the last meeting held by the participation of all authors. Results: The guideline includes the description, classification, pathophysiology as well as diagnosis and treatment of urticaria. Urticaria is classified into two main types: acute urticaria and chronic urticaria while chronic urticaria is further subdivided into spontaneous urticaria and inducible urticaria. The first step of treatment includes standard doses of H1-blockers. In patients who do not respond to the first step, antihistamine dose is increased up to four times; if unsuccessful, another second-generation antihistamine is given in the same dose. In antihistamine-resistant cases, introduction of omalizumab is required. Omalizumab dose may be increased in patients failing to respond to the standard dose. In patients unresponsive to omalizumab, cyclosporine-A may be given. Routine diagnostic tests are not recommended in acute urticaria. In chronic urticaria, erythrocyte sedimentation rate, differential blood count and C-reactive protein testing are the only investigations that are needed routinely. Conclusion: Chronic urticaria is a disease that can be challenging for the physician in terms of treatment and follow-up. Depending on evidence-based data (and individual experiences, this

  14. Contact urticaria : Present scenario

    Directory of Open Access Journals (Sweden)

    Bhatia Ruchi

    2009-01-01

    Full Text Available Immunological contact urticaria is a hypersensitivity reaction that appears on the skin following contact with an eliciting substance. Recent advances in our understanding of the molecular mechanism and pathogenesis of this reaction have altered its classification, diagnosis, and treatment. We discuss classification, epidemiology, diagnosis, testing, and treatment options that are available to patients with contact urticaria.

  15. Prospective study of biofeedback retraining in patients with chronic idiopathic functional constipation

    Institute of Scientific and Technical Information of China (English)

    Jun Wang; Mao-Hong Luo; Qing-Hui Qi; Zuo-Liang Dong

    2003-01-01

    AIM: To determine the efficacy and long-term outcome of biofeedback treatment for chronic idiopathic constipation and to compare the efficacy of two modes of biofeedback (EMG-based and manometry-based biofeedback).METHODS: Fifty consecutive contactable patients included 8 cases of slow transit constipation, 36 cases of anorectic outlet obstruction and 6 cases of mixed constipation. Two modes of biofeedback were used for these 50 patients, 30 of whom had EMG-based biofeedback, and 20 had manometrybased biofeedback. Before treatment, a consultation and physical examination were done for all the patients, related information such as bowel function and gut transit time was documented, psychological test (symptom checkJist 90, SCL90)and anorectic physiological test and defecography were applied. After biofeedback management, all the patients were followed up. The Student′s t-test, chi-squared test and Logistic regression were used for statistical analysis.RESULTS: The period of following up ranged from 12 to 24months (Median 18 months). 70% of patients felt that biofeedback was helpful, and 62.5% of patients with constipation were improved. Clinical manifestations including straining, abdominal pain, bloating, were relieved, and less oral laxative was used. Spontaneous bowel frequency and psychological state were improved significantly after treatment. Patients with slow and normal transit, and those with and without paradoxical contraction of the anal sphincter on straining, benefited equally from the treatment. The psychological status rather than anorectal test could predict outcome. The efficacy of the two modes of biofeedback was similar without side effects.CONCLUSION: This study suggests that biofeedback has a long-term effect with no side effects, for the majority of patients with chronic idiopathic constipation unresponsive to traditional treatment. Pelvic floor abnormalities and transit time should not be the selection criteria for treatment.

  16. Analysis of allergens in 531 patients with chronic urticaria%台州市531例慢性荨麻疹过敏原检测

    Institute of Scientific and Technical Information of China (English)

    任小丽; 苏湘川; 孙灵芬

    2014-01-01

    Objective: To detect common allergens in 531 patients with chronic urticaria in Taizhou.Methods:The serum allergens were detected by immunoblotting method. Results:The positivity rate of inhalation allergens was 25.24% (134 patients) and the most common allergen of inhalation was dust mite (119 patients 22.41%). The positivity rate of edibility allergens was 29% (154 patients) of which most common edibility allergen was crab (73 patients 13.75%). Conclusion:The most common allergen in Taizhou is dust mite.%目的:筛选台州市531例慢性荨麻疹患者过敏原。方法:采用免疫印迹法对531例慢性荨麻疹患者进行过敏原测定。结果:吸入性过敏原阳性率为25.24%(134例),其中尘螨阳性率22.41%(119例);食入性过敏原阳性率为29.0%(154例),其中蟹抗体阳性率13.75%(73例)。结论:本地区常见过敏原为尘螨。

  17. [Chronic idiopathic intestinal pseudo-obstruction: visceral myopathy. Report of 4 cases].

    Science.gov (United States)

    de Pini, A F; de Dávila, M T; Marín, A; Guastavino, E; Ruiz, J A; De Rosa, S

    1993-01-01

    Chronic intestinal pseudo-obstruction is the term applied to a heterogeneous group of functional motility disorders sharing a common clinical expression: signs and symptoms of bowel obstruction in absence of mechanical occlusion. It is caused by ineffective intestinal propulsion. The chronic form of intestinal pseudo-obstruction may be primary or secondary. Primary pseudo-obstruction or chronic idiopathic pseudo-obstruction (CIIP) defines a group of propulsive disorders having no recognized underlying diseases. This study presents four female patients, aged between 4 months to 7 years, and makes a review of the literature. The symptoms, very similar in three of them, were bilious vomiting, abdominal distention and constipation, alternating with diarrhea and malnutrition. The fourth patient, different from the others in the age of onset and evolution, only had severe constipation and abdominal bloating. The diagnostic was made by full thickness biopsies during laparotomy, getting specimens by mapping, at different heights of intestine and stomach. Samples were studied by optic and electronic microscopy and visceral myopathies were found. None of them had urinary disorders. Medical treatment consisted of total parental nutrition and/or enteral nutrition. Cisapride was not effective in the two patients who received it.

  18. Urticaria and Allergy-Mediated Conditions.

    Science.gov (United States)

    Jafilan, Lena; James, Charis

    2015-12-01

    Urticaria is a common condition that involves pruritic, raised skin wheals. Although urticaria is a benign, self-limiting condition, it may cause frustration for patients, often because of its chronicity and its tendency to recur. It can also be a life-threatening allergic reaction. Diagnosis is made clinically. It affects 20% of the general population. The first-line treatment for nonremitting cases includes H-1anti-histamines. However, other therapies may be employed. Other allergy-mediated skin conditions include angioedema, contact dermatitis, and atopic dermatitis. Diagnosis is clinical, and management focuses on prevention, avoiding triggers, and treating the itching and inflammation that accompany these conditions.

  19. Study of Autophagy and Microangiopathy in Sural Nerves of Patients with Chronic Idiopathic Axonal Polyneuropathy

    Science.gov (United States)

    Samuelsson, Kristin; Osman, Ayman A. M.; Angeria, Maria; Risling, Mårten; Mohseni, Simin; Press, Rayomand

    2016-01-01

    Twenty-five percent of polyneuropathies are idiopathic. Microangiopathy has been suggested to be a possible pathogenic cause of chronic idiopathic axonal polyneuropathy (CIAP). Dysfunction of the autophagy pathway has been implicated as a marker of neurodegeneration in the central nervous system, but the autophagy process is not explored in the peripheral nervous system. In the current study, we examined the presence of microangiopathy and autophagy-related structures in sural nerve biopsies of 10 patients with CIAP, 11 controls with inflammatory neuropathy and 10 controls without sensory polyneuropathy. We did not find any significant difference in endoneurial microangiopathic markers in patients with CIAP compared to normal controls, though we did find a correlation between basal lamina area thickness and age. Unexpectedly, we found a significantly larger basal lamina area thickness in patients with vasculitic neuropathy. Furthermore, we found a significantly higher density of endoneurial autophagy-related structures, particularly in patients with CIAP but also in patients with inflammatory neuropathy, compared to normal controls. It is unclear if the alteration in the autophagy pathway is a consequence or a cause of the neuropathy. Our results do not support the hypothesis that CIAP is primarily caused by a microangiopathic process in endoneurial blood vessels in peripheral nerves. The significantly higher density of autophagy structures in sural nerves obtained from patients with CIAP and inflammatory neuropathy vs. controls indicates the involvement of this pathway in neuropathy, particularly in CIAP, since the increase in density of autophagy-related structures was more pronounced in patients with CIAP than those with inflammatory neuropathy. To our knowledge this is the first report investigating signs of autophagy process in peripheral nerves in patients with CIAP and inflammatory neuropathy. PMID:27662650

  20. Abdominal Pain: A Comparison between Neurogenic Bowel Dysfunction and Chronic Idiopathic Constipation

    Science.gov (United States)

    Finnerup, Nanna Brix; Christensen, Peter

    2013-01-01

    Introduction. Most spinal-cord-injured patients have constipation. One-third develop chronic abdominal pain 10 years or more after injury. Nevertheless, very little is known about the nature of abdominal pain after spinal cord injury (SCI). It may be neuropathic or caused by constipation. Aim. To compare characteristics of abdominal pain in SCI with able-bodied with chronic idiopathic constipation (CIC). Subjects and Methods. 21 SCI and 15 CIC patients were referred for treatment of bowel symptoms. Constipation-related symptoms were assessed with the Cleveland Constipation Scoring System and the International Spinal Cord Injury Basic Bowel Function Data Set. Characteristics of abdominal pain were described using the Brief Danish Pain Questionnaire. Total gastrointestinal transit times (GITT) were measured by radiopaque markers. Results. Seventeen (81%) SCI and 14 (93%) CIC patients reported abdominal pain or discomfort within the last month (P = 0.38). Pain was considered more intense by CIC than by SCI patients (P GITT. Conclusion. Most characteristics of abdominal pain among SCI patients resemble those of CIC. This indicates that constipation is a major cause of pain after SCI. PMID:24159329

  1. Abdominal Pain: A Comparison between Neurogenic Bowel Dysfunction and Chronic Idiopathic Constipation

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    Pia Møller Faaborg

    2013-01-01

    Full Text Available Introduction. Most spinal-cord-injured patients have constipation. One-third develop chronic abdominal pain 10 years or more after injury. Nevertheless, very little is known about the nature of abdominal pain after spinal cord injury (SCI. It may be neuropathic or caused by constipation. Aim. To compare characteristics of abdominal pain in SCI with able-bodied with chronic idiopathic constipation (CIC. Subjects and Methods. 21 SCI and 15 CIC patients were referred for treatment of bowel symptoms. Constipation-related symptoms were assessed with the Cleveland Constipation Scoring System and the International Spinal Cord Injury Basic Bowel Function Data Set. Characteristics of abdominal pain were described using the Brief Danish Pain Questionnaire. Total gastrointestinal transit times (GITT were measured by radiopaque markers. Results. Seventeen (81% SCI and 14 (93% CIC patients reported abdominal pain or discomfort within the last month (. Pain was considered more intense by CIC than by SCI patients (. Only minor differences were found in patient’s qualitative description of abdominal pain or in the location of pain. In neither SCI nor CIC was pain associated with GITT. Conclusion. Most characteristics of abdominal pain among SCI patients resemble those of CIC. This indicates that constipation is a major cause of pain after SCI.

  2. Idiopathic Chronic Eosinophilic Pneumonia: Retrospective Analysis of 17 Cases from a Single Center in Turkey

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    Sibel Arınç

    2016-08-01

    Full Text Available Objective: Idiopathic chronic eosinophilic pneumonia (ICEP is a rare eosinophilic lung disorder with an unknown etiology and is characterized by subacute or chronic respiratory and general symptoms, alveolar and/or peripheral eosinophilia, and the accumulation of eosinophils in the lungs. We aimed to present diagnostic test results and follow-up outcomes of 17 patients who were diagnosed with ICEP in our hospital in light of literature. Methods: Between 2008 and 2013, we examined 17 cases of ICEP. We evaluated clinical and laboratory findings together with the long-term follow-up data. Results: The patients had a mean age of 40.8 years at presentation, and the female/male ratio was 0.8. The most common symptoms were cough (94%, shortness of breath (76%, and high fever (35%. Bronchoalveolar lavage eosinophil percentages of the patients ranged from 3% to 80%. Nine (53% patients experienced recurrence. Six patients were maintained on low dose steroid due to repeating relapses. Among these patients, 7 (77.7% had a total IgE level of above 500/IU/mL. Conclusion: Relapses are common in ICEP after the withdrawal of corticosteroid treatment or during dose reduction. We point out the importance of the close monitoring of patients for identifying relapse. A higher total IgE level during diagnosis may serve as a predictor of recurrence.

  3. [Urticaria and angioedema].

    Science.gov (United States)

    Guillén Escalón, J; Vargas Rosas, M A; Mendoza Magaña, E; Zepeda Ortega, B; Sienra Monge, Juan José Luise; del Río Navarro, Blanca Estela

    2007-01-01

    Urticaria is considered a heterogeneous group of diseases that share different patterns of skin reactions. The wide diversity in urticaria subtypes have been identified and this reflects partial understanding of the causes or factors that trigger it, as well as the molecular and cellular mechanisms that are involved in their physiopathology. The objective of this article was to make an extensive review of the literature to be able to offer the readers a complete information and updating on the basic, ethiologic and physiophatologic mechanisms and mainly to make a special emphasis on diagnosis and treatment of urticaria, promoting the continuous medical education.

  4. 禁食轮替疗法治疗食物不耐受的慢性荨麻疹临床研究%Study on the Mechanism of Chronic Urticaria Intolerance of Food Treatment by Fasting and Spell

    Institute of Scientific and Technical Information of China (English)

    杨啸宇; 黎昌强; 邱雄; 金泽龙; 汪平; 牟双梦; 杨闯; 陆小琴

    2013-01-01

    Objective To explore the possible mechanism of fasting and spell combined with antihistamines therapy on the Chronic Urticaria with Food Specific IgG Positive patients, then provide theoretical basis for clinical treatment. Methods 90 patients with Chronic Urticaria were divided into three groups, Group A was 30 cases of chronic urticaria with food specific IgG negative which were treated by mizolastine and ketotifen, Group B was 30 cases of chronic urticaria with food specific IgG positive which were treated the same treatment as A group, Group C was 30 cases of chronic urticaria with food specific IgG positive which were treated by mizolastine and ketotifen, simultaneously fasting and spell. Detecting the levels of food specific IgG, histamine and LTB-4 of the 3 groups before and after the treatment. Results After 6 months treatment, the histamine level of Group A and C decreased significantly compare with before treatment, while Group B was not;the LTB-4 level of Group A decreased significantly, while Group B and C did nots the levels of food specific IgG of group B had no significant changes, while group C significantly changed. Conclusion The intake of sensibiligen is decreased by fasting and spell treatment, thereby reduce the stimulation on mast cell and basophil for the Chronic Urticaria patients , and the release of the histamine.%目的 探索禁食、轮替疗法联合药物治疗食物特异性IgG阳性的慢性荨麻疹的可能机制,为临床治疗提供依据.方法 将慢性荨麻疹患者90例分为食物耐受组(A组)30例,采用咪唑斯叮、酮替芬治疗;食物不耐受Ⅰ组(B组)30例,同样采用咪唑斯叮、酮替芬治疗;食物不耐受Ⅱ组(C组)30例,采用咪唑斯叮、酮替芬治疗同时,配合禁食轮替疗法进行治疗;检测3组患者治疗前后食物特异性IgG、组胺及LTB4的水平.结果 治疗6个月后,A组和C组组胺水平比治疗前明显降低,B组无明显降低;A组LTB4的水平比治疗前

  5. 皮肤点刺试验在慢性荨麻疹变应原检测中的临床应用%Clinical application of skin-prick test in chronic urticaria allergen detection

    Institute of Scientific and Technical Information of China (English)

    陈小玉; 贺春香

    2011-01-01

    目的 了解永川地区及周边县城慢性荨麻疹病人的常见致敏原,评价变应原皮肤点刺试验在慢性荨麻疹病原诊断中的价值.方法 采用国际标准方法的皮肤点刺(skin prick test,SPT)试验,对950例慢性荨麻疹病人做30种变应原(北京协和公司提供)测定,其中吸入性变应原16种,食物性变应原14种,并设阳性及阴性对照,以阳性对照为判断标准.结果 950例慢性荨麻疹病人中阳性者630例,阳性率66.3%,吸入组、食入组阳性率分别为54.2%和34.2%、.吸入组中以以尘螨、蟑螂、蒿类花粉、棉絮、狗毛、香烟居前;食入组中虾类、蟹类、辣椒、带鱼、橘子、芒果居前,吸入性变应原与慢性荨麻的相关性强于食入性变应原.结论 变应原皮肤点刺试验安全、可靠,易操作,为慢性荨麻疹病人寻找可能的变应原提供客观依据,为预防、治疗及护理起到一定的指导作用.%Objective To investigate the common allergens of patients with chronic urticaria I and evaluate the value of skin prick test in the diagnosis of chronic urticaria pathogen. Methods 950 cases of chronic urticaria patients were detected with 30 kinds of allergens (provided by Beijing Union Company) in the skin prick ((skin prick test, SPT) experiments of international standard method, including 16 inhaled allergens andH food allergens. Positive and negative controls were established, of which the positive control was taken as the criterion. Results Of the 950 cases of chronic urticaria patients,630 cases were positive, and the positive rate was 66. 3%. The positive rates of inhalation group and food group were 54. 2% and 34. 2%. In the inhalation group, dust mites, cockroaches, Artemisia pollen, cotton, dog hair and cigarette were on the top. The top factors were shrimp, crab, peppers, octopus, orange and mango. The inhalation allergens were more associated with chronic urticaria than that of ingestion allergens. Conclusion

  6. Observation on the Treatment Effect of Chronic Urticaria with BCG-polysaccharide Nucleic Acid Injection%卡介菌多糖核酸注射液治疗慢性荨麻疹疗效观察

    Institute of Scientific and Technical Information of China (English)

    马跃民

    2000-01-01

    目的:观察卡介菌多糖核酸注射液治疗慢性荨麻疹的疗效。方法:将门诊慢性荨麻疹患者85例分为对照组40例(男23例,女17例),给抗组胺药物及外用止痒剂等常规治疗。治疗组45例(男26例,女19例),在给抗组胺药物及外用止痒剂等常规治疗基础上加用卡介菌多糖核酸注射液。结果:治疗组有效率93.3%,对照组有效率72.5%,无副作用。结论:用卡介菌多糖核酸注射液治疗慢性荨麻疹有效、安全。%Objective: To investigate the effect of BCG-polysaccharide nucleic acid injection (BCG-PSN)on chronic urticaria. Methods: 85 cases of chronic urticaria were treated at the outpatient department. Among them 40Patients(male 23, female 17)were chosen as control. They were given routine treatment shch as antihistamine drugs and topical agents. The othet 45 patients (male 26, female 19)were included in the treatment group. In addition to the routine treatment, they received intramuscular injection of BCG-PSN. ResuIts:Toal cure rate was 93.3% in the treatment group and 72.5% in the control group. No adverse effect was observed. ConcIusion: BCG-PSN was both safe and effective in treating chronic urticaria.

  7. Analysis of detection of allergens in 284 chronic urticaria cases in Zhuhai City%珠海地区慢性荨麻疹284例患者过敏原检测分析

    Institute of Scientific and Technical Information of China (English)

    王晓鸿; 蒋明华; 肖佐环

    2011-01-01

    Aim To investigate significance of allergens in pathogenesis of chronic urticaria. Methods Allergens in 133 female and 151 male cases with chronic urticaria were tested in vitro,including total serum IgE,inhalational allergens and ingestive allergens. Results The positive rates of IgE in 133 female cases and 151 male case were 92.30%(120/133)and 81.46%(123/133).The common allergens detected were house dust,acarid,fish and seafood. Conclusions Both inhalational and ingestive allergens are closely related to chronic urticaria.%目的 探讨过敏原在慢性荨麻疹发病中的意义.方法 采用过敏反应体外检测系统(IVT)对284例慢性荨麻疹患者进行血清总IgE检测、吸入性过敏原和食入性过敏原检测.结果 133例女性患者血清总IgE阳性120例,阳性率为92.30%,151例男性患者血清总IgE阳性123例,阳性率81.46%,吸入性过敏原过敏原阳性的多见于屋尘、尘螨,食入性过敏原阳性的多见于鱼类、海鲜类.结论 吸入性及食入性过敏原与慢性荨麻疹的发病密切相关.

  8. 230例慢性荨麻疹患者皮肤变应原点刺试验结果分析%Analysis of allergens on 230 patients with chronic urticaria

    Institute of Scientific and Technical Information of China (English)

    高虎; 宋继权; 夏敏; 高婷婷

    2014-01-01

    To detect the type of allergens in patients with chronic urticaria in Wuhan. Methods: Ten kinds of allergens were detected with skin prick test in 230 patients with chronic urticaria. Results:The total positive rate of 230 cases was 83.47%. The positivity rate of dust mite was highest, accounting for 80%, followed by sea crab (44.35%), shrimp (36.52%), pollen (28.26%), peanut (26.96%) and dog dander epithelium (21.30%). Conclusion: The dust mite is the most common allergen in Wuhan and the patients with chronic urticaria should avoid contacting dust mites as far as possible.%目的:明确武汉地区慢性荨麻疹患者变应原种类。方法:采用标准化皮肤点刺试验方法对230例慢性荨麻疹患者进行10种变应原检测。结果:受试者变应原粉尘螨阳性率最高占80%;其次是海蟹、海虾、花粉、花生、狗毛上皮,分别占44.35%、36.52%、28.26%、26.96%和21.30%。结论:本地区变应原以粉尘螨最常见,慢性荨麻疹患者应尽可能避免接触含尘螨较多的环境。

  9. 慢性顽固性荨麻疹采用温补肾阳法治疗的临床效果报道%Clinical effect of warming and invigorating kidney yang in treating chronic urticaria

    Institute of Scientific and Technical Information of China (English)

    虞小坚

    2016-01-01

    Objective To study the effect of Warming Kidney Yang on the treatment of chronic refractory urticaria.Methods 44 cases of chronic urticaria patients, according to the different treatment method is divided into two groups (n = 22), the observation group treated with warming and Tonifying Kidney Yang, while the control group was treated by the treatment of mitel.Results The total effective rate and adverse reaction rate of the observation group were 86.4% and 9.1%, compared with the control group (P < 0.05).Conclusion Warming Kidney Yang method can significantly improve the clinical symptoms of chronic urticaria patients, reduce the incidence of adverse reactions.%目的:研究温补肾阳法治疗慢性顽固性荨麻疹效果.方法:选取我院44例慢性顽固性荨麻疹患者,根据不同治疗方法分为两组(n=22例),观察组予温补肾阳法,对照组予敏迪治疗.结果:观察组患者临床治疗总有效率和不良反应发生率分别为86.4%、9.1%同对照组患者相比有明显统计学意义(P<0.05).结论:温补肾阳法可显著改善慢性顽固性荨麻疹患者临床症状,降低不良反应发生率.

  10. Observation of curative effect by pidotimod combined with desloratadine in the treatment of chronic urticaria%匹多莫德联合地氯雷他定治疗慢性荨麻疹疗效观察

    Institute of Scientific and Technical Information of China (English)

    种树彬

    2015-01-01

    Objective To observe the clinical effect of pidotimod tablets combined with desloratadine tablets in the treatment of chronic urticaria. Methods A total of 100 chronic urticaria patients were randomly divided into treatment group and control group, with 50 cases in each group. The treatment group received oral administration of pidotimod tablets combined with desloratadine tablets for treatment, and the control group received oral administration of desloratadine tablets alone for treatment. Curative effects of the two groups were compared. Results The treatment group had the total effective rate as 82%, and that of the control group was 64%. The treatment group had higher total effective rate than the control group (P<0.05). Conclusion Combination of pidotimod tablets and desloratadine tablets provide precise effect with high safety in treating chronic urticaria.%目的:观察匹多莫德片联合地氯雷他定片治疗慢性荨麻疹的临床疗效。方法100例慢性荨麻疹患者随机分为治疗组和对照组,各50例。治疗组口服地氯雷他定片,同时口服匹多莫德片治疗。对照组单独口服地氯雷他定片治疗。比较两组治疗效果。结果治疗组总有效率为82%;对照组总有效率为64%,治疗组总有效率高于对照组(P<0.05)。结论匹多莫德片联合地氯雷他定片治疗慢性荨麻疹,疗效显著,安全性高。

  11. THE CURATIVE EFFECT OF THE COMBINED USE OF PEMIROLAST POTASSIUM AND CETIRIZINE ON CHRONIC URTICARIA%吡嘧司特钾联合西替利嗪治疗慢性荨麻疹疗效观察

    Institute of Scientific and Technical Information of China (English)

    陈雷; 朱清娟; 王启华

    2014-01-01

    目的:观察西替利嗪联合吡嘧司特钾治疗慢性荨麻疹的治疗效果。方法将慢性荨麻疹患者90例随机分为治疗组和对照组各45例,治疗组采用西替利嗪片联合吡嘧司特钾片治疗,对照组则只服用西替利嗪治疗。结果治疗组的有效率为88.9%,明显高于对照组71.1%,两组对比有显著性差异( P <0.05)。结论西替利嗪联合吡嘧司特钾治疗慢性荨麻疹具有较好的疗效,值得临床推广应用。%Objective To observe the curative effect of the combined use of pemirolast potassium and cet-irizine on chronic urticaria .Methods 90 cases of chronic urticaria were randomly divided into the treatment and the contrast groups . The 45 cases in the treatment group were treated with the combined use of pemirolast potassium and cetirizine ,w hile the 45 cases in the cont-ast group were treated only with cetirizine .Results The curative rates in the treatment group and the con-trast group were 88 .9% and 71 .1% respectively( P <0 .05) .Conclusion The combined use of pemirolast potassium and cetirizine can produce good curative effects on chronic urticaria .

  12. Clinical research on integrated traditional and western medicine for Chronic urticaria%慢性荨麻疹162例中西医结合治疗的临床疗效分析

    Institute of Scientific and Technical Information of China (English)

    朱海; 杜伟峰; 黎雪芳

    2012-01-01

      目的观察中西医结合治疗慢性荨麻疹的临床疗效.方法将我院于2010年1月1日至2012年6月1日门诊治疗的162例慢性荨麻疹患者随机分为治疗组和对照组,每组81例,两组均给予匹多莫德/地氯雷他定口服治疗,对照组加用中药汤剂治疗,观察对比两组疗效.结果治疗组的总有效率为90.1%,对照组的总有效率为70.4%,具有显著性差异(P<0.05).结论中西医结合治疗慢性荨麻疹疗效确切,无明显不良反应,安全度高,值得临床推广应用.%  Objective:To evaluate the effectiveness of integrated traditional and western medicine for Chronic urticaria. Method:324 patients with confirmed Chronic urticaria in our hospital were divided into two groups (treatment and controled) . western medicine was given to al of the patients and traditional medicine was given to the treatment groups additional. Contrasting and analyzing clinical efficacy of the two groups. Results:The total effective rates of was90.1% in the treatment group and 70.4% in the controled group. Clinical efficacy of the treatment groups was significantly different from the controled group. Conclusion: Integrated traditional and western medicine was more effective and safe for Chronic urticaria.

  13. 氮卓斯汀联合恩再适治疗慢性荨麻疹的临床观察%The clinical observation of azelastine joint analgecine for treatment of chronic urticaria

    Institute of Scientific and Technical Information of China (English)

    杨晓梅

    2009-01-01

    Objective To observe the therapeutic effectiveness of Azelastine joint Analgecine for treatment of chronic urticaria. Methods 86 cases of chronic urticaria patients were divided into two groups randomly, treatment group with 46 patients (Azelastine joint Analgecine), 40 patients in the collator group (use Azelastine only) to compare with the therapeutic effectiveness of the two groups. Results The cure effective rate was 89.1% for the treatment group, 62.5% for the collator group, the difference between the two groups are significant(P<0.05).Conclusion The therapeutic effectiveness of Azelastine joint Analgecine for treatment of chronic urticaria is definite efficacy, it's safe.%目的 观察氮卓斯汀联合恩再适治疗慢性荨麻疹的疗效.方法 将86例慢性荨麻疹患者随机分为两组,治疗组46例(氮卓斯汀联合恩再适治疗),对照组40例(单用氮卓斯汀治疗),观察两组疗效.结果 治疗组总有效率为89.1%,对照组总有效率为62.5%,两组比较有显著性差异(P<0.05).结论 氮卓斯汀联合恩再适治疗慢性荨麻疹疗效确切,安全性良好.

  14. Neurogenic chronic idiopathic intestinal pseudo-obstruction, patent ductus arteriosus, and thrombocytopenia segregating as an X linked recessive disorder.

    Science.gov (United States)

    FitzPatrick, D R; Strain, L; Thomas, A E; Barr, D G; Todd, A; Smith, N M; Scobie, W G

    1997-08-01

    We present a family with three affected males in two generations with congenital neurogenic chronic idiopathic intestinal pseudo-obstruction (CIIP), patent ductus arteriosus, and large platelet thrombocytopenia apparently segregating as an X linked recessive disorder. The pattern of segregation of DNA markers within the family is consistent with linkage to the previously described neurogenic CIIP (CIIPX) locus at Xq28. This combination may represent a new contiguous gene disorder and appears to have a good prognosis with supportive therapy.

  15. Upregulated expression of substance P in basophils of the patients with chronic spontaneous urticaria: induction of histamine release and basophil accumulation by substance P.

    Science.gov (United States)

    Zheng, Wenjiao; Wang, Junling; Zhu, Wei; Xu, Chiyan; He, Shaoheng

    2016-06-01

    Human basophils have been implicated in the pathogenesis of chronic spontaneous urticaria (CSU), and substance P (SP) is a possible candidate as histamine-releasing factor in some patients with CSU. However, little is known of relationship between basophils and SP in CSU. In the present study, we investigated expression of SP and NK1R on basophils from patients with CSU, and influence of SP on basophil functions by using flow cytometry analysis, basophil challenge, and mouse sensitization model techniques. The results showed that plasma SP level and basophil numbers in CSU patients were higher than that in HC subject. The percentages of SP+ and NK1R+ basophils were markedly elevated in CSU blood in comparison with HC blood. Once added, SP induced up to 41.2 % net histamine release from basophils of CSU patients, which was comparable with that provoked by anti-IgE, and fMLP. It appeared that SP induced dramatic increase in blood basophil numbers of mice following peritoneal injection. Ovalbumin (OVA)-sensitized mice had much more SP+ and NK1R+ basophils in blood than non-sensitized mice. In conclusion, the elevated plasma concentration of SP, upregulated expression of SP and NK1R on basophils, and the ability of SP in induction of basophil degranulation and accumulation indicate strongly that SP is most likely a potent proinflammatory mediator, which contributes greatly to the pathogenesis of CSU through basophils. Inhibitors of SP and blockers of NK1R are likely useful agents for treatment of CSU.

  16. One-year safety and efficacy study of bilastine treatment in Japanese patients with chronic spontaneous urticaria or pruritus associated with skin diseases.

    Science.gov (United States)

    Yagami, Akiko; Furue, Masutaka; Togawa, Michinori; Saito, Akihiro; Hide, Michihiro

    2016-11-14

    A number of second-generation non-sedating antihistamines are used in clinical practices over the world. However, long-term safety and efficacy have not been proved high level evidence based medicine. We have performed an open-label, multicenter, phase III study to evaluate the long-term safety and efficacy of bilastine, a novel non-sedating H1 -antihistamine for patients with chronic spontaneous urticaria (CSU) or pruritus associated with skin diseases (trial registration no. JapicCTI-142528). Patients aged 18-74 years were treated with bilastine 20 mg once daily for up to 52 weeks. Safety and tolerability were assessed on the basis of adverse events (AE), bilastine-related AE, laboratory tests and vital signs. Efficacy was assessed based on rash score, itch score, overall improvement and quality of life. One hundred and ninety-eight patients enrolled, 122 of whom (61.6%) completed the 52-week treatment period. AE were reported in 64.5% and bilastine-related AE in 2.5% of patients throughout the 52-week treatment period. All AE were mild to moderate in severity. AE associated with the nervous system occurred in 10 patients (5.1%) including seven patients (3.6%) with headache. Somnolence reported in two of these patients (1.0%) was related to bilastine. All efficacy variables improved during treatment with bilastine. In conclusion, long-term treatment with bilastine 20 mg once daily for 52 weeks is safe and well tolerated in Japanese patients with CSU or pruritus associated with skin diseases. Bilastine improved disease symptoms of both conditions early in treatment, and the efficacy was maintained throughout the treatment.

  17. Role of Th17 cell and interleukin-17 in the pathogenesis of chronic urticaria%Th17细胞和IL-17在慢性荨麻疹患者发病中的作用

    Institute of Scientific and Technical Information of China (English)

    邹循辉; 石丽君; 李利豪

    2013-01-01

    Objective To investigate the roles of Th17 cells and interleukin-17 in the pathogenesis of chronic urticaria. Methods Peripheral blood were collected from 60 chronic urticaria patients and 30 normal controls,The expression of Th17 cells were tested with flow Cytometry,and serum level of interleukin-17 was tested with ELISA. The correlation between Th17 and interleukin-17 was analyzed. Results Compared with controls,the positive rate of Th17 cells and serum level of interleukin-17 were significantly higher in the chronic urticaria patients (P<0.05), showing a positive correlation between them (r=0.896,P<0.05). Conclusions Both of Th17 cells and interleukin-17 are involved in the course of chronic urticaria.%目的 探讨Th17细胞和白细胞介素(Interleukin,IL)-17在慢性荨麻疹患者发病机制中的作用. 方法 采用流式细胞仪检测60例慢性荨麻疹患者和30例健康体检者(对照组)外周血Th17细胞的表达,双抗夹心酶联免疫吸附法检测上述研究对象外周血血清IL-17水平,并分析二者相关性. 结果 慢性荨麻疹患者Th17细胞阳性率和IL-17水平均高于对照组(P<0.05),Th17细胞与血清IL-17水平呈正相关(r=0.896,P<0.05). 结论 Th17细胞和IL-17可能参与了慢性荨麻疹患者的发病过程.

  18. 阿伐斯汀联合复方甘草酸苷治疗慢性荨麻疹疗效观察%ACRIVASTINE COMBINED WITH COMPOUND GLYCYRRHIZIN IN TREATMENT OF CHRONIC URTICARIA

    Institute of Scientific and Technical Information of China (English)

    曹广喜; 于腾珍; 马丽华

    2015-01-01

    Objective To observation on combined Acrivastine clinical effects of compound glycyrrhizin in treatment of chronic urticaria .Methods Choose 133 cases of chronic urticaria ,Were divided into treatment and control groups ,Treatment group received Acrivastine in combination with compound glycyrrhizin in treatment of chronic urticaria with combination therapy ,Control group for the oral administration of Acriv‐astine treatment ,Both groups were treated for 4 weeks .Results The cure rate in the treatment group (64 . 18% ) and overall efficiency (92 .54% ) were significantly higher than the control group (31 .82% ,66 . 67% ) ,Both groups showed no side‐effects ,Both groups showed no side‐effects .Conclusion Acrivastine combined with compound glycyrrhizin in treatment of chronic urticaria ,High efficacy ,No side effects , Worth of clinical use .%目的:观察阿伐斯汀联合复方甘草酸苷治疗慢性荨麻疹的临床疗效。方法选择慢性荨麻疹患者133例,随机分成治疗组和对照组,治疗组采用阿伐斯汀联合复方甘草酸苷治疗慢性荨麻疹联合治疗,对照组仅予口服阿伐斯汀治疗,两组疗程均为4周。结果治疗组治愈率(64.18%)和总有效率(92.54%)均明显高于对照组(31.82%,66.67%),两组均无副作用。结论阿伐斯汀联合复方甘草酸苷治疗慢性荨麻疹,疗效高,无副作用,值得临床推广使用。

  19. Chronic idiopathic thrombocytopenic purpura in adult Chinese patients: a retrospective single-centered analysis of 1791 cases

    Institute of Scientific and Technical Information of China (English)

    LI Hong-qiang; ZHANG Lei; ZHAO Hui; JI Lin-xiang; YANG Ren-chi

    2005-01-01

    Background Adult chronic idiopathic thrombocytopenic purpura (ITP) is a common hematologic disease characterized by persistent thrombocytopenia. So far, there were only a few reports on adult Chinese patients with chronic ITP. This study aimed at defining the treatment outcome and prognostic factors for chronic ITP based on a large cohort of Chinese patients followed up for over 25 years at a single center.Methods The medical records of 1791 patients aged 14 years or older who were diagnosed as having chronic ITP at our hospital from 1974 to 1999 were retrospectively analyzed.Conclusions Adult Chinese chronic ITP patients can have long-term remission after steroid therapy and splenectomies. Primary steroid refractoriness is a prognostic factor predicting poor subsequent response to a splenectomy.

  20. Medicaments as the possible cause of urticaria in children.

    Science.gov (United States)

    Balaban, Jagoda

    2002-09-01

    Medicaments are reported as the most common cause of urticaria. The objective of this study was to determine, by retrospective analysis of 132 pediatric patients treated at the Pulmonology and Allergology ward of the Department of Pediatrics, Banja Luka, over a 5-year period, the scope to which medicaments act as the possible cause of urticaria. Results of the study showed that the disease manifested mostly in male children (59.8), mainly of pre-school and school age rather than <1 year age group. Acute urticaria predominated, and it was recorded in 91.7% of cases. A medicament as the possible etiologic factor of acute urticaria was found in 29.8% of cases. Regarding chronic urticaria, in most cases the cause of disease remained unknown (63.6%), whereas a medicament and infection as the possible causal factors were found in 9.1% of cases. Before the occurrence of urticaria, 37 (28%) children took some medicament. Usually, these were antibiotics (45.9%), antipyretics (35.1%), or a combination of antibiotics and antipyretics (16.2%). Penicillin V, G or ampicillin were the most frequently used antibiotics (88.2%), whereas acetylsalicylic acid was the most frequently used antipyretic (53.8%). In 28% of the children suffering from acute urticaria, apart from taking some medicament, clinically manifested infection was also recorded, mostly of the respiratory system, so it could not be stated for sure whether the medicament or infection was the etiologic factor for the occurrence of disease. In only two cases it could be stated for sure that a medicament was the cause of urticaria, one acute and chronic urticaria each

  1. A patient with steroids and antihistaminic drug allergy and newly occurred chronic urticaria angioedema: what about omalizumab?

    Science.gov (United States)

    Kutlu, A; Karabacak, E; Aydin, E; Ozturk, S; Bozkurt, B

    2014-08-01

    In this case report, successful use of omalizumab in the treatment of chronic urticarial and angioedema in a 24-year-old female patient with an allergic reaction history to almost every drug including steroids and antihistamines was presented. She also had allergy against a large number of foods, which were confirmed by oral provocation, specific Immunoglobulin E and allergy skin test.

  2. Metabolic Syndrome, Neurotoxic 1-Deoxysphingolipids and Nervous Tissue Inflammation in Chronic Idiopathic Axonal Polyneuropathy (CIAP)

    Science.gov (United States)

    Hube, Larissa; Dohrn, Maike F.; Karsai, Gergely; Hirshman, Sarah; Van Damme, Philip; Schulz, Jörg B.; Weis, Joachim; Hornemann, Thorsten; Claeys, Kristl G.

    2017-01-01

    Aim Chronic idiopathic axonal polyneuropathy (CIAP) is a slowly progressive, predominantly sensory, axonal polyneuropathy, with no aetiology being identified despite extensive investigations. We studied the potential role of the metabolic syndrome, neurotoxic 1-deoxysphingolipids (1-deoxySLs), microangiopathy and inflammation in sural nerve biopsies. Methods We included 30 CIAP-patients, 28 with diabetic distal symmetrical polyneuropathy (DSPN) and 31 healthy controls. We assessed standardised scales, tested for the metabolic syndrome, measured 1-deoxySLs in plasma, performed electroneurography and studied 17 sural nerve biopsies (10 CIAP; 7 DSPN). Results One third of the CIAP-patients had a metabolic syndrome, significantly less frequent than DSPN-patients (89%). Although the metabolic syndrome was not significantly more prevalent in CIAP compared to healthy controls, hypercholesterolemia did occur significantly more frequent. 1-deoxySLs were significantly and equally elevated in both patient groups compared to healthy controls. Mean basal lamina thickness of small endoneurial vessels and the number of CD68- or CD8-positive cells in biopsies of CIAP- and DSPN-patients did not differ significantly. However, the number of leucocyte-common-antigen positive cells was significantly increased in CIAP. Conclusions A non-significant trend towards a higher occurrence of the metabolic syndrome in CIAP-patients compared to healthy controls was found. 1-deoxySLs were significantly increased in plasma of CIAP-patients. Microangiopathy and an inflammatory component were present in CIAP-biopsies. PMID:28114358

  3. Lubiprostone for chronic idiopathic constipation and irritable bowel syndrome with constipation.

    Science.gov (United States)

    Saad, Richard; Chey, William D

    2008-08-01

    Lubiprostone, a locally acting highly selective type-2 chloride channel activator, has been US FDA approved since January 2006 for the treatment of adults with chronic idiopathic constipation and FDA approved since April 2008 for the treatment of woman aged 18 years or older suffering from irritable bowel syndrome (IBS) with constipation. Through activation of the type-2 chloride channels located on the luminal side of intestinal epithelial cells, it promotes fluid secretion, increasing the liquid content of stool and accelerating small bowel as well as colonic transit. Lubiprostone has demonstrated efficacy with respect to increasing weekly spontaneous bowel movements and improving stool consistency, straining and constipation severity, both in short- and long-term studies. It has also demonstrated efficacy in the treatment of IBS with constipation, with beneficial effects on global symptoms, abdominal pain, constipation-related symptoms and overall quality of life. There is no evidence of a rebound in constipation or IBS symptoms following cessation of lubiprostone. In general, lubiprostone is well tolerated, with the most common side effects including nausea, headache and diarrhea.

  4. Rapidly calcified all of multiple intracranial hemorrhages occurred in a patient with Chronic idiopathic thrombocytopenic purpura

    Directory of Open Access Journals (Sweden)

    Seong Rok Han, M.D., Ph.D.

    2016-03-01

    Full Text Available We report a 38-year-old female patient with chronic idiopathic thrombocytopenic purpura (ITP who occurred in rapidly calcified all of multiple intracranial hemorrhage (ICH lesions. The patient was admitted with poor oral intake and confused mentality. Neurologic examination revealed drowsy consciousness but no motor weakness. She had been diagnosed ITP 5 years ago, however, she was not taking any medication at the time of presentation. Brain CT demonstrated that multiple ICHs, which were located in left frontal lobe, left temporal lobe and right cerebellar hemisphere. Platelet count was 10,000 cells/mm3. The patient was treated with conservative management, which included corticosteroids and platelet transfusion. Follow-up CT performed 12 days after the admission revealed that multiple ICHs were grossly resolving state. Interestingly, high attenuated lesions were seen all of multiple ICH sites, which were considered calcification. After 30 months after hemorrhage, follow-up brain CT showed prominent calcification of all of previous multiple ICH lesions. The patient was well- being state.

  5. Chronic idiopathic intestinal pseudo-obstruction: the need for a multidisciplinary approach to management.

    Science.gov (United States)

    Silk, D B A

    2004-08-01

    At the outset of the research programme into irritable bowel syndrome (IBS) it was perceived that there was a need to develop a symptom-based classification for the patients. Four groups of patients were identified, those with spastic colon syndrome, diarrhoea-predominant spastic colon syndrome, functional diarrhoea and midgut dysmotility. While working with outpatients with IBS it was noted how some of them had suffered symptoms for many years; specifically, a group of patients satisfying the criteria for midgut dysmotility had also suffered from particularly severe and intractable intestinal symptoms. These patients underwent 24 h ambulatory studies of small intestinal motility and the majority were found to have manometric features of chronic idiopathic intestinal pseudo-obstruction (CIIP). To characterise the cause, laparoscopic full-thickness small intestine and colonic biopsies have been obtained in forty-five of the latter group of patients. Of these patients 58% have been found to have complete or partial deficiency of alpha-actin epitope staining in the inner circular layer of small intestinal smooth muscle. This deficiency is believed to represent an important biomarker rather than the cause of CIIP, since alpha-actin epitope deficiency has been observed in association with enteric neuropathy and myopathies. In relation to the management of CIIP patients, a multidisciplinary model is proposed incorporating management of co-morbid psychological and psychiatric pathology, abdominal and musculoskeletal pain, fatigue, urological symptoms and nutrition. A six-stage nutritional management plan for these patients is presented.

  6. Treatment of Infantile Chronic Idiopathic Thrombocytopenic Purpura by Auxiliary Use of Auriculo-Acupoint Pressing

    Institute of Scientific and Technical Information of China (English)

    卢燕

    2001-01-01

    @@According to the TCM theories of Meridian and Pulse-Picture, the author probed in the treatment of idiopathic thrombocytopenic purpura (ITP) with auriculo-acupoint pressing (AAP) and obtained good result. The study was reported as follows. METHODS General Materials Forty-five patients with chronic refractory of ITP selected from the 269 ITP in-patients, hospitalized from January 1991 to January 1998, were observed. They were diagnosed according to the clinical manifestations, peripheral blood picture and bone marrow examination, as well as platelet antibody test in some of them, which were all in accordance with the unified diagnostic standard of ITP in China(1). All of the patients had course of disease over half a year and their disease treated with hormone for 2-3 months ineffectively, and had hemorrhagic symptoms, such as dermatorrhagia and rhinorrhagia, with no hepatosplenomegaly, and platelet count within 8-72×109/L. The hormone therapy was withdrawn or stopped gradually in the observation period.

  7. Isolated idiopathic chronic pancreatitis associated with a compound heterozygosity for two mutations of the CFTR gene.

    Science.gov (United States)

    Reboul, Marie-Pierre; Laharie, David; Amouretti, Michel; Lacombe, Didier; Iron, Albert

    2003-01-01

    We report the case of a patient suffering from idiopathic chronic pancreatitis (ICP) and compound heterozygous for mutations G542X and S1235R of the cystic fibrosis transmembrane regulator (CFTR) gene. The patient had normal sweat test and no other clinical sign usually linked with a typical or moderate pathology (bronchiectasis, nasal polyposis, congenital absence of the vas deferens) of the CFTR gene. G542X is a severe mutation, which is usually found in classical cystic fibrosis when associated with other severe mutations. S1235R is a quite rare abnormality recently reported as being potentially pathogenic when combined in trans with a second CF mutation. Our case is quite similar to the only other six patients in the literature in whom only the pancreas is affected and who bear a rare mutation with moderate effect. The history and the clinical features of our patient indicate an unambiguous isolated ICP in which the presence of the S1235R mutation--in trans with regard to G542X--is likely responsible for the ICP phenotype. This case could throw light on some of the as yet poorly known abnormalities of the CFTR gene in the ICP phenotype.

  8. Genetics Home Reference: vibratory urticaria

    Science.gov (United States)

    ... in allergy symptoms such as hives (urticaria), swelling (angioedema), redness (erythema), and itching (pruritus) in the affected ... Genetic Testing (2 links) Genetic Testing Registry: Vibratory angioedema Genetic Testing Registry: Vibratory urticaria General Information from ...

  9. Clinical significance of autologous serum skin test (ASST) in the diagnosis of chronic urticaria%自体血清皮肤试验对诊断慢性荨麻疹的临床意义

    Institute of Scientific and Technical Information of China (English)

    何晓蕾; 雷铁池; 刘小明; 范智峰; 史赢

    2012-01-01

    目的 探讨慢性荨麻疹自体血清皮肤试验(ASST)的不同红斑风团反应读出结果与患者血清激发嗜碱粒细胞组胺释放和血清IgG型抗高亲和力IgE Fc受体α链(抗FcεRI)自身抗体含量的关系.方法 60例患者均符合慢性荨麻疹的诊断标准,ASST试验阳性结果判定参照Sabroe报告的标准,又依据红斑风团反应不同,进一步将Sabroe标准ASST阳性分为风团+红斑模式和单纯风团模式,将Sabroe标准ASST阴性分为单纯红斑模式与无反应模式.采用酶联免疫吸附试验(ELISA)对患者血清激发正常人外周血嗜碱粒细胞组胺释放能力和血清中抗FcεRI自身抗体含量进行测定.结果 60例慢性荨麻疹患者ASST测试阳性19例(31.7%),其中表现风团+红斑模式16例和风团模式3例;ASST阴性41例,其中无反应模式38例和红斑模式3例.慢性荨麻疹患者ASST阳性血清刺激嗜碱粒细胞组胺释放率(33.83%±9.83%)较ASST阴性血清(4.06%±1.44%)显著升高(t=5.13,P< 0.01),且几乎是10μmol/L趋化三肽(18.67%±1.77%)的2倍.仅ASST阳性(风团和红斑模式)的血清能检出高滴度的抗FcεRI自身抗体(757.64±168.99 ng/L),正常对照血清自身抗体含量仅为43.25±16.63 ng/L.结论 ASST阳性(风团和红斑模式)提示血清中含有高滴度的抗FcεRI自身抗体,可考虑自身免疫性慢性荨麻疹的临床诊断.%Objective To assess the relationships among the autologous serum-induced skin wheal-andflare reaction,ex vivo serum-induced basophil histamine release, and serum levels of IgG anti-FcεRI autoantibodies in patients with chronic idiopathic urticaria (CIU).Methods Sixty patients with CIU collected from the Renmin Hospital of Wuhan University were recruited for this study.Sera were obtained from the subjects,and ASST was performed in all of the subjects.The results of ASST were determined according to a recommended criterion described by Sabroe et al,and the positive results were

  10. The analysis of IgE and eosinophil determinations in acute and chronic urticaria children%儿童急、慢性荨麻疹 IgE 及嗜酸性粒细胞检测分析

    Institute of Scientific and Technical Information of China (English)

    蔡德丰; 陆元善; 袁艳; 杨晓林; 吴跃平; 马东礼

    2014-01-01

    Objective To investigate IgE levels,eosinophil change and their clinical significance in acute and chronic urticaria children.Methods Respectively by chemiluminescence,enzyme-linked immunofluorescence and volume,conductivity and scattering (VCS)principle,serum total IgE levels,food,mites and plant-specific IgE levels and eosinophil percentages were determined,and the samples were collected from 77 acute and 46 chronic urticaria children.The differences between acute and chronic urticaria children were analyzed comparatively.Results There was no statistical significance in total IgE levels and positive rates to food,mites and plant-specific IgE levels between acute and chronic urticaria children with other allergic diseases(P >0.05),but there was a significantly higher total IgE level in chronic group than that in acute group in acute and chronic urticaria children without other allergic diseases (P 0.05).Conclusions Eosinophil percentage is not a good index for differential diagnosis in acute and chronic urticaria children.IgE has a certain significance for diagnosing acute and chronic urticaria without other allergic diseases.However,in other cases,serum level of total IgE is not a good index for differential diagnosis in acute and chronic urticaria children.Integrating case history,course of disease and clinical symptom can help with making a correct diagnosis.%目的:探讨儿童急、慢性荨麻疹 IgE 水平和嗜酸性粒细胞变化及其临床意义。方法分别用化学发光法、酶免荧光法和 VCS(体积、电导性和散射)原理检测77例急性和46例慢性荨麻疹患儿血清总 IgE 水平,食物、螨虫及植物类特异性 IgE 和嗜酸性粒细胞比例,比较急、慢性荨麻疹患儿间上述指标的差异。结果伴有其它过敏性疾病的急、慢性荨麻疹患儿间血清总 IgE 水平,食物、螨虫及植物类特异性 IgE 阳性率差异无统计学意义(P >0.05),但不伴有其它过敏性疾

  11. Dermographism and delayed pressure urticaria.

    Science.gov (United States)

    Jauhar, Sachin; Staines, Konrad; McQueen, Marise; Watson, Ian B; Wray, David; Felix, David H

    2007-06-01

    There are few papers in the literature that describe pressure urticaria in the maxillofacial region. We present 2 cases and discuss the significance and principles of management. One case describes the diagnosis of pressure urticaria and the second describes the dental management of a patient with severe pressure urticaria.

  12. 益气养血祛风法治疗慢性荨麻疹临床研究%Clinical Study of the Yiqi Yangxue Qufeng Method on the Treatment of Chronic Urticaria

    Institute of Scientific and Technical Information of China (English)

    杨帆

    2016-01-01

    Objective To observe the effect of yiqi yangxue qufeng method on the treatment of chronic urticaria.Methods We divided 112 patients into two groups,the observation group used yiqi yangxue qufeng method and control group used oral hydrochloric acid treatment,compared the effect of two groups.ResultsThe total effective rate and recurrence rate of the observation group were significantly better than control group(P<0.05). Conclusion The effect of yiqi yangxue qufeng method on the treatment of chronic urticaria is ideal,and low recurrence rate.%目的:探讨益气养血祛风法慢性荨麻疹的临床疗效。方法随机将112例慢性荨麻疹患者平均分为两组。观察组采用益气养血祛风方治疗,对照组采用盐酸西替利嗪治疗。比较两组临床疗效。结果观察组总有效率、复发率等均优于对照组(P<0.05)。结论采用益气养血祛风方治疗慢性荨麻疹疗效理想,复发率低。

  13. Since the Blood Therapy in the Treatment of Chronic Urticaria of 59 Cases Combined with Acupoint Injection%穴位注射配合自血疗法治疗慢性风疹59例

    Institute of Scientific and Technical Information of China (English)

    魏超博

    2015-01-01

    Objective To study the therapeutic ef ect of acupoint injection combined with self blood therapy in the treatment of chronic urticaria in clinic. Methods The treatment of 59 cases of patients with this method, a total of 3 months after treatment curative ef ect observation. Results 28 cases were cured, 16 cases markedly ef ective, ef ective 10 cases, invalid 5 cases, the total ef ective rate was 91.5%. Conclusion Self blood therapy in the treatment of chronic urticaria with acupoint injection, clinical ef iciency is higher, and without any side ef ects, it is worth in clinical promotion.%目的:研究穴位注射配合自血疗法在临床上治疗慢性风疹的疗效。方法对符合标准的59例患者采用本法治疗,共计3个疗程后观察疗效。结果痊愈28例、显效16例、有效10例,无效5例,总有效率达91.5豫。结论穴位注射配合自血疗法治疗慢性风疹,临床有效率较高,且无任何毒副作用,值得在临床推广。

  14. Treatment of Severe Cold Contact Urticaria with Omalizumab: Case Reports

    Directory of Open Access Journals (Sweden)

    Petra Brodská

    2012-12-01

    Full Text Available We report 2 patients with cold urticaria with different response to treatment with omalizumab (Xolair®. Cold contact urticaria (CCU is a common subtype of physical urticaria. It is characterized by the development of wheal and/or angioedema within minutes after cold contact. Clinical manifestation of CCU can range from mild, localized whealing to life-threatening anaphylactic shock reactions. Omalizumab has been described to be useful in cases of chronic urticaria and may be an interesting option for treatment of CCU. We describe one patient with significant and long-lasting improvement of symptoms and one without any improvement after anti-immunoglobulin E therapy. In our case reports, we want to highlight that there is still a small group of patients without benefit from omalizumab treatment. It is necessary to identify this minor subgroup of patients where omalizumab does not represent an effective treatment possibility.

  15. A controlled investigation of the cause of chronic idiopathic axonal polyneuropathy.

    Science.gov (United States)

    Hughes, R A C; Umapathi, T; Gray, I A; Gregson, N A; Noori, M; Pannala, A S; Proteggente, A; Swan, A V

    2004-08-01

    To investigate the aetiology of chronic idiopathic axonal polyneuropathy (CIAP), 50 consecutive patients were compared with 50 control subjects from the same region. There were 22 patients with painful neuropathy and 28 without pain, 26 with sensory neuropathy and 24 with sensory and motor neuropathy. The typical picture was a gradually progressive sensory or sensory and motor neuropathy. It caused mild or sometimes moderate disability, and reduced the quality of life. There was no evidence that alcohol, venous insufficiency, arterial disease or antibodies to peripheral nerve antigens played a significant part. There was a possible history of peripheral neuropathy in the first or second-degree relatives of six patients and no controls (P = 0.01), and claw toes were present in 12 patients and four controls (P = 0.03). Thirty-two per cent of the patients and 14% of the controls had impaired glucose tolerance or fasting hyperglycaemia but, after adjusting for age and sex, the difference was not significant (P = 0.45), even in the painful neuropathy subgroup. The mean (SD) fasting insulin concentrations were significantly (P = 0.01) higher in the patients [75.9 (44.4) mmol/l] than the controls [47.3 (37.9) mmol/l], and the mean was higher still in the painful neuropathy subgroup [92.2 (37.1) mmol/l] (P environmental toxin exposure and hypertriglyceridaemia, but not glucose intolerance or alcohol overuse as significant risk factors that deserve further investigation as possible causes of CIAP.

  16. [An autopsy case of atypical Friedreich's ataxia with chronic idiopathic intestinal pseudo-obstruction].

    Science.gov (United States)

    Nagata, T; Aoki, M; Hasegawa, T; Shiga, Y; Hayashi, T; Higuchi, J; Abe, K; Tanno, T; Konno, H; Itoyama, Y

    2001-07-01

    We report a 58-year-old man with slowly progressive muscle atrophy and weakness in the four extremities, accompanying cerebellar ataxia and sensory impairment of all modalities. He was a product of consanguineous marriage. His neurological manifestations began in childhood. He was admitted to our hospital because of marked abdominal distension and pretibial edema with hypoalbuminemia and hyperlipidemia. Neuroimaging studies showed marked atrophy of the cerebellum and spinal cord. Nerve conduction studies presented with slowing and sural nerve biopsy revealed demyelination with onion-bulbs. Abdominal distension was interpreted to be caused by chronic idiopathic intestinal pseudo-obstruction (CIIP), leading to protein-losing gastroenteropathy and hypalbuminemia caused by the CIIP. He died of DIC by myelodysplasic syndrome and DIC, two years later. Postmortem study demonstrated with severe loss of anterior horn cells and gliosis in the spinal cord. The Clarke's column was also affected. There was symmetrical degeneration in the dorsal column and corticospinal tracts. The cerebellum showed atrophy of molecular layer, prominent loss of Purkinje's cells and sparse granular cell layer, but no obvious change in the dentate nucleus. Neuronal loss in the dorsal root ganglia was remarkable. There were no alternations in the cerebral cortex, striatum, thalamus, subthalamic nucleus, and pontine nucleus, except for mild changes in substantia nigra and inferior olivary nucleus. This case was clinically suspected either of variant of Friedreich's ataxia or an early onset ataxia associated with hypoalbuminemia (EOAHA), although marked autonomic dysfunction was atypical. But the postmortem study, demonstrated with marked neuronal loss in anterior horn cells and cerebellan cortex and rather suggested an independent category of this case.

  17. Dapsona como alternativa no tratamento de urticária crônica não responsiva a anti-histamínicos Dapsone as an alternative to the treatment of chronic urticaria non-responsive to antihistamines

    Directory of Open Access Journals (Sweden)

    Juliana Soares Pires

    2008-10-01

    Full Text Available FUNDAMENTOS: A urticária crônica é dermatose que interfere negativamente na qualidade de vida de seus portadores. O tratamento clássico com anti-histamínicos muitas vezes é ineficaz. OBJETIVO: Avaliar a eficácia e a segurança do uso da dapsona no tratamento da urticária crônica não responsiva a anti-histamínicos. METÓDOS: Realizou-se estudo retrospectivo mediante a revisão de prontuários de pacientes atendidos em ambulatório especializado em urticária entre novembro de 1996 e março de 2007. RESULTADOS: Foram avaliados 20 pacientes com urticária crônica de difícil controle, que receberam tratamento com dapsona na dose de 100mg/dia. Associados à dapsona, foram mantidos anti-histamínicos em altas doses, que, isoladamente, não controlavam os sintomas. Quatorze pacientes (70% responderam com melhora do quadro, observada tanto na diminuição ou desaparecimento das lesões quanto na redução do prurido; três (15% não obtiveram nenhum sucesso com a medicação; e três (15% tiveram o tratamento suspenso em decorrência de efeitos colaterais. CONCLUSÃO: Neste estudo, conclui-se que a dapsona é opção segura e eficaz para pacientes com urticária crônica grave não responsiva a anti-histamínicos.BACKGROUND: Chronic urticaria is a dermatosis that negatively interferes in quality of life of affected individuals. The classic treatment with antihistamines is many times ineffective. OBJECTIVE: To evaluate the efficacy and safety of using dapsone in the treatment of chronic urticaria non-responsive to antihistamines. METHODS: A retrospective study was carried out by reviewing the medical charts of patients seen at an outpatient’s clinic specialized in urticaria, between November 1996 and March 2007. RESULTS: Twenty patients with difficult to control chronic urticaria and who were treated with 100 mg/day of dapsone were evaluated. High doses of antihistamines were maintained and associated with dapsone. Antihistamines alone did

  18. Fatal hepatic failure associated with graft rejection following reduced-intensity stem-cell transplantation for chronic idiopathic myelofibrosis (CIMF).

    Science.gov (United States)

    Miyakoshi, Shigesaburo; Kami, Masahiro; Kishi, Yukiko; Murashige, Naoko; Yuji, Koichiro; Kusumi, Eiji; Matsumura, Tomoko; Onishi, Yasushi; Kobayashi, Kazuhiko; Kim, Sung-Won; Hamaki, Tamae; Takaue, Yoichi; Taniguchi, Shuichi

    2004-12-01

    A 54-year-old man with chronic idiopathic myelofibrosis (CIMF) underwent RIST. His clinical course had been uneventful until day 60, when splenomegaly reappeared. Hepatic dysfunction developed on day 75. Recipient-type hematopoiesis increased to 51% on day 90. After rapid tapering of cyclosporin, serum levels of AST and ALP normalized in parallel with recovery of complete chimerism on day 134. Yet, jaundice progressed. He died of liver failure on day 176. Postmortem examination revealed neither GVHD nor VOD. Graft rejection following RIST for CIMF may lead to fatal hepatic damage through extramedullary hematopoiesis in the liver or cytokine-mediated immune dysregulations.

  19. Treatment of chronic urticaria in children and women during pregnancy or lactation%儿童、孕妇和哺乳期妇女慢性荨麻疹的治疗观点

    Institute of Scientific and Technical Information of China (English)

    王芳; 唐慧; 徐金华

    2008-01-01

    儿童、孕妇和哺乳期妇女的生理状况特殊.治疗儿童慢性荨麻疹时,在避免可能诱发因素的基础上,应根据患儿的年龄和体质量选择H1受体拈抗剂.对于孕妇,在妊娠期应尽可能避免服药,在权衡药物对控制病情和对妊娠结局影响的利弊后,可以选择相对安伞性高的H1受体拮抗剂.一些H1受体拮抗剂可以从妇女的乳汁中分泌出来,故哺乳期妇女应慎重选择此类药物.%Children and women in pregnancy or lactation have special physiological characteristics. For children with chronic urticaria, H1-receptor antagonists should be chosen based on patients' age and weight in addition to avoidance of possible triggers. Medication should be avoided in pregnant women with urticaria, however, H1-receptor antagonists may be administered after balancing the benefits for mothers and harms to foetus. Some H1-receptor antagonists can be secreted in breast milk, so cautions should be paid to the use of these drugs in women during lactation.

  20. Pharmacoeconomic analysis of mizolastine and cetirizine in treatment of chronic urticaria%咪唑斯汀与西替利嗪治疗慢性荨麻疹的药物经济学分析

    Institute of Scientific and Technical Information of China (English)

    胡德建; 李勇剑; 肖璇

    2012-01-01

    目的 比较咪唑斯汀与西替利嗪治疗慢性荨麻疹的成本-效果(C/E).方法 96例慢性荨麻疹患者随机分为A组和B组,分别口服咪唑斯汀和西替利嗪14 d,1次/d,10 mg/次,比较2组临床疗效以及运用药物经济学方法进行C/E分析.结果 A、B2组的总有效率分别为66.67%(32例)和64.58%(31例),差异无统计学意义(P>0.05);B组的C/E(0.22)明显低于A组(0.85),差异有统计学意义(P<0.05).结论 西替利嗪治疗荨麻疹的C/E较低,较咪唑斯汀更适宜临床推广使用.%Objective To evaluate the cost-effectiveness (C/E) of mizolastine and cetirizine in treatment of chronic urticaria.Methods Ninety-six cases with chronic urticaria were randomized into group A and group B.They were administered with mizolastine and cetirizine for 14 d,qd,10 mg/time,respectively.The curative effects were observed and C/E analysis was made by cost economics approach.Results The total effective rates of group A and group B were 66.67% and 64.58%,respectively.There were no significant differences in total effective rates between the two groups ( P > 0.05 ).The C/E of group B (0.22 ) was significantly lower than that of group A (0.85).The difference between the two groups had a statistical significance (P < 0.05).Conclusion The C / E of cetirizine is low in treatment of chronic urticaria.

  1. Clinical curative effect observation of mizolastine in the treatment of chronic urticaria%咪唑斯汀治疗慢性荨麻疹的临床疗效观察

    Institute of Scientific and Technical Information of China (English)

    郑羽宇

    2014-01-01

    目的:观察咪唑斯汀在治疗慢性荨麻疹方面的临床疗效并对其安全性进行评价,比较2周疗法与4周疗法的治疗效果。方法:2012年3月-2013年6月收治慢性荨麻疹患者74例,给予患者口服咪唑斯汀10 mg/d,治疗4周,在第14天和第28天分4个等级分评分,记录患者症状及体征(瘙痒及风团的大小和数量)。结果:在治疗2周时的有效率68.9%,治疗4周时的有效率90.5%,仅有2.7%的患者发生不良反应。结论:咪唑斯汀治疗慢性荨麻疹的临床效果良好,具有高安全性和较低不良反应的优点。%Objective:To observe the clinical effect of mizolastine in the treatment of chronic urticaria and evaluate its security.To comparethe treatment effects of 2 weeks therapy with 4 weeks therapy.Methods:74 cases with chronic urticaria were selected from March 2012 to June 2013.The patietns were given oral mizolastine 10 mg one day,treatment for 4 weeks.They were scored in 4 grades scores on the fourteenth day and the twenty-eighth day.The symptoms and signs of patients were recorded(pruritus and the size and number of wheal).Results:The effective rate of treatment 2 weeks was 68.9%;the effective rate of treatment 4 weeks was 90.5%.Only 2.7% of patients had adverse reactions.Conclusion:The mizolastine in the treatment of chronic urticaria has good clinical effect.It has the advantages of high safety and low adverse reaction.

  2. Clinical efficacy of personalized nursing intervention in patients with chronic urticaria%个性化护理干预在慢性荨麻疹患者护理中的效果

    Institute of Scientific and Technical Information of China (English)

    李珊秀

    2014-01-01

    目的:探讨个性化护理干预对慢性荨麻疹患者的临床疗效。方法选取72例慢性荨麻疹患者随机分为两组,对照组36例给予常规的药物治疗,研究组36例给予除药物治疗外,给予个性化护理干预,比较两组患者疗效。结果经过不同治疗,两组患者生活质量均有所提高,而研究组的提高水平显著高于对照组;同时,研究组的有效率(94.44%)明显高于对照组(77.78%),两组之间的差异具有统计学意义(P<0.05)。结论对慢性荨麻疹患者实施个性化护理干预,可以显著增强治疗效果,提高生活质量,适合推广。%Objective To investigate clinical efficacy of personalized nursing intervention in patients with chronic urticaria. Methods 72 patients with chronic urticaria were divided into the control group (36),treated by conventional drug therapy and the study group(36),treated by personalized nursing intervention on the basis of control group.The clinical efficacy of two groups were analyzed. Results After treatment,the quality of life of two groups of patients were improved and raise the level of the study group was significantly higher than that of the control group.The total effective rate of the study group (94.44%) was significantly higher than the control group (77.78%)(P < 0.05). Conclusion Implementation of individualized nursing intervention for patients with chronic urticaria,can significantly enhance the therapeutic effect,improving the quality of life.

  3. 甘露聚糖肽联合氯雷他定治疗慢性荨麻疹的分析%Analysis of mannan peptide combined with loratadine in the treatment of chronic urticaria

    Institute of Scientific and Technical Information of China (English)

    谢利萍

    2015-01-01

    目的:探究应用甘露聚糖肽联合氯雷他定治疗慢性荨麻疹的临床治疗效果。方法:选取接受慢性荨麻疹治疗的患者80例,将其随机分为对照组和试验组,平均每组40例,对照组氯雷他定治疗,试验组甘露聚糖肽联合氯雷他定治疗,观察、比较两组患者的临床治疗效果。结果:试验组治疗后的总有效率(90%)明显高于对照组治疗后的总有效率(60%),两组有显著性差异,有统计学意义(P﹤0.05)。结论:甘露聚糖肽联合氯雷他定治疗慢性荨麻疹中,安全并且见效速度快、能达到很好的痊愈效果,值得临床应用推广。%Objective To explore the clinical therapeutic effect of application of mannan peptide combined with loratadine in the treatment of chronic urticaria. Method 80 patients who received the treatment of chronic urticaria nearly two years were randomly divided into the con-trol group and the experimental group,with 40 people in each group,the control group received loratadine for treatment,the experimental group received Mannan peptide combined with loratadine for treatment,the clinical therapeutic effect of two groups was observed and com-pared. Results The total efficiency of the experimental group after the treatment( 90%) was significantly higher than the control group (60%),there was significant difference between two groups,with statistical significance(P﹤0. 05). Conclusion Mannan peptide combined with loratadine in the treatment of chronic urticaria,which can achieve good cure effect,it is worthy of clinical application because its safety and quick reply.

  4. 升降散合清营汤治疗慢性荨麻疹33例%Clinical Observation on Shengjiang Powder combined with Qingying Decoction in the Treatment of Chronic Urticaria for 33 Cases

    Institute of Scientific and Technical Information of China (English)

    赵彦

    2016-01-01

    目的:观察升降散合清营汤治疗慢性荨麻疹临床疗效。方法63例慢性荨麻疹患者按照随机数字法分组,治疗组33例,对照组30例,两组均给予氯雷他定口服,治疗组同时口服升降散合清营汤。疗程6周,第8周做疗效评定。结果治疗组痊愈7例,显效14例,有效9例,无效3例,总有效率90.9%;对照组痊愈4例,显效10例,有效8例,无效8例,总有效率为73.3%。两组总有效率有明显差异( P<0.05)。结论升降散合清营汤治疗慢性荨麻疹的临床疗效明显。%Objective To observe the therapeutic effect of Shengjiang powder combined with Qingying decoction in the treatment of chronic urticaria.Methods 63 patients with chronic urticaria were randomized into treatment group of 33 cases and control group of 30 cases.Both of groups took orally Loratadine tablets .The treatment group was intervened by Shengjiang powder and Qingying decoction .The duration of treatment was 6months for each case .The therapeutic effect was evaluated as 8 weeks.Result In the experimental group , 7 cases convalesced, 14 cases were markedly effective, 9 cases were effective, 3 cases were invalid, and the total effective rate was 90.9%.In the control group, 4 cases convalesced, 10 cases were markedly effective, 8 cases were effective, 8 cases were invalid, and the total effective rate was 73.3%.The total effective rate between the two groups had significant difference (P<0.05).Conclusion Shengjiang powder combined with Qingying decoction in the treatment of chronic urticaria has significantly therapeutic effect .

  5. 薯蓣丸治疗围绝经期女性慢性荨麻疹的疗效观察%Efficacy Observation of Shuyu Pills in the Treatment of Chronic Urticaria in Perimenopausal Women

    Institute of Scientific and Technical Information of China (English)

    杨艳梅; 熊德上

    2011-01-01

    目的:观察薯蓣丸治疗围绝经期女性慢性荨麻疹的临床疗效与安全性.方法:将围绝经期女性慢性荨麻疹患者74例,随机分为治疗组(48例)和对照组(26例),观察2组总体疗效、远期疗效及不良反应.结果:治疗组和对照组总有效率分别为81.25%、57.69%,复发率分别为19.05%、45.45%,2组比较有显著性差异(P<0.05).治疗期间治疗组未见不良反应,对照组有20例出现嗜睡、乏力等不适,停药后消失.结论:薯蓣丸治疗围绝经期女性慢性荨麻疹疗效好,复发率低,不良反应少.%OBJECTIVE: To observe the clinical efficacy of Shuyu pills in the treatment of chronic urticaria in perimenopausal women. METHODS: 74 perimenopausal women with chronic urticaria were randomly divided into treatment group (48 cases) and control group (26 cases). The total efficacy, long-term efficacy and adverse drug reactions were observed. RESULTS: The total effective rates were 81.25% for treatment group and 57.69% for control group. The relapse rates were 19.05% and 45.45%, respectively. Significant difference was found between 2 groups(P<0.05). No adverse drug reaction was found in treatment group during treatment. In control group 20 cases suffered form somenolence and feeble, etc. The symptoms all disappeared after drug withdarwal. CONCLUSION: Shuyu pills for perimenopausal women with chronic urticaria have sound efficacy, low relapse rate and less adverse drug reactions.

  6. 氯雷他定联合复方甘草酸苷治疗慢性荨麻疹的疗效观察%Clinical Effect of Loratadine Combined with Glycyrrhizin in the Treatment of Chronic Urticaria

    Institute of Scientific and Technical Information of China (English)

    刁依心

    2014-01-01

    目的:探讨氯雷他定联合复方甘草酸苷治疗慢性荨麻疹的临床疗效。方法选择2012年11月-2013年10月本院收治的102例慢性荨麻疹患者,将患者随机分为治疗组(52例)和对照组(50例),治疗组采用氯雷他定联合复方甘草酸苷治疗,对照组仅口服氯雷他定治疗,均连续用药8周。结果治疗组治疗后第2周、第4周、第8周的疗效均优于对照组,差异有统计学意义(P ﹤0.05)。结论氯雷他定联合复方甘草酸苷治疗慢性荨麻疹疗效显著,复发率小,无明显不良反应。%Objective To discuss the effect of loratadine combined with glycyrrhizin treating chronic urticaria. Meth-ods 102 cases of chronic urticaria patients in our hospital from November 2012 to October 2013,were randomly divided into treatment group(52 cases)and control group(50 cases),the treatment group was given loratadine combined with glycyrrhiz-in,the control group only was given loratadine. Two groups were treated for 8 weeks. Results After treatment,curative effect of the second week,fourth weeks,eighth weeks of treatment group were superior to the control group,the differences were sta-tistically significant(P ﹤ 0. 05). Conclusion Loratadine combined with glycyrrhizin treating chronic urticaria have significant effect,lower recurrence rate,without adverse reaction.

  7. Analysis of Effect of Montelukast Sodium combined with BCG-PSN on Sick Children with Chronic Urticaria.%孟鲁司特联合卡介菌素治疗儿童慢性荨麻疹

    Institute of Scientific and Technical Information of China (English)

    吕广秀; 曹勇; 陈青青

    2012-01-01

      Objective The efficacy of the concept Chameng Lu Special Secretary and BCG polysaccharide nucleic acid injection treatment of chronic urticaria. Methods Control group with BCG Polysaccharide Nucleic Acid Injection 0.5mg every other day, intramuscular injection, 10d1 courses, a total of three courses, the experimental group add services on the basis of montelukast oral daily 5mg, per nightorally once. Results Results of 117 cases ,the 59 was for test group , and 58 for control group .The effective rate of test group was 88.1%, while 70.7% for control group ,the difference had statistically significant (P<0.05).Conclusion BCG-PSN was effective for treatment chronic urticaria in children ,and BCG-PSN combined with Montelukast could raise the treating effect of sick children with chronic urticaria ,and reduce the recurrence .%  目的观察孟鲁司特和卡介菌多糖核酸注射液治疗慢性荨麻疹的疗效.方法对照组单用卡介菌多糖核酸注射液0.5mg,隔日一次,肌内注射,10d1个疗程,共计3个疗程,实验组在此基础上加服孟鲁司特口服,每天5mg,每晚一次口服.结果共治疗117例,实验组59例,对照组58例,实验组有效率为88.1%,对照组有效率为70.7%,两组比较差异有统计学意义(P <0.05).结论孟鲁司特联合卡介菌素多糖核酸注射液治疗可提高儿童慢性荨麻疹病的疗效,以减少复发率.

  8. Observation of Curative Effect of MORA Combined with Diammonium Glycyrrhizinate on Chronic Urticaria%MORA生物共振联合甘草酸二胺治疗慢性荨麻疹疗效观察

    Institute of Scientific and Technical Information of China (English)

    房武宁

    2015-01-01

    目的:观察MORA生物共振系统联合甘草酸二胺胶囊治疗慢性荨麻疹的疗效。方法:选取168例慢性荨麻疹患者为研究对象,分为治疗组和对照组,治疗组采用MORA生物共振系统联合甘草酸二胺胶囊治疗,对照组单给予甘草酸二胺胶囊治疗,对比两组患者的治疗效果,进行数据分析。结果:治疗组的症状积分均比对照组低,总有效率为90.5%,明显比对照组64.3%高,均P<0.05,差异具有统计学意义。结论:MORA生物共振系统联合甘草酸二胺胶囊治疗慢性荨麻疹疗效良好,且无需耗材,无副作用,值得在临床上推广。%Objective: To observe the effect of MORA combined with diammonium glycyrrhizinate on patients with chronic urticaria. Methods: 58 patients with chronic urticaria were divided into treatment group and control group. The control group was given diammonium glycyrrhizinate and the treatment group was given MORA combined with diammonium glycyrrhizinate.The curative effects of the two groups were observed and the related datum were analyzed. Results: The symptom score of the treatment group was lower than that of the control group and the total effective rate of the treatment group was higher than that of the control group (90.48%vs64.29%). The difference was statistically significant (P<0.05). Conclusion: The effect of MORA combined with diammonium glycyrrhizinate on patients with chronic urticaria is significant. It has no side effects and is worthy of application in clinic.

  9. 桂枝加桂汤治疗阳虚型慢性荨麻疹的疗效观察%Cassia twig and laurel soup treatment curative effect observation of Yang deficiency type of chronic urticaria

    Institute of Scientific and Technical Information of China (English)

    乔丹霞

    2015-01-01

    目的:观察桂枝加桂汤治疗阳虚型慢性荨麻疹的疗效。方法:将40例阳虚型慢性荨麻疹患者随机分为观察组(20例)和治疗组(20例),对照组采取盐酸西替利嗪治疗,治疗组采取桂枝加桂汤予以口服治疗,观察两组临床疗效情况。结果:治疗28天,观察组总有效率为90.0%,对照组总有效率为75.0%,两组总有效率比较有显著性差异(P<0.05),治疗组高于对照组。结论:桂枝加桂汤治疗阳虚型慢性荨麻疹疗效优于盐酸西替利嗪。%Objective:To observe the cassia twig and laurel soup treatment the curative effect of chronic urticaria Yang deficiency type. Methods:Fourty cases of Yang deficiency in patients with chronic urticaria were randomly divided into observation group (20 cases) and treatment group (20 cases) and control group treated with cetirizine hydrochloride;Treatment group take cassia twig and laurel soup to oral therapy, observe two groups of clinical curative effect. Results:28 days, observation group total effective rate was 90.0%, control group total effective rate was 75.0%, two groups total effective rate was significant difference (P < 0.05), the treatment group is higher than the control group. Conclusion:Cassia twig and laurel soup Yang deficiency type chronic urticaria curative effect is better than that of cetirizine hydrochloride.

  10. Investigate Chronic Urticaria Patient' s Condition Correlating to C3, C4 of Peripheral Blood%外周血C3,C4与慢性荨麻疹患者病情的相关性

    Institute of Scientific and Technical Information of China (English)

    何泽生; 安国芝; 赵海春

    2013-01-01

    目的 探讨慢性荨麻疹(chronic urticaria,CU)患者外周血C3,C4水平与病情的相关性.方法 采用免疫比浊法检测19例急性荨麻疹(acute urticaria,AU)、146例CU患者的外周血C3,C4及IgG水平,并以20例健康人为对照.并通过荨麻疹活动评分(UAS)对165例荨麻疹患者的病情进行评分.结果 AU,CU患者外周血的C3,C4及IgG水平差异均无统计学意义(P均>0.05).男女性CU患者外周血的C3,C4及IgG水平差异均无统计学意义(P均>0.05).32例CU患者IgG水平高于正常值(IgG> 17g/L),与C3,C4水平呈负相关(P<0.05).UAS与荨麻疹外用血的C3,C4及IgG水平相关性差,差异无统计学意义(P均>0.05),但与IgG水平升高CU患者的C3,C4水平呈负相关,差异有统计学意义(P<0.05).结论 外周血C3,C4水平可以反应IgG水平升高的CU患者的病情.%Objective To investigate the expression of C3, C4 and IgG in peripheral blood of patients with chronic urti-caria(CU) and its correlationship with CU patients' severity. Methods The expression of C3, C4 and IgG was measured by Immune Turbidimetry in 19 patients with acute urticaria( AU), 146 patients with CU and 20 normal controls. The severity of 165 patients with uricaria was evaluated by Urticaria Activity Score (UAS). Results There were no statistically difference in the expression of C3, C4 and IgG between AU and CU patients(P>0.05) , between male and female CU patients respectively(P>0. 05). The expression of IgG was higher than normal control(IgC > 17g/L) in 32 CU patients, and showed negative correlation with the expression of C3 and C4( P < 0. 05 ). UAS was poor relation to the expression of C3 , C4 and IgG in urticaria patient's peripheral blood, but was negative correlation to the levels of C3, C4 in CU patients whose expression of IgG was higher than normal control( P <0.05). Conclusion The expression of C3, C4 could respond to the severity of CU patients whose expression of IgG is higher than normal control.

  11. NFATc3 and VIP in Idiopathic Pulmonary Fibrosis and Chronic Obstructive Pulmonary Disease

    Science.gov (United States)

    Szema, Anthony M.; Forsyth, Edward; Ying, Benjamin; Hamidi, Sayyed A.; Chen, John J.; Hwang, Sonya; Li, Jonathan C.; Sabatini Dwyer, Debra; Ramiro-Diaz, Juan M.; Giermakowska, Wieslawa; Gonzalez Bosc, Laura V.

    2017-01-01

    Idiopathic pulmonary fibrosis (IPF) and chronic obstructive pulmonary disease (COPD) are both debilitating lung diseases which can lead to hypoxemia and pulmonary hypertension (PH). Nuclear Factor of Activated T-cells (NFAT) is a transcription factor implicated in the etiology of vascular remodeling in hypoxic PH. We have previously shown that mice lacking the ability to generate Vasoactive Intestinal Peptide (VIP) develop spontaneous PH, pulmonary arterial remodeling and lung inflammation. Inhibition of NFAT attenuated PH in these mice suggesting a connection between NFAT and VIP. To test the hypotheses that: 1) VIP inhibits NFAT isoform c3 (NFATc3) activity in pulmonary vascular smooth muscle cells; 2) lung NFATc3 activation is associated with disease severity in IPF and COPD patients, and 3) VIP and NFATc3 expression correlate in lung tissue from IPF and COPD patients. NFAT activity was determined in isolated pulmonary arteries from NFAT-luciferase reporter mice. The % of nuclei with NFAT nuclear accumulation was determined in primary human pulmonary artery smooth muscle cell (PASMC) cultures; in lung airway epithelia and smooth muscle and pulmonary endothelia and smooth muscle from IPF and COPD patients; and in PASMC from mouse lung sections by fluorescence microscopy. Both NFAT and VIP mRNA levels were measured in lungs from IPF and COPD patients. Empirical strategies applied to test hypotheses regarding VIP, NFATc3 expression and activity, and disease type and severity. This study shows a significant negative correlation between NFAT isoform c3 protein expression levels in PASMC, activity of NFATc3 in pulmonary endothelial cells, expression and activity of NFATc3 in bronchial epithelial cells and lung function in IPF patients, supporting the concept that NFATc3 is activated in the early stages of IPF. We further show that there is a significant positive correlation between NFATc3 mRNA expression and VIP RNA expression only in lungs from IPF patients. In

  12. [Argentine guidelines for urticaria and angioedema].

    Science.gov (United States)

    Máspero, Jorge; Cabrera, Hugo; Ardusso, Ledit; De Gennaro, Mónica; Fernández Bussy, Ramón; Galimany, José; Galimberti, Daniel; Label, Marcelo; La Forgia, Marta; Medina, Iris; Neffen, Hugo; Troielli, Patricia

    2014-01-01

    This interdisciplinary paper summarizes the news in the diagnosis and treatment of chronic urticaria (CU), and provides concepts, definitions and evidence-based suggestions for its management. Urticaria occurs in at least 20% of the population at some point in their lives. Acute urticaria (less than 6 weeks' duration), differs from CU in its etiology, but the onset of this disease is always acute. CU may occur as spontaneous (SCU) or induced (ICU). The diagnosis is simple, although a careful evaluation is necessary for differential diagnosis. ICU's diagnosis is mainly clinical, even if provocation tests can be useful. Supplementary studies should be limited and based on the clinical suspicion. Treatment may be divided into three approaches: avoidance, elimination or treatment of the cause, and pharmacological treatment. Recently treatment has been modified with the use of second-generation antihistamines as first-line and increased doses of nonsedating H1 antihistamines, up to 4 times, as second line. Antihistamines are essential to treat CU; however, 40% of patients do not achieve good control despite increased doses and require additional treatment. The most recent evidence indicates a group of drugs to be used as third line in these cases, to improve quality of life and to limit toxicity from frequent or chronic use of systemic steroids. Only 3 drugs are recommended as third line: omalizumab, cyclosporin A or anti-leukotrienes.

  13. Role of biologics in intractable urticaria

    Directory of Open Access Journals (Sweden)

    Cooke A

    2015-04-01

    Full Text Available Andrew Cooke,1 Adeeb Bulkhi,1,2 Thomas B Casale1 1Department of Internal Medicine, Division of Allergy and Immunology, University of South Florida, Tampa, FL, USA; 2Department of Internal Medicine, College of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia Abstract: Chronic urticaria (CU is a common condition faced by many clinicians. CU has been estimated to affect approximately 0.5%–1% of the population, with nearly 20% of sufferers remaining symptomatic 20 years after onset. Antihistamines are the first-line therapy for CU. Unfortunately, nearly half of these patients will fail this first-line therapy and require other medication, including immune response modifiers or biologics. Recent advances in our understanding of urticarial disorders have led to more targeted therapeutic options for CU and other urticarial diseases. The specific biologic agents most investigated for antihistamine-refractory CU are omalizumab, rituximab, and intravenous immunoglobulin (IVIG. Of these, the anti-IgE monoclonal antibody omalizumab is the best studied, and has recently been approved for the management of CU. Other agents, such as interleukin-1 inhibitors, have proved beneficial for Schnitzler syndrome and cryopyrin-associated periodic syndromes (CAPS, diseases associated with urticaria. This review summarizes the relevant data regarding the efficacy of biologics in antihistamine-refractory CU. Keywords: chronic urticaria, omalizumab, intravenous immunoglobulin, anakinra, canakinumab

  14. 伴甲状腺抗体阳性的荨麻疹患者血清白介素13、总IgG及IgG3水平检测%Detection of IL-13, IgG and IgG3 in serum of patients with urticaria containing anti-thyreoid autoantibodies

    Institute of Scientific and Technical Information of China (English)

    李莉敏; 廖文俊; 李承新; 高天文

    2011-01-01

    目的:观察伴有器官特异性自身抗体的荨麻疹患者血清中白介素(IL)-13、总IgG及IgG3的水平.方法:用ELISA方法检测24例伴有器官特异性自身抗体的荨麻疹患者、24例慢性荨麻疹患者及24例健康对照者血清IL-13的水平;用散射比浊方法检测30例伴有器官特异性自身抗体的荨麻疹患者和20例健康对照血清总IgG及IgG3水平.结果:自身免疫性荨麻疹患者血清中IL-13明显高于慢性荨麻疹组及健康对照组,总IgG及IgG3的水平亦高于健康对照组,差异具有统计学意义(P < 0.05).结论:IL-13及IgG3可能参与了自身免疫性荨麻疹的发病过程.%Objective: To detect the levels of IL-13, IgG and IgG3 in serum of patients with urticaria containing organ specific auto-antibodies.Methods: The sera were collected from patients with urticaria containing organ specific auto-antibodies (24 cases), chronic idiopathic urticaria (24 cases) and healthy donors (24 cases).IL-13, IgG and IgG3 in serums were detected respectively by enzyme linked immunosorbent assay (ELISA) technique and rate nephelometry technique.Results:The serum concentration of IL-13 in patients with urticaria containing organ specific auto-antibodies was significantly increased than those in normal controls and chronic idiopathic urticaria.The serum levels of IgG and IgG3 in patients with urticaria containing organ specific auto-antibodies was significantly higher than those in normal controls.Conclusion: IL-13 and IgG3 may contribute to the progression of urticaria with organ specific auto-antibodies.

  15. Treatment of 35 Cases of Chronic Urticaria with Insecurity of Deficient Qi with Yufeng Gubiao Zhiyang Granule%御风固表止痒颗粒治疗气虚不固型慢性荨麻疹35例

    Institute of Scientific and Technical Information of China (English)

    柯立芝; 席建元

    2013-01-01

    目的:观察御风固表止痒颗粒治疗气虚不固型慢性荨麻疹的临床疗效.方法:将的70例慢性荨麻疹患者随机分为治疗组和对照组各35例.治疗组给予御风固表止痒颗粒治疗,对照组采用口服芪风颗粒治疗,两组均以4周为1个疗程,治疗1个疗程后判定疗效,1个月后随访复发率.结果:两组均能不同程度改善慢性荨麻疹患者的病情,每组治疗前后症状积分差异具有统计学意义(P<0.01).治疗组与对照组比较,治疗组在治疗后综合评分及综合疗效方面均优于对照组(P<0.01),治疗组总有效率为87%,对照组总有效率为74%,两组总有效率比较,差异有显著性意义(P<0.05).疗程结束1个月后对复发率进行统计,治疗组复发率为18.2%,明显低于对照组的66.7%,两组比较,差异具有统计学意义(P<0.05).结论:御风固表止痒颗粒治疗气虚不固型慢性荨麻疹有明显的临床疗效,且无明显的毒副作用.%Objective:To observe the clinical curative effect of Yufeng Gubiao Zhiyang Granule in the treatment of chronic urticaria with insecurity of deficient qi.Methods:70 patients with chronic urticaria were randomly divided into the treatment group and the control group,35 cases in each group.The treatment group was given Yufeng Gubiao Zhiyang Granule,the control group oral administration of Qifeng Granule,4 weeks as 1 course of treatment for two groups,the curative effects were tested after 1 course of treatment,the follow-up indicated the recurrence rates 1 month later.Results:The conditions of patients with chronic urticaria in the two groups improved in different degrees,the symptom scores before and after treatment in each group had significant differences (P <0.01).The treatment group was superior to the control group in the comprehensive scores and comprehensive effective rates after the treatment (P <0.01),the total effective rate of treatment group was 87%,while that of the control

  16. Urticária Urticaria

    Directory of Open Access Journals (Sweden)

    Paulo Ricardo Criado

    2005-12-01

    Full Text Available A urticária apresenta-se com diversas formas clínicas e causas distintas. Constitui uma das dermatoses mais freqüentes: 15% a 20% da população têm pelo menos um episódio agudo da doença em sua vida, resultando em percentual que varia de um a 2% dos atendimentos nas especialidades de Dermatologia e Alergologia. A urticária é classificada do ponto de vista de duração da evolução temporal em aguda (inferior a seis semanas ou crônica (superior a seis semanas. O tratamento da urticária pode compreender medidas não farmacológicas e intervenções medicamentosas, as quais são agrupadas em tratamentos de primeira (anti-histamínicos, segunda (corticosteróides e antileucotrienos e terceira linha (medicamentos imunomoduladores. As medidas terapêuticas de segunda e terceira linha apresentam maiores efeitos adversos, devendo ser reservadas aos doentes que não apresentaram controle da doença com os de primeira linha, ou àqueles a respeito dos quais não é possível estabelecer uma etiologia, tal como nas urticárias auto-imunes.Urticaria has diverse clinical presentations and causes. It is one of the most frequent dermatological conditions: 15% to 20% of population has at least one acute eruption during their lifetime, resulting in 1% to 2% of dermatological and allergological visits. Urticaria is classified based on its temporal evolution as acute (less than 6 weeks or chronic (more than 6 weeks. Management strategies may involve non-pharmacological measures and drug interventions, which are grouped into first- (antihistamines, second- (corticosteroids and anti-leukotrienes and third-line therapies (immunomodulators. Stronger, but potentially riskier, second- and third-line management may be justified for patients who do not respond to first-line therapy, or whenever a specific etiology cannot be determined, such as in autoimmune urticaria.

  17. Effect of hemodiafiltration with endogenous reinfusion on overt idiopathic chronic inflammation in maintenance hemodialysis patients: a multicenter longitudinal study.

    Science.gov (United States)

    Borrelli, Silvio; Minutolo, Roberto; De Nicola, Luca; De Simone, Emanuele; De Simone, Walter; Zito, Bruno; Guastaferro, Pasquale; Nigro, Filippo; Iulianiello, Giuseppe; Credendino, Olga; Bassi, Antonio; Leone, Luigi; Capuano, Maria; Auricchio, Maria Rita; Conte, Giuseppe

    2014-10-01

    Chronic inflammation is widely diffuse in maintenance hemodialysis (MHD) patients and is associated with poor survival. Hemodiafiltration with endogenous reinfusion (HFR) is a dialysis technique, highly biocompatible, able to adsorb proinflammatory cytokines and to decrease amino acids and antioxidants loss. These features could be helpful in MHD patients affected by idiopathic chronic inflammation, but this issue remains to be elucidated. We performed a multicenter longitudinal study to assess the effect of the switching from bicarbonate HD to HFR in patients with serum C-reactive Protein (CRP) > 5 mg/L coupled with albumin inflammation. At baseline, serum levels of CRP (18.7[7.0-39.4] mg/L) and albumin (3.5[3.3-3.7] g/dL) were significantly correlated (r = -0.49; P = 0.028). The effect on CRP and albumin was almost evident in the first 4 months and remained stable until to eighth month. A strict correlation (R = -0.49; 0.040) between percentage change of CRP (-35%) and albumin (+14%) after 8 months of HFR. These effects were associated with the reduction of IL-6, IL-1β, and TNF-α and the increment of pre-albumin and leptin, whereas the serum levels of Branched Chain Amino Acid (BCAA) remained unchanged. In MHD patients affected by idiopathic chronic inflammation the switching from BHD to HFR is associated with improvement of inflammation. Whether these favorable effects may modify the outcomes of these high-risk patients needs to be confirmed by studies ad hoc.

  18. Eltrombopag for the treatment of chronic immune or idiopathic thrombocytopenic purpura: a NICE single technology appraisal.

    Science.gov (United States)

    Boyers, Dwayne; Jia, Xueli; Jenkinson, David; Mowatt, Graham

    2012-06-01

    The National Institute for Health and Clinical Excellence (NICE) invited the manufacturer of eltrombopag (GlaxoSmithKline) to submit evidence for the clinical and cost effectiveness of this drug for the treatment of patients with chronic immune or idiopathic thrombocytopenic purpura (ITP), as part of the their Single Technology Appraisal (STA) process. The Aberdeen Technology Assessment Review (TAR) Group, commissioned to act as the evidence review group (ERG), critically reviewed and supplemented the submitted evidence. This paper describes the company submission, the ERG review and NICE's subsequent decisions. The ERG critically appraised the clinical and cost-effectiveness evidence submitted by the manufacturer, independently searched for relevant literature, conducted a critical appraisal of the submitted economic models and explored the impact of altering some of the key model assumptions as well as combining relevant sensitivity analyses. Three trials were used to inform the safety and efficacy aspects of this submission; however, one high-quality randomized controlled trial (RAISE study) was the principal source of evidence and was used to inform the economic model. Eltrombopag had greater odds of achieving the primary outcome of a platelet count between 50 × 10^⁹/L and 400 × 10^⁹/L during the 6-month treatment period than placebo (odds ratio [OR] 8.2, 99% CI 3.6, 18.7). In the eltrombopag group, 50/83 (60%) of non-splenectomized patients and 18/49 (37%) of splenectomized patients achieved this outcome. The median duration of response was 10.9 weeks for eltrombopag (splenectomized 6 and non-splenectomized 13.4) compared with 0 for placebo. Eltrombopag patients required less rescue medication and had lower odds of bleeding events for both the splenectomized and the non-splenectomized patients. For a watch-and-rescue strategy of care, the comparator was placebo and the ERG found that substantial reductions in the cost of eltrombopag are needed

  19. Bilastine: in allergic rhinitis and urticaria.

    Science.gov (United States)

    Carter, Natalie J

    2012-06-18

    Bilastine is an orally administered, second-generation antihistamine used in the symptomatic treatment of seasonal or perennial allergic rhinoconjunctivitis and urticaria. In two well designed phase III trials, 14 days' treatment with bilastine was associated with a significantly lower area under the effect curve (AUEC) for the reflective total symptom score (TSS) than placebo in patients with symptomatic seasonal allergic rhinitis. Additionally, reflective nasal symptom scores were significantly lower in bilastine than placebo recipients in patients with a history of seasonal allergic rhinitis who were challenged with grass pollen allergen in a single-centre, phase II study. Neither bilastine nor cetirizine was effective in the treatment of perennial allergic rhinitis with regard to the mean AUEC for reflective TSS in another well designed phase III trial. However, results may have been altered by differences in some baseline characteristics and placebo responses between study countries. In another well designed phase III trial, compared with placebo, bilastine was associated with a significantly greater change from baseline to day 28 in the mean reflective daily urticaria symptom score in patients with chronic urticaria. There were no significant differences in primary endpoint results between bilastine and any of the active comparators used in these trials (i.e. cetirizine, levocetirizine and desloratadine). Bilastine was generally well tolerated, with a tolerability profile that was generally similar to that of the other second-generation antihistamines included in phase III clinical trials.

  20. Analysis of the association of chronic spontaneous urticaria with interlekin-4, -10, transforming growth factor-β1, interferon-γ, interleukin-17A and -23 by autologous serum skin test

    Science.gov (United States)

    Kırmaz, Cengiz; Vatansever, Seda; Onur, Ece; Nal, Emine; Erdin, Soner; Ozyurt, Beyhan

    2017-01-01

    Aim To contribute to the understanding of the pathogenesis of chronic spontaneous urticaria (CSU) by identifying its relationship with autoimmunity and cytokines using the autologous serum skin test (ASST) and peripheral blood mononuclear cell culture (PBMC) method. Material and methods Interleukins (IL)-4, IL-10, transforming growth factor (TGF-β1), interferon (IFN)-γ, IL-17A, and IL-23 levels in cell supernatants obtained by the PBMC method were measured using ELISA. Disease activity was assessed by determining the urticaria activity score (UAS). Results A total of 40 patients diagnosed with CSU participated in this study. Twenty patients had positive ASST results, and 20 had negative results. The control group included 20 healthy volunteers. We found that the IL-23 (p = 0.01), IL-10 (p = 0.04) and IL-4 (p = 0.04) levels of the patient groups were significantly lower compared with those of the control group. The IL-23 (p = 0.009), IL-10 (p = 0.009), IL-4 (p = 0.001), and IL-17 (p = 0.05) levels of the ASST(–) patient group were significantly lower compared with those of the control group. In addition, the IL-4 (p = 0.03) and IFN-γ (p = 0.05) levels of the ASST(+) patient group were significantly lower compared with those of the control group, and the ASST(+) patients had a significantly higher UAS than the ASST(–) patients (p = 0.021). Conclusions These results, when considered together with current reports in the literature, indicate that immune dysregulation occurs in the pathogenesis of CSU, causing cytokine imbalance. PMID:28261034

  1. Immunohistological comparison of granulated cell proteins in induced immediate urticarial dermographism and delayed pressure urticaria lesions.

    Science.gov (United States)

    McEvoy, M T; Peterson, E A; Kobza-Black, A; English, J S; Dover, J S; Murphy, G M; Bhogal, B; Greaves, M W; Winkelmann, R K; Leiferman, K M

    1995-12-01

    Urticarial dermographism and delayed pressure urticaria are two forms of physical urticaria which are well defined clinically and histologically. Previous studies have shown eosinophil granule protein deposition in urticarial reactions, including chronic urticaria, solar urticaria and delayed pressure urticaria. To evaluate and compare the involvement of granulated inflammatory cells in urticarial dermographism and delayed pressure urticaria, we studied sequential biopsies of induced lesions of urticarial dermographism and delayed pressure urticaria by indirect immunofluorescence, to detect eosinophil granule major basic protein (MBP) and neutrophil granule elastase. Biopsies from dermographic lesions at time 0, 5 min, 15 min, 2 h and 24 h, showed few infiltrating eosinophils, with minimal extracellular MBP deposition, and a few infiltrating neutrophils, with minimal neutrophil elastase deposition, throughout the evolution of the lesions. Sequential biopsies of delayed pressure urticaria at time 0, 20 min, 6, 12 and 24 h, showed eosinophil infiltration with extensive MBP deposition beginning at 20 min, and neutrophil infiltration with variable elastase deposition beginning at 20 min. Control tissue specimens from normal volunteers showed neutrophil infiltration and slight degranulation, but no eosinophil infiltration or degranulation. Comparison of urticarial dermographism with delayed pressure urticaria showed marked differences in the patterns of infiltration. Delayed pressure urticaria, with eosinophil and neutrophil degranulation, was strikingly similar to the IgE-mediated late phase reaction. In contrast, eosinophil and neutrophil involvement in urticarial dermographism was minimal. Considering the extent of eosinophil granule protein deposition and the biological activities of the eosinophil granule proteins, the findings in delayed pressure urticaria point to an important pathophysiological role of eosinophils in the disease.

  2. Papular urticaria: A review of causal agents in Colombia.

    Science.gov (United States)

    Lozano, Ana Milena; López, Juan Felipe; Zakzuk, Josefina; García, Elizabeth

    2016-12-01

    Papular urticaria is a chronic allergic reaction induced by insect bites, which is common in the tropics. The objective of this review was to deepen on epidemiological and immunological aspects of this disease, focused on data published in Latin American countries.We conducted a non-systematic review of the literature through electronic search on the epidemiology of papular urticaria, the entomological characteristics of the causative agents and associated immunological mechanisms.Several reports from medical centers suggest that papular urticaria is common in Latin America. Only one epidemiological survey designed to estimate prevalence of papular urticaria has been published, reporting that about a quarter of children under six years of age is affected by this condition in Bogotá. There is evidence on the causal relationship among exposure to indoor fleas, poverty and papular urticaria in Bogotá, a representative city of the Andean altitudes. Information about causal insects in tropical warmer areas is scarce, although from clinical reports Aedes aegypti and Culex quienquefasciatus appear to be the most common. Th2 cellular-mediated mechanisms are involved in its pathogenesis, which explains its delayed hypersensitivity. The role of immunoglobulin E is not clear in this disease. Insect-derived antigens directly involved in papular urticaria etiology are unknown. However, it is possible that common molecules among causal insects mediate cross-reactive reactions, such as Cte f 2 allergen, found in cat fleas, and its counterparts in mosquitoes.Papular urticaria is a frequent disease in Latin America that should be further investigated. Immunological characterization of the molecular components that cause this condition may solve questions about its pathogenesis.

  3. How not to miss autoinflammatory diseases masquerading as urticaria

    DEFF Research Database (Denmark)

    Krause, K; Grattan, C E; Bindslev-Jensen, C;

    2012-01-01

    symptoms including recurrent fever attacks, arthralgia or arthritis and fatigue. Autoinflammatory diseases are often associated with a diagnostic delay of many years and do not respond to antihistamines and other treatments of urticaria. Also, the chronic inflammation may lead to long-term complications...

  4. Clinical management of patients with a history of urticaria/angioedema induced by multiple NSAIDs: an expert panel review.

    Science.gov (United States)

    Asero, Riccardo; Bavbek, Sevim; Blanca, Miguel; Blanca-Lopez, Natalia; Cortellini, Gabriele; Nizankowska-Mogilnicka, Ewa; Quaratino, Donato; Romano, Antonino; Sanchez-Borges, Mario; Torres-Jaen, Maria Josè

    2013-01-01

    Nonsteroidal anti-inflammatory drugs (NSAIDs) represent one of the most frequent causes of drug-induced urticaria/angioedema worldwide. Recent review articles have classified patients experiencing NSAID-induced urticaria/angioedema into different categories, including single reactors, multiple reactors, and multiple reactors with underlying chronic urticaria. Each of these categories requires a different clinical approach. The present article, written by a panel of experts, reports the main recommendations for the practical clinical management of patients with a history of urticaria/angioedema induced by multiple NSAID based on current knowledge.

  5. Therapeutic observation of the effect of combining therapy of desloratadine citrate disodium capsules and yupengfeng on chronic urticaria and effects on serum levels of ige%枸地氯雷他定胶囊联合玉屏风颗粒治疗慢性荨麻疹及对血清IgE的影响

    Institute of Scientific and Technical Information of China (English)

    田静; 黄圣波

    2015-01-01

    Objective To observe the therapeutic effect of desloratadine citrate disodium capsules combined with Yu-pengfeng in treating chronic urticaria and effects on Serum Levels of IgE. Method 172 patients with chronic urticaria were divided into two groups randomly. The treatment group were treated with desloratadine citrate disodium capsules combined with Yupengfeng. The control group were treated with desloratadine citrate disodium capsules alone. The treatment lasted for 4 weeks. Result The effective rates of the two groups were 93. 0% and 76. 7% respectively. There was statistically significant difference (P0.05)。结论 枸地氯雷他定胶囊联合玉屏风颗粒治疗慢性荨麻疹疗效好,复发率低,能明显降低血清IgE水平。

  6. Dermographism: A Rare Cause of Intraoperative Hypotension and Urticaria.

    Science.gov (United States)

    Burbridge, Mark

    2016-07-15

    A 54-year-old man with dermographism presented for spine surgery, and shortly after induction of anesthesia, he experienced severe hypotension and urticaria, resulting in cancellation of the case on suspicion of allergic reaction. For subsequent ventral hernia repair, a perioperative management strategy was devised, which resulted in an uneventful perioperative course. This case report is the first to demonstrate severe intraoperative hypotension and urticaria from dermographism. We discuss the strategy that made the subsequent surgery a success and provide guidance for practitioners who face a patient with a severe form of this chronic disease.

  7. Serum Cobalamin (Vitamin B12) Concentrations in Rhesus Macaques (Macaca mulatta) and Pigtailed Macaques (Macaca nemestrina) with Chronic Idiopathic Diarrhea.

    Science.gov (United States)

    Izzi, Jessica M; Beck, Sarah E; Adams, Robert J; Metcalf Pate, Kelly A; Hutchinson, Eric K

    2016-01-01

    Chronic diarrhea poses a significant threat to the health of NHP research colonies, and its primary etiology remains unclear. In macaques, the clinical presentation of intractable diarrhea and weight loss that are accompanied by inflammatory infiltrates within the gastrointestinal tract closely resembles inflammatory bowel disease of humans, dogs, and cats, in which low serum and tissue cobalamin (vitamin B12) levels are due to intestinal malabsorption. We therefore hypothesized that macaques with chronic idiopathic diarrhea (CID) have lower serum cobalamin concentrations than do healthy macaques. Here we measured serum cobalamin concentrations in both rhesus and pigtailed macaques with CID and compared them with those of healthy controls. Serum cobalamin levels were 2.5-fold lower in pigtailed macaques with CID than control animals but did not differ between rhesus macaques with CID and their controls. This finding supports the use of serum cobalamin concentration as an adjunct diagnostic tool in pigtailed macaques that present with clinical symptoms of chronic gastrointestinal disease. This use of serum vitamin B12 levels has implications for the future use of parenteral cobalamin supplementation to improve clinical outcomes in this species.

  8. 成都地区859例慢性荨麻疹患者过敏原检测结果分析%Detection and analysis of allergens in 859 patients with chronic urticaria in Chengdu

    Institute of Scientific and Technical Information of China (English)

    宋黎; 叶俊儒; 陆茂; 唐懿; 刘彦麟

    2016-01-01

    Objective To analyze the allergens and sex ,age distribution of chronic urticaria in Chengdu .Methods Totally 859 patients with chronic urticaria were tested with 13 kinds inhaled allergens and 15 kinds of food allergens by skin prick test .Re‐sults The top 5 allergens were:dermatophagoides farinae、dermatophagoides pteronyssinus ,cockroach ,shrimp and sea‐crab .The positive rate of dermatophagoides farinae was 58 .7% ,dermatophagoides pteronyssinus which was 55 .1% took second place .No difference was found between sex ,more inhaled allergens were found positive than food allergens in both sex groups .The positive rate was higher in people younger than 60 .Conclusion Dermatophagoides farinae ,dermatophagoides pteronyssinus ,cockroach , shrimp and sea‐crab are the commonest allergens in Chengdu .The skin prick test is important in the individualized treatment of chronic urticaria and health education .It may also be helpful in the management of chronic allergic skin diseases .%目的:分析成都地区慢性荨麻疹的常见过敏原及其性别、年龄分布。方法采用变应原点刺液(商品名:阿罗格)对859例慢性荨麻疹患者实施13种吸入物及15种食物过敏原皮肤点刺试验。结果皮试阳性率最高的前5位变应原依次是:粉尘螨、屋尘螨、蟑螂、小虾和蟹肉。其中粉尘螨阳性率最高,为58.7%,屋尘螨次之,为55.1%。不同性别变应原阳性率差异无统计学意义,男女两组吸入组变应原阳性率明显高于食物组。儿童、青中年人群变应原阳性率更高。结论粉尘螨、屋尘螨、蟑螂、小虾和蟹肉等是成都地区慢性荨麻疹的主要过敏原。皮肤点刺试验可以明确过敏原,对于慢性荨麻疹的个体化治疗及健康教育起重要作用,并为该地区慢性病管理提供合理数据。

  9. Analysis of allergen specific lgE and lgG in patients with chronic urticaria%慢性荨麻疹患者过敏原特异性IgE与特异性IgG分析

    Institute of Scientific and Technical Information of China (English)

    马超; 王伟; 吴玉红

    2014-01-01

    Objective To investigate the diagnosis and significance of serum specific IgE and specific IgG detection in chronic urti-caria allergen.Methods A hospital dermatology treatment of 89 patients with chronic urticaria was as the research object,the ELISA method was used in serum food allergen-specific IgG,while Western blot was used in the detection of serum food allergens and inhalant allergens orig-inal specific IgE.Results Food allergen specific IgG positive rate was 83.15%,and the main food allergens were eggs and milk;food aller-gen-specific IgE-positive rate was 68.54%,and the main food allergens were freshwater fish,marine fish and shrimp crab;inhalant allergen-specific IgE-positive rate was 80.90%,and the main allergens were house dust,mites combinations.Conclusion The combined detection of serum-specific IgE and allergen-specific IgG can give insight into the different aspects of the allergen type and state of the patient's allergies, medical diagnosis and guide treatment of chronic urticaria.%目的:探讨血清特异性IgE和特异性IgG检测在慢性荨麻疹过敏原诊断中的应用价值。方法选取我院皮肤科诊治的慢性荨麻疹患者89例作为研究对象,采用酶联免疫方法检测血清中食物过敏原的特异性IgG,同时采用免疫印迹方法检测血清中食物过敏原和吸入性过敏原的特异性IgE,并进行统计分析。结果食物过敏原特异性IgG的总阳性率为83.15%,主要食物过敏原是鸡蛋和牛奶;食物过敏原特异性IgE的总阳性率为68.54%,主要食物过敏原是淡水鱼、海鱼和虾蟹;吸入性过敏原特异性IgE的总阳性率为80.90%,主要过敏原是屋尘、螨虫组合。结论联合检测患者血清中的过敏原特异性IgE与特异性IgG,能从不同的方面了解患者的变应原种类及患者的过敏状态,指导慢性荨麻疹的诊断与治疗。

  10. 社会支持与应对方式对慢性荨麻疹患者生活质量的影响%Influence of Social Support and Coping Style on Quality of Life for Patients with Chronic Urticaria

    Institute of Scientific and Technical Information of China (English)

    何明月; 赵桂华; 范晓哲

    2013-01-01

    目的 探讨社会支持和应对方式对慢性荨麻疹患者生活质量的影响.方法 采用便利抽样法选取2011年11月至2012年4月在天津市中医药研究院附属医院住院的慢性荨麻疹患者90例,采用世界卫生组织生活质量测定量表简表、社会支持评定量表及医学应对方式问卷对其进行问卷调查.结果 患者的医疗费用支付方式和病程与生活质量有相关性(P0.05).结论 慢性荨麻疹患者的生活质量偏低;社会支持及应对方式影响慢性荨麻疹患者的生活质量.在临床工作中应评估患者所采取的应对方式及生活质量,通过有效的心理干预,帮助患者采用积极的应对方式,从而有效地利用社会支持,提高生活质量.%Objective To investigate the influence of social support and coping style on quality of life for patients with chronic urticaria. Methods By convenience sampling method,ninety patients with chronic urticaria were surveyed with World Health Organization Quality of Life assessment instrument-Brief (WHOQOL-BREF), Medical coping Modes Questionnaire(MCMQ) and Social Support Rating Scale (SSRS) from November 2011 to April 2012. Results Significant positive correlations were detected between payment of medical expenses, course of disease and quality of life (P<0. 05) ,subjective or objective social support and quality of life(P<0. 05 or P<0. 01). Significant positive correlations were also found between avoidance of coping modes and physical, psychological, social domains of life quality(P<0. 05). Conclusion Influenced by social support and coping style, life quality of chronic urticaria is still fairly low. Social support and coping style of chronic urticaria should be assessed in clinical practice. Effective and active psychological interventions should be implemented to help patients to adopt active coping style and efficient social support,so as to improve the life quality of chronic urticaria.

  11. 慢性荨麻疹患者外周血单一核细胞T-bet/GATA-3的表达研究%Detection of T-bet/GATA-3 expression in peripheral blood mononudear cells of chronic urticaria patients

    Institute of Scientific and Technical Information of China (English)

    罗敏; 林万飞; 余倩莹; 陈磊平

    2012-01-01

    目的 检测慢性荨麻疹患者外周血单-核细胞(PBMC)T-bet、GATA-3 mRNA的表达,计算T-bet/GATA-3比值,探讨Th1/Th2失衡与慢性荨麻疹的关系.方法 采用实时定量多聚合酶链反应(RT-PCR)方法检测30例慢性荨麻疹患者(CU)和30例健康对照者PBMC中T-bet和GATA-3 mRNA的表达水平,并计算T-bet/GATA-3比值.结果 CU组PBMC中T-bet mRNA表达水平较对照组降低,而GATA-3 mRNA的水平较对照组升高,CU组T-bet/GATA-3比值较对照组显著下降.结论 慢性荨麻疹患者T-bet/GATA-3表达异常,患者存在显著的Th1/Th2免疫失衡.%Objective To detect the T-bet and GATA-3 expression in chronic urticaria patients,and calculate the ratio of T-bet/GATA-3,then to investigate the relationship between the immune-imbalance and chronic urticaria.Methods Real-time quantitative PCR technology was used to detect the expression of T-bet and GATA-3 in peripheral blood mononuclear ceils from 30 chronic urticaria patients(CU group)and 30 normal in dividuals(control group).And then the ratio of T-bet / GATA-3 was calculated and compared.Results Tbet expression in CU group was lower than control group(P =0.0001),while GATA-3 was higher than that in control group(P =0.0001),and the ratio of T-bet / GATA-3 in CU group was obviously lower than that in control group (P =0.0001).Conclusions T-bet / GATA-3 decreased in chronic urticaria patients,there is prominent immune imbalance of Th1/Th2 in the chronic urticaria.

  12. 地氯雷他定联合孟鲁斯特钠治疗慢性荨麻疹疗效评价%Assessment of desloratadine combined with montelukast in the treatment of chronic urticaria

    Institute of Scientific and Technical Information of China (English)

    刘麟; 郑海霞

    2015-01-01

    目的::评价地氯雷他定联合孟鲁斯特钠治疗慢性荨麻疹( chronic urticaria,CU)的疗效。方法:68例慢性荨麻疹患者随机分为联合用药组( CTT组)和对照组( CTL组),每组34例,CTT组给予地氯雷他定(5 mg,1次/d)联合孟鲁斯特钠(0.1 g,3次/d)进行治疗,CTL组仅给予地氯雷他定(5 mg,1次/d)治疗,两组患者均连续服药8周。根据患者瘙痒程度、风团大小(最大直径)、风团数目等对两组患者进行疗效评价。结果: CTT 组有效率为94.12%, CTL 组73.53%,差异有统计学意义( P<0.05)。随访28周,CTT组和CTL组复发率分别为21.88%和56.00%,差异有统计学意义( P<0.01)。结论:地氯雷他定联合孟鲁斯特钠治疗CU不仅可获得更高的有效率且可降低患者的复发率。%Objective:To assess the efficacy of desloratadine combined with montelukast in the treatment of chronic urticaria ( CU) . Methods:Sixty-eight patients with CU were divided into the control ( CTL) group and the combined treatment ( CTT) group randomly ( 34 patients in each group) . All the patients were treated with desloratadine 5 mg, once a day and the patients in the CTT group were given additional leukotrienes re-ceptor antagonist of montelukast 0.1 g, three times a day, for 8 weeks. The efficacies in the two groups were assessed according to the itch degree, numbers and sizes of urticaria. Results: The effective rate in the CTT group was 94.12%, which was higher than that in the CTL group (73.53%), with a significant difference (P<0.05). The recurrent rate in the CTT group was 21.88%, which was lower than that in the CTL group ( 56.00%) after the 28 weeks follow-up, with a significant difference ( P<0.01) . Conclusion:Desloratadine combined with montelukast is more effective and lower recurrent rate than desloratadine alone in the treatment of CU.

  13. Use of anti-TNFs for difficult-to-treat urticaria: response to Cooke et al

    Directory of Open Access Journals (Sweden)

    Thomsen SF

    2015-11-01

    Full Text Available Simon Francis Thomsen,1,2 Freja Lærke Sand1,2 1Department of Dermatology, Bispebjerg Hospital, Copenhagen, Denmark; 2Department of Biomedical Sciences, University of Copenhagen, Copenhagen, DenmarkWe read with interest the recent paper by Cooke et al about the use of biologic agents for intractable urticaria.1 Particularly, the authors reckon that the evidence supporting the use of anti-TNFs is limited by the small numbers of patients in non-controlled studies, often with urticarial disorders not typical of chronic urticaria such as vasculitis and delayed pressure urticaria. However, we want to draw the authors’ and readers’ attention to our report from 2013 about the use of adalimumab and etanercept in 20 patients with chronic urticaria with or without angioedema2 (updated in 2015 with an additional five patients.3View original article by Cooke et al 

  14. What′s new in urticaria ?

    Directory of Open Access Journals (Sweden)

    Ghosh Sanjay

    2009-01-01

    Full Text Available Urticaria, a perplexing disease of ever-changing explanations, is being renovated almost everyday by newer facts and findings accumulated from different parts of the globe. Cost of the urticaria treatment gradually grows higher and higher whereas the ailment disturbs the quality of life very adversely. Disorder of coagulation cascade has recently thrown some new light into its mechanism. Non-allergic angioedema induced by bradykinin caused by genetic defects and ACE-inhibitors has also been noted. Role of H. pylori in the pathogenesis of urticaria has also been re-reviewed. Urticaria could sometimes mimic erythema multiforme and is termed urticaria multiforme. Skin biopsy showed features of vasculitis in good number of urticaria irrespective of clinical features. Contact sensitization showed positive results in certain cases thus proving contact urticaria. Topical clobetasol, systemic omalizumab and NB UVB have shown promising results in certain forms of urticaria.

  15. Recurrent facial urticaria following herpes simplex labialis.

    Science.gov (United States)

    Zawar, Vijay; Godse, Kiran

    2012-03-01

    We describe recurrent acute right-sided facial urticaria associated with herpes labialis infection in a middle-aged female patient. Antiviral medications and antihistamines not only successfully cleared the herpes infection and urticaria but also prevented further recurrences.

  16. Recurrent facial urticaria following herpes simplex labialis

    OpenAIRE

    Vijay Zawar; Kiran Godse

    2012-01-01

    We describe recurrent acute right-sided facial urticaria associated with herpes labialis infection in a middle-aged female patient. Antiviral medications and antihistamines not only successfully cleared the herpes infection and urticaria but also prevented further recurrences.

  17. Evaluation of the causes of physical urticarias

    Directory of Open Access Journals (Sweden)

    Singh Mohan

    1990-01-01

    Full Text Available Five hundred patients with urticaria were evaluated for physical factors. While 415 (83% patients associated one or more physical factors in their history, only 37% were found to be suffering- from physical urticaria following tests. These included symptomatic dermographism (16.38%, cholinergic urticaria (10.84%, cold urticaria (8.43%. solar urticaria (0.72%, pressure urticaria (0-48% and delayed cold urticaria (0.48%. The study stresses the, importance of doing physical challenge tests in all patients since historical iuivicions were not always confirmed on subsequ6nt tests. Moreover, some patients of cold chofinergic urticaria were not aware of the precipitating factors and did not provide any clue in the history.

  18. Hives (urticaria) on the trunk (image)

    Science.gov (United States)

    This person has raised, red, itchy welts (urticaria) on the chest and abdomen. The majority of urticaria develop as a result of allergic reactions. Occasionally, they may be associated with autoimmune ...

  19. [Treatment of chronic refractory idiopathic thrombocytopenia purpura. 10 years experience at the Salvador Zubiran National Institute of Nutrition].

    Science.gov (United States)

    Pita-Ramírez, L; Hurtado-Monroy, R; Labardini-Méndez, J

    1992-01-01

    A total of 126 patients with chronic idiopathic thrombocytopenic purpura were diagnosed from January 1980 to January 1990 in our institute. In this group of patients, 21 were refractory to prednisone therapy, splenectomy or both, or had had a relapse after a good response with these treatments. They were given other therapies. There was enough information for evaluation in 16 of the 21 patients. The treatment responses were classified according to the post-therapy platelet counts: complete response (CR) = > 150 x 10(9)/L for more than three months; partial response (PR) = 50-150 x 10(9)/L for more than three months; any response (AR) = CR + PR; no response (NR) = < 50 x 10(9)/L. There were 15 women and one male. The median age was 41 years (range 11 to 65). 6-mercaptopurine was given in all patients with CR = 31.2%, PR = 18.8%, AR = 50% and NR = 50%. Seven patients received cyclophosphamide with CR = 28.6%, PR = 14.3%, AR = 42.9% and NR = 57%. Vincristine was given in four patients with only one PR. Interferon alpha 2B was given in four patients with two transitory PR. One patient received colchicine and vitamin C without response. It is concluded that 6-mercaptopurine and cyclophosphamide are useful drugs in refractory thrombocytopenic purpura.

  20. Chronic idiopathic intestinal pseudo-obstruction caused by acquired visceral neuropathy localised in the left colon: report of two cases.

    Science.gov (United States)

    Suzuki, H; Amano, S; Matsumoto, K; Kitagawa, T; Masuda, T

    1987-07-01

    Two cases of chronic idiopathic intestinal pseudo-obstruction (CIIP) are reported. One is a 51-year-old man, and the other is a 47-year-old woman. Both patients presented with severe constipation and barium enema showed a marked dilation of the right colon, and a narrowing in the left colon. Studies done on the motility of the colon and anorectum revealed normal resting pressure profiles of the anorectom, a normal recto-anal reflex, and a normal resting tone of the collapsed colon. Administration of methacholine chloride, however, provoked large, non-propulsive movements in the collapsed colon, which were inhibited by the administration of atropin sulfate. Histologic examination disclosed a marked decrease in neurons and an increase of Schwann cells in the myenteric plexus of the collapsed colon. CIIP due to acquired visceral neuropathy localised in the left colon, was diagnosed as a result of manometric and histologic findings. One case was cured surgically, by a left hemi-colectomy, and the other was cured medically using choline antagonists and laxatives.

  1. A novel locus for syndromic chronic idiopathic intestinal pseudo-obstruction maps to chromosome 8q23-q24.

    Science.gov (United States)

    Deglincerti, Alessia; De Giorgio, Roberto; Cefle, Kivanc; Devoto, Marcella; Pippucci, Tommaso; Castegnaro, Giovanni; Panza, Emanuele; Barbara, Giovanni; Cogliandro, Rosanna F; Mungan, Zeynel; Palanduz, Sukru; Corinaldesi, Roberto; Romeo, Giovanni; Seri, Marco; Stanghellini, Vincenzo

    2007-08-01

    Chronic idiopathic intestinal pseudo-obstruction (CIIP) is a rare and severe clinical syndrome characterized by symptoms and signs of intestinal occlusion, in the absence of any mechanical obstruction of the gut lumen. In the attempt to identify the genetic basis of CIIP, we analyzed a Turkish pedigree with a high degree of consanguinity in which three siblings presented with a syndromic form of CIIP. All affected family members were characterized by recurrent, self-limiting subocclusive episodes, long-segment Barrett esophagus, and a variety of minor cardiac valve or septal defects. In some patients full-thickness intestinal biopsy samples were obtained and tissues were processed for immunohistochemistry using antibodies to different markers of the intestinal neuromuscular tract. Full-thickness biopsies of the gut wall showed abnormalities of both the neural and muscular components suggesting an underlying intestinal neuro-myopathy. Blood samples were collected for DNA extraction from each available family member and DNAs were genotyped using 382 microsatellites spanning the entire genome with the aim to take advantage of the homozygosity mapping approach. Linkage analysis identified a new syndromic locus on chromosome 8q23-q24 (multipoint LOD score=5.01). Our data strongly support the presence of a new genetic locus associated with CIIP, long-segment Barrett esophagus, and cardiac involvement on chromosome 8.

  2. 慢性荨麻疹患者血清二胺氧化酶活性和总IgE检测及意义%Detection and Significance of Serum Diamine Oxidase Activity and Total IgE in Chronic Urticaria Patients

    Institute of Scientific and Technical Information of China (English)

    张敏; 李桂珍; 宋蒙蒙; 张理涛

    2011-01-01

    目的:探讨二胺氧化酶(DAO)活性改变和血清总IgE水平在慢性荨麻疹发病中的意义.方法:采用分光光度法和酶联免疫吸附法测定68例慢性荨麻疹患者和54例健康对照者血清中DAO的活性及血清总IgE水平,并将其活性与病情程度和评分进行相关性分析.结果:慢性荨麻疹组血清DAO的活性在3个不同的时点均低于健康对照组,2组患者血清DAO活性时间效应、组问比较差异均有统计学意义(P<0.01),且分组与时间有交互作用(P<0.01):患者血清DAO活性与其病情的轻、中、重度存在正相关(P<0.05).慢性荨麻疹患者和健康者在血清总IgE水平上差异有统计学意义(P<0.01),且当血清总IgE≥175IU/mL时,其与病情分级成正相关(P<0.05).结论:慢性荨麻疹患者血清DAO活性降低及血清总IgE水平过高,可能与其慢性病程及严重程度有关.%Objective: To detect the serum activity of diamine oxidase and the total serum IgE levels in chronic urticaria patients, and the significance thereof. Methods: The serum levels of diamine oxidase activity and the total serum IgE were determined by spectrophotometry and enzyme-linked immunosorbent assay in 68 patients with chronic urticaria and 54 healthy controls. The relationship of the activity and the urticaria severity was compared using linear correlation. Results:The serum levels of diamine oxidase activity were lower in three different time points of chronic urticaria group than those of healthy control group. There were significant differences in the serum activity of diamine oxidase and the total serum IgE level between the two groups (P < 0.01). There was a significant difference in the correlation between the activity and the urticaria severity (P < 0.05). There was a significant correlation between the serum diamine oxidase activity and the disease severity (mild, moderate and severe, P < 0.05). There was a significant difference in the total serum IgE level between

  3. Cardiac arrest secondary to type 2 Kounis syndrome resulting from urticaria and angioedema.

    Science.gov (United States)

    Connor, Suzy; Child, Nick; Burdon-Jones, David; Connor, Andrew

    2010-07-01

    A 43-year-old man with no cardiac history presented with chest pain followed by cardiac arrest. He was successfully defibrillated and underwent primary percutaneous coronary angioplasty to a culprit coronary artery lesion. He later re-presented with a diffuse urticarial rash and lip swelling, reporting that these symptoms had been present for 4 weeks before his cardiac arrest and voicing concern that a further cardiac arrest may be imminent. A diagnosis of post-viral or idiopathic autoimmune urticaria and angioedema was made. Given the absence of cardiac symptoms before the development of the rash, it was hypothesised that coronary artery spasm precipitated by histamine release due to his dermatological condition contributed to his myocardial infarction and cardiac arrest. The final diagnosis was therefore cardiac arrest secondary to type II Kounis syndrome, resulting from idiopathic autoimmune or post-viral urticaria and angioedema.

  4. Idiopathic infantile arterial calcification in a 12-year-old girl presenting as chronic mesenteric ischemia: imaging findings and angioplasty results

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Edwin; Owen, Richard [University of Alberta, Department of Radiology and Diagnostic Imaging, Edmonton (Canada); Bruce, Garth [University of Saskatchewan, Department of Pediatrics, Royal University Hospital, Saskatoon (Canada); Wiebe, Sheldon [University of Saskatchewan, Department of Medical Imaging, Royal University Hospital, Saskatoon (Canada)

    2011-11-15

    We report an unusual case of chronic mesenteric ischemia presenting in a 12-year-old girl with idiopathic infantile arterial calcinosis (IIAC). This is the first reported case in the literature of chronic mesenteric ischemia in the setting of IIAC. The girl presented with a classical history of postprandial abdominal pain. Imaging demonstrated significant stenoses of the celiac axis, superior mesenteric artery (SMA) and inferior mesenteric artery (IMA). Angioplasty of the celiac axis and SMA was attempted, with successful dilation of the SMA only. At 3-, 6- and 12-month follow-ups, the child's symptoms had almost resolved. This case report has three important ramifications: chronic mesenteric ischemia is a possible clinical presentation in children with IACC, pre-angioplasty imaging is important in guiding treatment approach, and angioplasty was effective in this case of chronic mesenteric ischemia and offers hope for other similarly affected children. (orig.)

  5. Idiopathic venous thromboembolism and thrombophilia

    OpenAIRE

    Sinescu, C; Hostiuc, M; Bartos, D.

    2011-01-01

    During the past decade idiopathic venous thromboembolism has become a separate entity, a chronic illness which has required prolonged anticoagulation and other prevention strategies to avoid recurrences. This article reviews recent developments regarding unprovoked venous thromboembolism and its relation with thrombophilia. In the beginning, the latest definition of idiopathic venous thromboembolism is presented. The article continues with statistics about thrombophilia, related venous thromb...

  6. 复方甘草酸苷注射液联合氯雷他定片治疗慢性荨麻疹的效果观察%The Effect of Glycosides Compound Glycyrrhizin Injection and Loratadi ne Tablets for the Treatment of ChronicUrticaria

    Institute of Scientific and Technical Information of China (English)

    陈丽; 崔斌; 田爱敏

    2015-01-01

    Objective To observe the clinical effect of compound glycyrrhizin injection and loratadine tablets in treatment of chronic urticaria. Methods Selected 132 cases of patients with chronic urticaria from February 2010 to February 2010 in our hospital, randomly divided into control group and observation group, control group patients were treated with oral loratadine tablets, observation group patients were treated with oral compound glycyrrhizin glucoside and loratadine, to observe the curative effect of the two groups. Results The total effective rate in observation group of patients was significantly higher than the control group patients, P<0.05, with statistical signiifcance. Conclusion Compound glycyrrhizin glucoside with loratadine therapy to treat chronic urticaria has great curative effec.%目的:观察复方甘草酸苷注射液联合氯雷他定片治疗慢性荨麻疹的临床效果。方法选取2010年2月~2013年2月本院收治的慢性荨麻疹患者132例,随机分为对照组和观察组各66例,对照组患者口服氯雷他定片,观察组患者口服复方甘草酸苷注射液和氯雷他定片,观察两组疗效。结果观察组患者总有效率明显高于对照组患者, P<0.05,有统计学意义。结论复方甘草酸苷注射液联合氯雷他定片治疗慢性荨麻疹疗效较好。

  7. Observation of Curative Effects on Treating Chronic Urticaria with Compound Glycyrrhizin Concomitant with Cetirizine%复方甘草酸苷联合盐酸西替利嗪治疗慢性荨麻疹临床疗效观察

    Institute of Scientific and Technical Information of China (English)

    薄建华

    2011-01-01

    Objective: To observe the therapeutic effect of treating chronic urticaria with compound glycyrrhizin concomitant with cetirizine.Methods:: A total of 80 patients with chronic urticaria were enrolled, the control group were randomly assigned to receive oral cetirizine tablet 10mg/d for 4 weeks, and the treatment group to receive compound glycyrrhizin tablet 2t and cetirizine tablet 10mg/d for 4 weeks. Results: The total effective rates of the treatment group and the control group were 100% and 70.0%, respectivery and there was significant difference between the 2 groups (p<0.05). Conclusion: Compound glycyrrhizin can be used as an assistant of cetirizine in the treatmet of chronic urticaria.%目的:观察复方甘草酸苷联合盐酸西替利嗪治疗慢性荨麻疹的临床疗效、安全性.方法:80例患者随机分为治疗组和对照组,两组患者均每日口服盐酸西替利嗪10mg,治疗组同时口服复方甘草酸苷2片,3次/d,均治疗观察4周,评价疗效.结果:治疗组和对照组的有效率分别为100%和70.0%,两组有效率比较差异具有统计学意义(P<0.01).结论:复方甘草酸苷联合盐酸西替利嗪治疗慢性荨麻疹疗效可靠、安全性好,可供临床选用.

  8. Observation of clinical efficacy of compound glycyrrhizin combined with Cetirizine in treatment of chronic urticaria%复方甘草酸苷联合西替利嗪治疗48例慢性荨麻疹临床疗效观察

    Institute of Scientific and Technical Information of China (English)

    吴静

    2014-01-01

    Objective:To evaluate efficacy and safety of compound glycyrrhizin combined with Cetirizine in treatment of chronic urticaria. Methods:96 patients with chronic urticaria were divided into control group and treatment group randomly, with each group of 48 cases. The two groups were given Cetirizine (10mg, once daily). The treatment group was given compound glycyrrhizin (2 tablets, 3 times daily) on the basis of the conventional treatment. The treatment lasted for 4 weeks. Results: The total effective rate in treat-ment group (93. 75%) was higher than that in control group (72. 92%, P<0. 05). Conclusions: It is more effective by compound glycyrrhizin combined with Cetirizine in the treatment of chronic urticaria.%目的::观察复方甘草酸苷联合西替利嗪治疗慢性荨麻疹临床疗效及安全性。方法:将96例慢性荨麻疹患者随机分为治疗组(48例)与对照组(48例),两组患者均每日口服西替利嗪10mg,治疗组患者加用复方甘草酸苷2片,3次/d,均治疗4周。结果:治疗组患者较对照组总有效率高(P<0.05)。结论:复方甘草酸苷联合西替利嗪治疗慢性荨麻疹临床疗效肯定。

  9. Clinical Observation of BCG-PSN Combined with Loratadine in Treatment of Chronic Urticaria in Children%卡介菌多糖核酸联合氯雷他定治疗儿童慢性荨麻疹的疗效观察

    Institute of Scientific and Technical Information of China (English)

    钟建华; 李健清

    2009-01-01

    目的 观察卡介菌多搪核酸联合氯雷他定治疗儿童慢性荨麻疹的疗效和安全性.方法 将100例儿童慢性荨麻疹患者随机分成两组,治疗组隔天臀部肌注卡介菌多糖核酸0.5 ml及每天口服氯雷他定5 mg,共4周;对照组每天口服氯雷他定5 nag,共4周.结果 治愈率治疗组81%.明显高于对照组60%,两组差异有显著性意义X2=14.7,P<0.05.结论 卡介菌多糖核酸联合氯雷他定治疗儿童慢性荨麻疹有较好的疗效.%Objective To determine the efficacy and safety of BCG-PSN and Ioratadine in the treatment of chronic urticaria in children. Methods One hundred children with chronic urticaria were divided randomly into two groups, with fifty children each. The treatment group took intramuscular in-jection BCG- PSN 0.5 ml every other day and oral loratadine, 5 mg, once a day for four weeks. In the control group, only oral loratadine, 5 mg daily, was administrated for four weeks. Results The effective rate of the treatment group was 81%, while the effective rate of the control group was 60%. The difference between two groups was significant(X2=14.7, P <0.05). Canelusion Treatment of chronic urticaria in children by BCG-PSN combined with Io-ratadin has a better curative effect.

  10. Curative effect observation of desloratadine combined with compound glycyrrhizin in the treatment of chronic urticaria%地氯雷他定联合复方甘草酸苷治疗慢性荨麻疹的效果观察

    Institute of Scientific and Technical Information of China (English)

    周顺玉

    2016-01-01

    目的:探讨地氯雷他定联合复方甘草酸苷治疗慢性荨麻疹的效果。方法:收治慢性荨麻疹患者76例,随机分为观察组46例和对照组30例,对照组给予地氯雷他定片治疗,观察组在此基础上联合复方甘草酸苷治疗。结果:对照组治疗总有效率高于观察组(P<0.05)。结论:地氯雷他定联合复方甘草酸苷治疗慢性荨麻疹安全、有效,并发症少。%Objective:To investigate the efficacy of desloratadine combined with compound glycyrrhizin in the treatment of chronic urticaria.Methods:76 patients with chronic urticaria were selected.They were randomly divided into the observation group with 46 cases and the control group with 30 cases.The control group was given the desloratadine tablets treatment,and the observation group was given the compound glycyrrhizin treatment on the basis of the control group.Results:The total effective rate of the control group was higher than that of the observation group(P<0.05).Conclusion:Desloratadine combined with compound glycyrrhizin is safe and effective in the treatment of chronic urticaria,and it has less complications.

  11. Recommendations for assessing patient-reported outcomes and health-related quality of life in patients with urticaria: a GA(2) LEN taskforce position paper

    DEFF Research Database (Denmark)

    Baiardini, I; Braido, F; Bindslev-Jensen, Carsten

    2011-01-01

    ) and the chronic urticaria questionnaire on quality of life CU-Q(2)oL. This latter tool, CU-Q(2)oL, is available in many languages and should be preferred, where available, over more generic instruments for assessing urticaria-specific effects on quality of life. CU-Q(2)oL is only suited for the investigation...

  12. Therapeutic helminth infection of macaques with idiopathic chronic diarrhea alters the inflammatory signature and mucosal microbiota of the colon.

    Directory of Open Access Journals (Sweden)

    Mara Jana Broadhurst

    Full Text Available Idiopathic chronic diarrhea (ICD is a leading cause of morbidity amongst rhesus monkeys kept in captivity. Here, we show that exposure of affected animals to the whipworm Trichuris trichiura led to clinical improvement in fecal consistency, accompanied by weight gain, in four out of the five treated monkeys. By flow cytometry analysis of pinch biopsies collected during colonoscopies before and after treatment, we found an induction of a mucosal T(H2 response following helminth treatment that was associated with a decrease in activated CD4(+ Ki67+ cells. In parallel, expression profiling with oligonucleotide microarrays and real-time PCR analysis revealed reductions in T(H1-type inflammatory gene expression and increased expression of genes associated with IgE signaling, mast cell activation, eosinophil recruitment, alternative activation of macrophages, and worm expulsion. By quantifying bacterial 16S rRNA in pinch biopsies using real-time PCR analysis, we found reduced bacterial attachment to the intestinal mucosa post-treatment. Finally, deep sequencing of bacterial 16S rRNA revealed changes to the composition of microbial communities attached to the intestinal mucosa following helminth treatment. Thus, the genus Streptophyta of the phylum Cyanobacteria was vastly increased in abundance in three out of five ICD monkeys relative to healthy controls, but was reduced to control levels post-treatment; by contrast, the phylum Tenericutes was expanded post-treatment. These findings suggest that helminth treatment in primates can ameliorate colitis by restoring mucosal barrier functions and reducing overall bacterial attachment, and also by altering the communities of attached bacteria. These results also define ICD in monkeys as a tractable preclinical model for ulcerative colitis in which these effects can be further investigated.

  13. Role of helicobacter pylori infection in pathogenesis of chronic urticaria%幽门螺旋杆菌感染与慢性荨麻疹发病的相关性

    Institute of Scientific and Technical Information of China (English)

    戴前梅; 刘仁霞

    2015-01-01

    Objective To investigate the role of helicobacter pylori (HP) infection in the pathogenesis of chronic urticaria (CU). Methods 14C urea breath test was carried out to detect HP infection in 88 cases of CU patients and 43 cases of healthy controls. The CU patients with HP infection were randomly divided into treatment group and control group. Both groups were treated with oral desloratadine cit-rate combined with anti-HP therapy and single oral desloratadine citrate respectively. Results 62 (70. 45%) patients showed positive HP in 88 cases of CU, while 15 (34. 88%) healthy controls had HP infection. The difference between the two groups was statistically significant (P<0. 05). The total effective rate was 78. 13% in the treatment group, while 46. 67% in control group. The difference of total effective rate between the two groups had statistical significance (P<0. 05). Conclusion HP infection is related to the onset of chronic urticaria in some patients. HP detection is recommended in routine examination of CU patients. The combination of antihistamines and anti-HP medi-cines is suggested in treating those CU patients coexisted with HP infection.%目的:探讨幽门螺旋杆菌(HP)感染与慢性荨麻疹(CU)发病的关系。方法应用尿素14C呼气试验对88例CU患者和43例健康体检者进行HP检测。 HP(+)的CU患者随机分为治疗组和对照组,治疗组采用枸地氯雷他啶联合抗HP药物口服,对照组单独口服枸地氯雷他啶。结果88例慢性荨麻疹 CU 患者中62例(70.45%) HP (+),43例健康体检者中15例(34.88%)HP(+),两者差异有统计学意义(P<0.05)。治疗组和对照组的总有效率分别为78.13%和46.67%,两组之间的总有效率差异有统计学意义(P<0.05)。结论 HP感染与慢性荨麻疹的发病有一定相关性,建议对CU患者常规进行HP检测,对于伴发HP感染的CU患者,予以抗组胺药物和抗HP药物联合治疗。

  14. 左西替利嗪联合多糖蛋白片治疗慢性荨麻疹的临床分析%Clinical analysis of levocetirizine combined with proteoglycans therapy for the patients with chronic urticaria

    Institute of Scientific and Technical Information of China (English)

    江平

    2013-01-01

    Objective To investigate the clinical effect of levocetirizine combined with proteoglycans on the patients with chronic urticarias. Methods 90 cases of patients admitted to our hospital from June 2010 to August 2012 were randomly divided into two groups. Control group( n =45 ) was given levocetirizine only,and treatment group was given levocetirizine combined with proteoglycans. The clinical efficacy, symptom score and the levels of immune function of the two groups were observed and compared. Results The total efficacy rate of the treatment group was 88. 89%,while it was 71. 11% of the control group, there was significant difference between the two groups( P < 0. 05 ); the symptom scores of wheal number, wheal diameter, pruritus, wheal occurrences, wheal duration of treatment group were significantly lower than those of control group( P < 0. 05 ); there were significant differences in IL-10 and IL-18 between the two groups( P < 0. 05 ). Conclusion The clinical application of proteoglycans on chronic urticaria patients can significantly alleviate symptoms, control immune levels and improve the clinical effect.%目的 探讨多糖蛋白片辅助左西替利嗪治疗慢性荨麻疹的临床疗效.方法 2010年6月至2012年8月我院诊治的90例慢性荨麻疹患者随机分成2组,每组45例.对照组采用盐酸左西替利嗪治疗;试验组采用多糖蛋白片联合盐酸左西替利嗪治疗.观察和比较两组的近期疗效、症状积分、免疫指标水平.结果 试验组和对照组的总有效率分别为88.89%、71.11%,试验组的近期疗效明显优于对照组(P<0.05);试验组患者的风团数目、风团直径、瘙痒程度、风团发生次数、风团持续时间等症状积分均明显低于对照组(P<0.05);两组治疗后的白介素-10(IL-10)、白介素-18(IL-18)比较,差异有统计学意义(P<0.05).结论 多糖蛋白片辅助治疗慢性荨麻疹能更好地改善临床症状,调节免疫功能,提高治疗效果.

  15. Assessment of dermatology life quality index in 421 patients with chronic urticaria%421例慢性荨麻疹患者皮肤病生活质量的评估

    Institute of Scientific and Technical Information of China (English)

    罗婕; 郝飞; 李垚莹; 宋志强; 钟华; 尹锐; 程良金; 阎衡; 翟志芳; 张琬

    2012-01-01

    Objective: To assess the quality of life in patients with chronic urticaria (CU). Methods: The patients with CU were assessed with dermatology life quality index (DLQI). SPSS13.0 was used to measure the reliability and validity as well as influencing factors. Results: Four hundred and twenty - one patients with CU were asked to complete DLQI (158 males and 263 females) . The DLQI score, which varied from 1 to 30 with an average of 9.30 ± 6.05. In daily life, Females were more influenced than man ( P < 0.01) . Patients with angioedema were more likely to be influenced, compared to the patients with wheal only ( P < 0.05) . Conclusion: Assessment of the quality of life in the patients with CU in DLQI may be helpful for the health education and treatment.%目的:评价慢性荨麻疹(CU)患者生活质量.方法:对CU患者行皮肤病生活质量指数(DLQI)问卷调查,用SPSS软件进行信度、效度及影响因素分析.结果:共调查421例CU患者,男性158例,女性263例.DLQI评分1~30分,平均9.30±6.05分.比较发现,女性对日常活动的影响高于男性(P<0.01).伴有血管性水肿比单纯风团影响显著(P<0.05).结论:对CU患者开展DLQI研究,有利于指导临床健康教育和治疗.

  16. 慢性荨麻疹患者血清中特异性 IgE 和 IgG检测的临床应用%Clinical application of serum specific IgE and IgG detection in chronic urticaria patients

    Institute of Scientific and Technical Information of China (English)

    何君; 邢艳

    2013-01-01

    目的:探讨慢性荨麻疹患者血清特异性IgE(sIgE)和特异性IgG(sIgG)检测的意义及其在临床中的应用。方法:对593例慢性荨麻疹患者采用免疫印迹法检测血清中食物过敏原和吸入性过敏原sIgE,同时采用酶联免疫法检测血清中食物sIgG,并在不同年龄组间进行比较。结果:593例慢性荨麻疹患者食物sIgG的总阳性率为76.73%,前4位的食物依次是鸡蛋、牛奶、蟹和大豆。食物sIgE的总阳性率为54.13%,前4位的食物依次是蟹、虾、牛奶和腰果;食物sIgG和sIgE的检测结果不一致( P<0.01)。不同年龄组的过敏原检测结果有所不同,吸入性过敏原sIgE的总阳性率为89.38%,前3位依次均是户尘螨、矮豚草、霉菌组合。结论:联合测定患者血清中sIgE和sIgG是寻找慢性荨麻疹患者过敏原的有效方法。尽早采取有效的环境控制和食物规避,对预防和治疗急性荨麻疹及慢性荨麻疹急性发作相当重要。%Objective:To investigate the significance of sIgE and sIgG detection and their clinical application in chronic urticaria serum patients .Methods:593 cases of chronic urticaria patients were recruited in this study .The food and inhalant sIgE were detected using immunoblot assay from serum of chronic urticaria patients , while enzyme-linked immunosorbent assay was applied for sIgG detection .The results in different age groups were compared .Results:The positive rate of ingested sIgG in 593 patients was 76.73%, the top four food was eggs , milk, crab and soybean .The ingested sIgE positive rate was 54.13%, and the top four food was crab , shrimp, milk and cashew nuts .Food sIgG and sIgE test results were significantly different ( P<0.01) .The anaphylactogen in different age groups was not the same .The total positive rate of inhalation of allergen sIgE was 89.38%, the top three was dermatophagoides pteronyssinus , dwarf ragweed , and mold combination

  17. Cinical Efficacy and Cost-Effectiveness Analysis of Combination of Traditional Chinese and Western Medicine in Treatment of Chronic Urticaria%中西药联用治疗慢性荨麻疹临床疗效观察及其成本效果分析

    Institute of Scientific and Technical Information of China (English)

    李亚玲; 李俊; 叶云; 余德智; 陈红艳

    2013-01-01

    目的:观察中西药联用治疗慢性荨麻疹的临床疗效及安全性,并评价其药物经济学效果.方法:95例慢性荨麻疹患者采用随机数字表法随机分为两组,观察组给予西咪等抗组胺药联合中药复方治疗,对照组给予盐酸左西替利嗪联用美能,疗程均为4周,观察两组疗效及不良反应,运用药物经济学方法分析其成本效果.结果:治疗4周后,治疗组与对照组治愈率、总有效率及复发率、成本效果比比较差异均有显著性(P<0.05).结论:基本抗组胺药物联合中药复方去荨汤治疗慢性荨麻疹有较好的临床疗效,治愈率高、复发率低,是治疗慢性荨麻疹的较佳方案.%Objective: Observations on clinical efficacy and safety of chronic urticaria treated by traditional Chinese and Western medicine,and evaluation of the economic effects of the drug were made. Methods:95 cases of chronic urticaria were randomly divided into 2 groups by using random number tables, observation group was given antihistamine medicine combined with traditional Chinese medicine for treatment, control group was given levo-Cetirizine Hydrochloride combined with Compound Glycyrrhiz-in Tablets, the course of treatment was 4 weeks, observing efficacy and adverse reactions of two groups, and making pharmacoeco-nomic analysis on cost-effectiveness. Results: After 4 weeks, the treatment group and the control group had more differences at cured rate, total effective rate, recurrence rate and cost-efficiency (P < 0. 05 ). Conclusion: Antihistamine drugs and traditional Chinese medicine in treating chronic urticaria has good clinical efficacy, high cured rate and low recurrence rate, which is a better programme of treatment for chronic urticaria.

  18. 慢性荨麻疹患者160例对27种植物精油临床适应性的检测%Detection of 27 kinds plant essential oil's adaptability in clinical treatment of 160 chronic urticaria patients

    Institute of Scientific and Technical Information of China (English)

    陈正琴; 潘钰蔚; 刘倩; 张怀亮

    2012-01-01

    Objective Screen chronic urticaria patients with 27 kinds natural plant essential oil to find the best adapted varieties. Methods We uses the meridian bio-resonance technique screening chronic urticaria patients through meridian points with MED Model to find the adapted essential oil,and control with standard samples. Results The adaptation percentage of 27 kinds natural plant essential oil to 160 chronic urticaria patients was 10.63%~26.25%, average 18.38%.A11 kinds had their corresponding adaptive patients. The top ten were Russia pine needle, Australia tangerine oil, North America neroli, morocco geranium oil, west india ginger oil, ceylon citronella grass, Spain fennel oil, France rosemary oil, India peppermint oil. Conclusion Some of the 27 natural plant essential oil are good to the rehabilitation of chronic urticaria patients.%目的 采用27种植物精油纯品对慢性荨麻疹患者进行适应性筛选检测,找到慢性荨麻疹患者植物精油的最佳适应品种.方法 采用经络生物共振技术,通过人体经络穴位检测筛选植物精油对慢性荨麻疹患者的适应性,并与检验标准品作对照.结果 27种植物精油160例慢性荨麻疹的适应百分率为10.63%~26.25%,平均为18.38%.所有的植物精油均有适应的患者,排列在前10位的植物精油分别是俄罗斯松针、澳洲红桔油、北美橙花油、摩洛哥天竺葵油、西印度姜油、斯里兰卡香茅油、西班牙茴香油、法国迷迭香油、印度薄荷油、澳洲柠檬油.结论 部分植物精油对慢性荨麻疹患者适应性较好,可用于慢性荨麻疹患者康复治疗.

  19. Study in effect of humanized nursing on psychological state of patients with chronic urticaria re-ceiving autohemotherapy%人性化护理对改善行自血疗法的慢性荨麻疹患者心理状态的效果研究

    Institute of Scientific and Technical Information of China (English)

    石家宴; 吴海斌; 石建萍; 杨义成; 陈华

    2009-01-01

    目的 探讨人性化护理对改善行自血疗法的慢性荨麻疹患者负性心理状态的效果.方法 将58例慢性荨麻疹患者随机分为对照组和观察组各29例,对照组采用常规护理,观察组在此基础上实施人性化护理程序.治疗结束后对2组患者的焦虑、抑郁状况和满意度评分进行比较.进行χ2检验和t检验.结果 观察组焦虑自评量表(SAS)评分明显低于对照组;观察组抑郁自评量表(SDS)得分亦明显低于对照组;观察组总满意度明显高于对照组.结论 自血疗法治疗慢性荨麻疹采用人性化护理措施能有效地降低患者的焦虑和抑郁心理,对慢性荨麻疹患者的治疗有重要意义.%Objective To evaluate effect of humanized nursing on psychological state of patients with chronic urticaria receiving autohemotherapy. Methods 58 cases with chronic urticaria in our hos-pital were randomly divided into the observation group and the control group with 29 cases in each group, the control group was treated with conventional care, the observation group received conventional care combined with humanized nursing. The anxiety, depression and satisfaction degree were compared for these two groups and the data went through χ2 test and t test. Results The score of self- rating anxiety scale (SAS) and serf-rating depression scale (SDS) of the observation group was significantly lower than that of the control group, the satisfaction rate of the observation group was significantly higher than that of the con-trol group. Conclusions Application of humanized nursing in patients with chronic urticaria receiving autohemotherapy can reduce their anxiety and depression and has pivotal significance on treatment of pa-tients with chronic urticaria.

  20. Clinical Observation of Desloratadine Citrate Disodium in the Decremental Treatment of Chronic Urticaria%枸地氯雷他定递减疗法治疗慢性荨麻疹的临床观察Δ

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    目的:观察枸地氯雷他定递减疗法治疗慢性荨麻疹的临床疗效和安全性。方法:212例慢性荨麻疹患者随机均分为递减疗法组和对照组。递减疗法组患者按递减疗法给予枸地氯雷他定胶囊:第1周17.6 mg,口服,每日1次;第2周8.8 mg,口服,每日1次;第3周8.8 mg,口服,2天1次;第4周8.8 mg,口服,3天1次。对照组患者给予枸地氯雷他定胶囊8.8 mg,口服,每日1次。两组患者疗程均为4周。观察两组患者的临床疗效,治疗前后血清免疫球蛋白E(IgE)水平、临床症状评分、复发率及不良反应发生情况。结果:两组患者总有效率、不良反应发生率比较,差异均无统计学意义(P>0.05),递减疗法组复发率显著低于对照组,差异有统计学意义(P<0.05)。治疗结束时及停药4周后,两组患者血清IgE水平均显著低于同组治疗前,且停药4周后递减疗法组低于对照组,差异均有统计学意义(P<0.01);对照组患者停药4周时IgE水平显著高于治疗结束时,差异有统计学意义(P<0.01)。治疗后,两组患者临床症状评分均显著低于同组治疗前,差异有统计学意义(P<0.01);但两组间比较,差异无统计学意义(P>0.05)。结论:枸地氯雷他定递减疗法与常规疗法治疗慢性荨麻疹的临床疗效和安全性均相当,但在改善血清IgE方面,枸地氯雷他定递减疗法优于常规疗法。%OBJECTIVE:To observe the clinical efficacy and safety of the effect of desloratadine citrate disodium in the decre-mental treatment of chronic urticaria. METHODS:212 patients with chronic urticaria were randomly divided into decremental treat-ment group and control group. Decremental treatment group was treated with Desloratadine citrate disodium capsules 17.6 mg in the first week,orally,qd;8.8 mg in the second week,orally,qd;8.8 mg in the third week,orally,qod;and 8.8 mg in

  1. Detection of serum IL-35 and IL-17 in the patients with chronic urticaria%慢性荨麻疹患者血清 IL-35 和 IL-17的检测

    Institute of Scientific and Technical Information of China (English)

    郭敏; 白莉

    2016-01-01

    Objective:To detect the level of IL-35 and IL-17 in the patients with chronic urticaria ( CU) . Methods:The levels of IL-35 and IL-17 in 60 patients and 60 controls were detected by ELISA and the se-verity of the patients was assessed by urticaria activity score ( UAS) . The correlation between the level of ser-um IL-35 and IL-17, and CU severity scores was analyzed. Results: The serum level of IL-35 in the pa-tients was (46.73±17.19) ng/L, which was lower than that in the controls (73.78±25.51) ng/L. The differ-ence was statistically significant (P<0.05). The serum level of IL-17 in the patients was (18.03±8.88) ng/L, which was higher than that in the controls (8.46±3.29) ng/L. The difference was statistically significant ( P<0.05) . The CU severity score was negatively correlated to the level of IL-35 and positively to the level of IL-17 ( P<0.05) . Conclusion:The expression of IL-35 and IL-17 may be involved in the onset and severity of CU.%目的: 检测慢性荨麻疹( CU)患者血清中IL-35及IL-17的表达. 方法: 病例组60例,根据荨麻疹活动性评分标准( UAS)评价疾病严重程度,60例健康体检者作为对照. ELISA法检测CU患者与对照血清中IL-35和IL-17的水平,分析其与疾病严重程度的相关性. 结果: CU患者组血清IL-35水平为(46.73±17.19)ng/L明显低于健康对照组的(73.78±25.51)ng/L(P<0.05);CU组IL-17表达水平为(18.03±8.88)ng/L,明显高于对照组的(8.46±3.29)ng/L(P<0.05). 疾病严重程度评分与IL-35表达水平呈负相关( P<0.05) ,与IL-17表达水平呈正相关( P<0.05). 结论: IL-35和IL-17可能与CU的发病及严重程度有关.

  2. Application evaluation of the levels of serum total IgE and food allergen-specific IgG antibody in patients with chronic urticaria and eczema%血清总IgE与食物特异性IgG检测在慢性荨麻疹和慢性湿疹中的应用评价

    Institute of Scientific and Technical Information of China (English)

    靳情

    2015-01-01

    目的:探讨慢性荨麻疹和慢性湿疹患者食物特异性IgG变应原和血清总IgE的水平,为临床诊治提供参考。方法:应用ELISA法,检测153例慢性荨麻疹患者与135例慢性湿疹患者血清总IgE与14种食物特异性IgG,并与48名健康体检者对照。结果:慢性荨麻疹食物特异性IgG阳性率94.1%,慢性湿疹阳性率95.6%,而健康体检人群阳性率54.2%。以鸡蛋(蛋白/蛋黄)、牛奶、鳕鱼、螃蟹、大豆阳性率最高,鸡肉、玉米、大米、虾、西红柿、小麦次之,猪肉、牛肉、蘑菇较低。慢性荨麻疹和慢性湿疹患者血清总IgE均为100.0%阳性,而健康体检人群仅有29.8%。结论:慢性荨麻疹、慢性湿疹不仅与IgE介导的Ⅰ型变态反应有关,还与食物特异性IgG引起的不耐受有一定相关性;其检测可及时调整患者食谱,缓解临床症状,为患者诊治提供有益帮助。%Objective:To explore the levels of serum total IgE and food allergen-specific IgG antibody in patients with chronic urticaria and eczema,and provide the reference for their clinical diagnosis and therapy. Methods:The levels of the serum total IgE in 153 patients with chronic urticaria and 135 patients with chronic eczema, and allergen-specific IgG antibodies in 14 kinds of food were measured by enzyme linked immunosorbent assay( ELISA) . Forty-eight healthy people were set as the control. Results:The total positive rates of specific IgG antibodies in chronic urticaria,chronic eczema and healthy people were 94. 1%,95. 6% and 54. 2%,respectively. The most common food allergen were egg,milk,cod,crab and bean,followed by chicken,maize,rice,shrimp,tomato and wheat,and then pork,beef and mushrooms. The total positive rates of total serum IgE in chronic urticaria and eczema patients were 100. 0%,but it was 29. 8% in healthy people. Conclusions:The chronic urticaria and eczema are not only associated with typeⅠallergy,but also with food intolerance induced by the

  3. A case of figurate urticaria by etanercept

    Directory of Open Access Journals (Sweden)

    Maurizio Sessa

    2016-01-01

    Full Text Available Etanercept is a competitive inhibitor of tumor necrosis factor-alpha (TNF-α a polypeptide hormone, involved in the development of the immune system, in host defense and immune surveillance. Even if the etanercept mechanism of action is not completely understood, it is supposed that it negatively modulates biological responses mediated by molecules (cytokines, adhesion molecules, or proteinases induced or regulated by TNF. For this reason, it is widely used in the treatment of immunologicals diseases, such as rheumatoid and psoriatic arthritis, polyarticular juvenile idiopathic active, ankylosing spondylitis, and plaque psoriasis. Etanercept has a good tolerability profile. Adverse events related to skin are rare, arising usually in about 5% of patients treated with anti-TNF α. In this scenario, we describe a case of figurate urticaria arose after the re-administration of etanercept in a patient affected by psoriasis and hepatitis B. A 65-year-old man, affected by psoriasis, was hospitalized in September 2014 to the Regional Center for the treatment of psoriasis and Biological Drugs of Second University of Naples for progressive extension of psoriatic skin lesions. The laboratory analysis detected positivity for hepatitis B virus (HBV antigens. For this reason, it was administered to him lamivudine 100 mg/die about 30 days before to start etanercept treatment. The etanercept therapy has resulted in a progressive improving of skin manifestations, and the patient decided individually to stop the therapy. Afterwards, for worsening of the psoriatic lesions, he was again hospitalized and treated with the same therapeutic schedule (lamivudine followed by etanercept. Ten days after the start of therapy, the patient showed the onset of urticarial rash. Due to this, the treatment with lamivudine and etanercept was suspended and the patient′s clinical conditions improved. It is probably that immunological disorders due to etanercept therapy and HBV

  4. Is There an Association between Restless Legs Syndrome and Urticaria?

    Science.gov (United States)

    Tuna, Serpil; Alan, Sevil; Samancı, Nehir; Karakaş, Ayşe Akman

    2016-05-01

    Restless legs syndrome (RLS) is a disease characterized by the urge to move the legs and sleep disturbances. Similarly, chronic spontaneous urticaria (CSU) is a dermatological disease characterized by pruritus and sleep disorders. In this study, we aimed to determine the prevalence and severity of RLS in patients with chronic spontaneous urticaria (CSU) and to compare the quality of sleep of patients with and without RLS in the CSU group using the Pittsburgh Sleep Quality Index. A total of 130 patients with CSU and 100 healthy controls were included in this study. The frequency of RLS, frequency of sleep disturbances, and average score of RLS in patients with CSU were statistically significantly higher than control groups (respectively P = 0.008, P = 0.009, P = 0.004). Subjective sleep quality, sleep latency and habitual sleep efficiency scores in patients with RLS were statistically significantly higher than patients without RLS (respectively P = 0.016, P = 0.007, P = 0.035). We claimed that pruritus of urticaria may decrease the quality of sleep in patients with RLS and it may trigger and worsen the restless legs syndrome. Furthermore, RLS and CSU may share a common etiology.

  5. Multiple application delayed onset contact urticaria

    DEFF Research Database (Denmark)

    Andersen, Klaus Ejner; Maibach, H I

    1984-01-01

    An unusual type of contact urticaria to formalin is described, based on 4 patients and experiments in 14 volunteers. The contact urticaria appeared on healthy skin only following repeated open applications or after a single application on slightly diseased skin. The possible relation...... of this phenomenon for patients claiming textile intolerance is discussed. Further tests are required to reveal the mechanism of this delayed onset contact urticaria to formalin....

  6. Urticaria in Monozygotic and Dizygotic Twins

    Directory of Open Access Journals (Sweden)

    Simon Francis Thomsen

    2012-01-01

    Full Text Available Aim. To identify risk factors for urticaria, to determine the relative proportion of the susceptibility to urticaria that is due to genetic factors in an adult clinical twin sample, and to further determine whether the genetic susceptibility to urticaria overlaps with the genetic susceptibility to atopic diseases. Methods. A total of 256 complete twin pairs and 63 single twins, who were selected from sibships with self-reported asthma via a questionnaire survey of 21,162 adult twins from the Danish Twin Registry, were clinically interviewed about a history of urticaria and examined for atopic diseases. Data were analysed with Cox proportional hazards regression and variance components models. Results. A total of 151 individuals (26% had a history of urticaria, whereas 24 (4% had had symptoms within the past year. Female sex, HR=2.09 (1.46–2.99, P=0.000; hay fever, HR=1.92 (1.36–2.72, P=0.000; and atopic dermatitis, HR=1.44 (1.02–2.06, P=0.041 were significant risk factors for urticaria. After adjustment for sex and age at onset of urticaria in the index twin, the risk of urticaria was increased in MZ cotwins relative to DZ cotwins, HR=1.42 (0.63–3.18, P=0.394. Genetic factors explained 45% (16–74%, P=0.005, of the variation in susceptibility to urticaria. The genetic correlation between urticaria and hay fever was 0.45 (0.01–0.89, P=0.040. Conclusions. Susceptibility to urticaria is partly determined by genetic factors. Urticaria is more common in women, and in subjects with hay fever and atopic dermatitis, and shares genetic variance with hay fever.

  7. Contact urticaria syndrome caused by haptens

    OpenAIRE

    Gomułka, Krzysztof; Panaszek, Bernard

    2014-01-01

    In the group of urticaria, contact urticaria syndrome is a particular variety. In these patients, appearance of typical skin lesions is preceded by contact of the skin and mucous membranes with various inhaled allergens, nutrients or contact details. Furthermore, symptoms connected with contact urticaria syndrome are characterized by gradual, stepwise waveform, which can be easily generalized – patients may develop systemic symptoms similar to those found in the angioedema, asthma or anaphyla...

  8. 900例湿疹及荨麻疹患者血清食物过敏原特异性IgG检测的临床意义%Clinical significance of detecting food allergic specific IgG in serum of patients with eczema and chronic urticaria

    Institute of Scientific and Technical Information of China (English)

    谭丽娜; 张桂英; 颜兰香; 王盛; 陆前进

    2010-01-01

    Objective To investigate the levels of 14 kinds of food allergic specific IgG antibody in eczema and chronic urticaria patients'serum and the role of food allergens in allergic skin diseases and provide scientific basis for clinical treatment and prophylaxis. Methods We used ELISA method to detect the concentration of 14 kinds of food allergic specific IgG antibody in the serum of 900 eczema and chronic urticaria patients and 18 healthy people. Results The food allergen of positive rate in studied group and control group was 90.2% and 11.1%. The positive rate of 14 kinds of food allergic specific IgG antibody in 900 eczema and chronic urticaria patients' serum from high to low was eggs, wheat, shrimp, milk, soja,crab, rice, corn, tomato, chicken, mushroom, beef, pork and ling. The food allergen positive rate in eczema and chronic urticaria patients'serum was 91.9% and 88. 9% ( P >0. 05). The positive rate of shrimp,mushroom and ling in eczema patients'serum was higher than that in chronic urticaria patients'serum ( P 0. 05 ). The main allergens were egg, wheat and milk in children's group. The sensitization of crab and shrimp increased as people grew up. In 812 positive patients, who were intolerant of three and more than three foods accounted for 53.7%. In 175 follow-up patients, the effective rate was 50.9% in 20 days and 61.1% in 60 days after they avoided the intolerant food. The patients'diet was adjusted according to the test results.In 325 follow-up patients, the effective rate in eczema group was 59.9% in 20 days and 70. 4% in 60 days ( P 0.05).湿疹患者中虾、蘑菇和鳕鱼的阳性率明显高于慢性荨麻疹患者(P0.05).少儿组以鸡蛋、小麦和牛奶为主要过敏原,随着年龄的增长,虾、蟹的致敏性逐渐增高;(3)食物过敏原检测阳性的812例患者中,3种以上食物过敏原阳性的患者占53.7%,随访了其中175例患者,避免接触不耐受食物20 d和60 d后,有效率分别为50.9%和61.1%;(4)根据检测结

  9. A CLINICAL STUDY OF URTICARIA AND ANGIOEDEMA WITH PARTICULAR REFERENCE TO THE ETIOLOGY

    Directory of Open Access Journals (Sweden)

    Raksha M Patel

    2014-04-01

    Results: In our study maximum numbers of cases Maximum numbers of cases (127 belonged to the age groups 21 to 30 and 31 to 40 years. The youngest was eight months old and the oldest was 85 years of age. Females (307 out-numbered males (193 in the present study. Food induced urticaria was found in 136(27.2%, due to drugs in 128(25.6%, physical urticaria in 83(16.6%, infestation as a cause of urticaria in 14(2.8%, infection in 16(3.2%, dust in 07(1.2%, atopy in 03(0.86 endocrine disease in 03(0.6% including thyroid disorder in 1(0.2%,contact with wool in 01(0.29% and carcinoma in 01(0.2%. In 133(26.6% patients we were not able to find the cause and those where labeled as idiopathic urticaria. Conclusion: That there is little relation between cause identified by history and confirmation by investigation. Routine laboratory tests are of limited value in finding the etiology. History taking is most important tool. [Natl J Med Res 2014; 4(2.000: 132-137

  10. Occupational urticaria from welding polyurethane

    Energy Technology Data Exchange (ETDEWEB)

    Kanerva, L.; Estlander, T.; Jolanki, R.; Laehteenmaeki, M.T.Ke.; Keskinen, H. (Institute of Occupational Health, Helsinki (Finland))

    1991-05-01

    An urticarial reaction associated with high fever developed in a welder on four occasions while he was welding steel profiles filled with polyurethane. The fumes emitted during pyrolysis of polyurethane and inhaled by the patient probably caused the urticarial reaction. Provocation tests with two pyrolysis products, 4,4-diphenylmethane diisocyanate and 4,4-diaminophenylmethane, were negative. This case demonstrates the difficulty in detecting the cause of urticaria induced by airborne chemicals.

  11. Recent advances in the understanding of the penicillin urticarias.

    Science.gov (United States)

    Jillson, O F; Porter, P S

    1965-08-01

    The three major groups of immunoglobulins (gamma G, gamma A, and gamma M) associated with this disease are reviewed. The presence or absence of atopic disease may account for percentage variability of gamma A because reagins (skin-sensitizing antibodies) are found in this immunoglobulin. The gamma A is the antibody usually responsible for anaphylaxis, rather than the gamma G precipitins, so stressed in the past. All three immunoglobulins may be found in serum sickness, which could account for the complex nature of this type of penicillin urticaria. The merits of the immunological tests (penicilloyl-polylysine, benzyl penicillin, hemagglutination, basophil degranulation) for the detection of penicillin sensitivity are analyzed, particularly as each applies to the various types of penicillin urticaria (serum sickness, anaphylactic, dermographic, delayed dermographic, and simple chronic urticaria and the lupus diathesis). The penicilloyl-polylysine test is greatly overrated as a means of predicting possible anaphylaxis. The benzyl penicillin skin test properly performed is an excellent means of indicating this.

  12. Management of urticaria and angioedema in children : new trends

    NARCIS (Netherlands)

    Oranje, A. P.

    2010-01-01

    Urticaria in childhood is a common problem. History of development of urticaria should be carefully taken from a written history/information list. For urticaria, the EAACI/GALEN/EDF consensus guidelines on definition, classification, diagnosis and management of urticaria should be considered. Soon a

  13. Aquagenic urticaria: diagnostic and management challenges

    Directory of Open Access Journals (Sweden)

    Rothbaum R

    2016-11-01

    Full Text Available Robert Rothbaum, Jean S McGee Department of Dermatology, Boston University School of Medicine, Boston, MA, USA Abstract: Aquagenic urticaria (AU is a rare inducible form of physical urticaria, which occurs in response to cutaneous exposure to water, including sweat and tears. Patients present with characteristic 1–3 mm folliculocentric wheals with surrounding 1–3 cm erythematous flares within 20–30 minutes following skin contact with water. In rare cases, there are concomitant systemic symptoms, such as wheezing or shortness of breath. The pathogenesis of AU is poorly understood at this time, and it appears to be mediated in both a histamine-dependent and independent manner. Diagnosis is based on eliciting a thorough clinical history combined with a water challenge test. Some patients may need to undergo further testing to exclude other physical urticarias. Rarely, multiple physical urticarias can be present in one patient, which can complicate diagnosis and treatment. Currently, the first-line therapy for AU is an oral administration of nonsedating, second-generation H1 antihistamines, but many patients may require further interventions to have adequate symptomatic control. In this review, we discuss the diagnostic and management challenges of AU. We review the key diagnostic features that differentiate AU from other physical urticarias. We additionally describe a therapeutic ladder for the treatment of AU and the rationale supporting these treatments. Keywords: aquagenic urticaria, physical urticaria, inducible urticaria, diagnosis, management

  14. Recurrent facial urticaria following herpes simplex labialis

    Directory of Open Access Journals (Sweden)

    Vijay Zawar

    2012-01-01

    Full Text Available We describe recurrent acute right-sided facial urticaria associated with herpes labialis infection in a middle-aged female patient. Antiviral medications and antihistamines not only successfully cleared the herpes infection and urticaria but also prevented further recurrences.

  15. ACQUIRED CUTIS LAXA WITH RECURRENT URTICARIA

    Directory of Open Access Journals (Sweden)

    Ganaparthi

    2015-05-01

    Full Text Available A 30 year old male patient presented with progressive laxity and wrinkling of skin over the face for past 10 years, patient also gives history of recurrent urticaria since 12 years. Skin biopsy using Verhoff Van Gieson stain suggestive of cutis laxa. We are reporting a rare case of acquired cutis laxa with recurrent urticaria

  16. Diagnosis and management of cold urticaria.

    Science.gov (United States)

    Singleton, Reid; Halverstam, Caroline P

    2016-01-01

    Cold urticaria is a physical urticaria characterized by a localized or systemic eruption of papules upon exposure of the skin to cold air, liquids, and/or objects. In some cases, angioedema and anaphylaxis also may occur. The symptoms of cold urticaria can have a negative impact on patients' quality of life. Second-generation H1 antihistamines are the first line of treatment in cold urticaria; however, patients who are unresponsive to initial treatment with H1 antihistamines may require further management options. Avoidance of cold exposure is the most effective prophylactic measure. In mild to moderate cases, the primary goal of therapy is to improve the patient's quality of life. In more severe cases, treatment measures to protect the patient's airway, breathing, and circulation may be necessary. We report the case of a 23-year-old man with cold urticaria who was refractory to initial therapy with H1 antihistamines. A review of the literature also is provided.

  17. Effect of glycyrrhizin on chronic urticaria patients in IL-4,IL-8,IL-17 and IL-22%18-β甘草酸苷对慢性荨麻疹患者血清中IL-4、IL-8、IL-17和IL-22的影响

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    目的:通过对18-β甘草酸苷治疗前后慢性荨麻疹患者血清中IL-4、IL-8、IL-17和IL-22的检测,探讨甘草酸苷治疗慢性荨麻疹的作用机制。方法:用Western blot检测法分别检测20例慢性荨麻疹患者经甘草酸苷治疗前、后及20例健康对照组血清中IL-4、IL-8、IL-17和IL-22的水平。结果:慢性荨麻疹患者经18-β甘草酸苷治疗前血清中IL-4浓度(22.75±6.87pg/ml)、IL-8浓度(20.26±4.52pg/ml)、IL-17浓度(24.62±7.28pg/ml)和IL-22浓度(23.26±9.04pg/ml)高于健康对照组(P<0.05)。治疗后,IL-4浓度(14.44±4.29pg/ml)、IL-8浓度(12.24±3.32pg/ml)、IL-17浓度(13.32±1.61pg/ml)和IL-22浓度(14.32±1.59pg/ml)较治疗前显著降低(P<0.05),与健康对照比较差异无统计学意义(P>0.05)。结论:慢性荨麻疹患者的血清中存在IL-4、IL-8、IL-17和IL-22水平异于正常,提示慢性荨麻疹患者的机体免疫功能紊乱;而18-β甘草酸苷治疗后血清中IL-4、IL-8、IL-17和IL-22明显降低,提示18-β甘草酸苷可能通过影响辅助T细胞相关因子来发挥治疗慢性荨麻疹的作用。%Objective Based on measurement of chronic urticaria patients serum IL-4 and IL-8,IL-17 and IL-22 before and after 18 beta glycyrrhizin in the treatment of glycyrrhizin mechanism on treating chronic urticaria. Methods The levels of serum IL-22,IL-8,IL-17 and IL-4 in 20 cases of chronic urticaria were detected by blot Western assay and 20 cases of healthy controls. Results In patients with chronic urticaria by 18 beta glycyrrhizin treatment IL and serum concentrations of IL- 4(22.75 ± 6.87pg/ml),IL- 8 concentration(20.26 ± 4.52pg/ml),IL- 17 concentration(24.62 ± 7.28pg/ml)and IL- 22 concentration (23.26±9.04pg/ml),higher than the healthy control group(P0.05). Conclusion The serum of patients with chronic urticaria of IL-4 and IL-8,IL-17 and IL-22 levels different from normal,suggesting that chronic urticaria patients with the

  18. Cough in idiopathic pulmonary fibrosis

    NARCIS (Netherlands)

    M.J.G. Van Manen (Mirjam J.G.); S.S. Birring (Surinder S.); C. Vancheri (Carlo); V. Cottin (Vincent); Renzoni, E.A. (Elisabetta A.); Russell, A.-M. (Anne-Marie); M.S. Wijsenbeek (Marlies)

    2016-01-01

    textabstractMany patients with idiopathic pulmonary fibrosis (IPF) complain of chronic refractory cough. Chronic cough is a distressing and disabling symptom with a major impact on quality of life. During recent years, progress has been made in gaining insight into the pathogenesis of cough in IPF,

  19. Evaluation on the effect of Run Zao Zhi Yang capsule combined with ebastine in the treatment of chronic urticaria%润燥止痒胶囊联合依巴斯汀治疗慢性荨麻疹的效果评价

    Institute of Scientific and Technical Information of China (English)

    尹琳

    2015-01-01

    Objective:To investigate the effect of Run Zao Zhi Yang capsule combined with ebastine in the treatment of chronic urticaria.Methods:72 patients with chronic urticaria were selected and randomly divided into the observation group and the control group,with 36 cases in each.Patients in the control group were treated with ebastine,while the observation group were treated with Run Zao Zhi Yang capsule combined with ebastine,then we observed the therapeutic effect of two groups.Results:In the observation group with 36 cases,the total efficiency was 91.67%,significantly higher than that in the control group of 75%,and the difference was statistically significant between two groups,P<0.05.Meanwhile,there had no serious adverse reactions in both of the groups.Conclusion:Run Zao Zhi Yang capsule combined with ebastine in the treatment of chronic urticaria has remarkable application effect,high safety and feasibility,so it is worthy of clinical application.%目的:探讨润燥止痒胶囊联合依巴斯汀治疗慢性荨麻疹的效果。方法:收治慢性荨麻疹患者72例,随机分为对照组和观察组各36例,对照组给予依巴斯汀治疗,观察组给予润燥止痒胶囊联合依巴斯汀治疗,并观察两组患者治疗效果。结果:观察组治疗总有效率91.67%明显高于对照组75.0%,两组比较,P<0.05差异有统计学意义,同时两组患者均未出现严重不良反应。结论:润燥止痒胶囊联合依巴斯汀在慢性荨麻疹治疗中应用效果显著,安全性和可行性高,值得临床推广使用。

  20. Observation of clinical efficiency of Desloratadine combined with modified Yupingfeng powder in treatment of patients with chronic urticaria%地氯雷他定联合玉屏风散加味方治疗慢性荨麻疹患者的疗效观察

    Institute of Scientific and Technical Information of China (English)

    范宏生

    2015-01-01

    目的::观察地氯雷他定联合玉屏风散加味方治疗慢性荨麻疹患者的临床疗效及安全性。方法:将98例慢性荨麻疹患者随机分成两组,治疗组患者50例给予地氯雷他定片联合玉屏风散加味方治疗;对照组患者只给予地氯雷他定片治疗。比较患者的疗效、不良反应和复发情况。结果:治疗组患者总有效率是88.0%,对照组患者总有效率是70.8%,有显著意义(x2=4.44,P<0.05);对照组患者复发18例(复发率52.9%),治疗组患者复发11例(复发率25.0%),差异有显著意义(x2=6.41,P<0.05)。两组患者均未见明显不良反应。结论:地氯雷他定联合玉屏风散加味方治疗慢性荨麻疹疗效显著、复发率低、不良反应少。%Objective:To observe clinical efficiency and safety of Desloratadine combined with modified Yupingfeng powder in treatment of patients with chronic urticaria. Methods:98 cases of chronic urticaria patients were randomly divided into treatment group (50 cases) and control group (48 cases). The treatment group was treated with modified Yupingfeng powder and Desloratadine, while the control group was only treated with Desloratadine. The efficiency, adverse reactions and recurrence rate of the two groups were ob-served after the treatment. Results:The total effective rates of treatment group and control group were 88. 0% and 70. 8%, and the difference was statistically significant (x2=4. 44, P<0. 05). The recurrence rates of control group and treatment group were 52. 9%(18 cases) and 25. 0% (11 cases), and the difference was significant (x2=6. 41, P<0. 05). The two groups had no obvious adverse reactions. Conclusions:To the patients with chronic urticaria, Desloratadine combined with modified Yupingfeng powder is effective and safe, and has a low recurrence rate.

  1. Clinical observation of Wuweigancaonamin capsule combined with Human Placenta Lipopolysaccharide in the treatment of chronic urticaria%五维甘草那敏胶囊联合人胎盘脂多糖治疗慢性荨麻疹疗效观察

    Institute of Scientific and Technical Information of China (English)

    王江涛

    2013-01-01

    Objective To evaluate the efficacy of Wuweigancaonamin capsule combined with Human Placenta Lipopolysaccharide in the treatment of chronic urticaria. Methods One hundred and twenty patients with chronic urticaria were divided into two groups randomly, the study group (60 patients) and the control group (60 patients). Patients in the study group were treated by Wuweigancaonamin capsule orally and were given Human Placenta Lipopolysaccharide every two days. Patients in the control group were treated by Wuweigancaonamin capsule alone. All the patients were treated for four weeks. Results The effective rate was 85.0% in the study group, significantly higher than 68.3% in the control group (P<0.05). Conclusion The combination of Wuweigancaonamin capsule and Human Placenta Lipopolysaccharide is a safe and effective way for treating chronic urticaria, and the side effect is quite small.%目的 观察五维甘草那敏胶囊联合人胎盘脂多糖治疗慢性荨麻疹的临床疗效.方法 将120 例慢性荨麻疹患者随机分为两组,治疗组60 例,对照组60 例,治疗组采用口服五维甘草那敏胶囊,同时隔日肌注人胎盘脂多糖,对照组单独口服五维甘草那敏胶囊,两组疗程均为4 周.结果 治疗组有效率为85.0%;对照组有效率为68.3%,治疗组有效率高于对照组,两组比较差异有统计学意义(P<0.05).结论 五维甘草那敏胶囊联合人胎盘脂多糖治疗慢性荨麻疹,疗效显著,安全性高,不良反应小.

  2. Effect of intravenous immunoglobulin in Guilain-Barre syndrome, myasthenia gravis and chronic idiopathic demyelinative polyneuropathy, A survey in Imam Khomeini Hospital

    Directory of Open Access Journals (Sweden)

    Qaffarpoor M

    1999-09-01

    Full Text Available With retrospective evaluation of 44 patients suffering from Guilan-Barre Syndrome (GBS, Chronic Idiopathic Demtyelinative Polyradiculoneuropathy (CIDP and Myasthenia Gravis (MG treated with intravenous immunoglobulin, we found following results: 1 Initial symptoms of improvement on forth or fifth days. 2 Maximum recovery for CIDP and MG were after 16-24 and 3-11 days, respectively. 3 No major complication, but mild side effects in 32% of patients. 4 In patients with GBS one grade improvement achieved after 8-30 days. 5 Intravenous immunoglobulin (IVIG plus plasmapheresis had no advantages over IVIG alone. 6 No reasonable conclusion about relapsing rate and duration of response due to follow up restrictions.

  3. Treatment of Urticaria with Cupping at Back-Shu Points - A Report of 40 Cases

    Institute of Scientific and Technical Information of China (English)

    李丽梅; 丁杰

    2001-01-01

    @@Urticaria is a common and frequently encountered disease, which is mainly manifested by extreme pruritus and lumpish eruption of the skin. Acute urticaria with a short disease course can be cured, while the chronic one with repeated attacks is a lingering disorder. In the past few years, 40 cases of urticaria were treated by cupping at the back-shu points of the five zang-organs and Geshu (BL 17). Another 20 cases in the control group were treated with Fang Feng Tong Sheng Wan (防风通圣丸Miraculous Pills of Ledebouriella) and chlorpheniramine maleate. The therapeutic effect in the treatment group was significantly superior to that in the control group. The results are reported as follows.

  4. Urticaria in monozygotic and dizygotic twins

    DEFF Research Database (Denmark)

    Thomsen, Simon Francis; van der Sluis, Sophie; Kyvik, Kirsten Ohm

    2012-01-01

    Aim. To identify risk factors for urticaria, to determine the relative proportion of the susceptibility to urticaria that is due to genetic factors in an adult clinical twin sample, and to further determine whether the genetic susceptibility to urticaria overlaps with the genetic susceptibility...... to atopic diseases. Methods. A total of 256 complete twin pairs and 63 single twins, who were selected from sibships with self-reported asthma via a questionnaire survey of 21,162 adult twins from the Danish Twin Registry, were clinically interviewed about a history of urticaria and examined for atopic.......36-2.72), P = 0.000; and atopic dermatitis, HR = 1.44 (1.02-2.06), P = 0.041 were significant risk factors for urticaria. After adjustment for sex and age at onset of urticaria in the index twin, the risk of urticaria was increased in MZ cotwins relative to DZ cotwins, HR = 1.42 (0.63-3.18), P = 0...

  5. Urticaria multiforme er en variant af urticaria, som imiterer erythema multiforme

    DEFF Research Database (Denmark)

    Authried, Georg; Bracher, Linda; Bygum, Anette

    2013-01-01

    A 21-month-old boy developed urticaria multiforme during the course of a presumed pneumonia, which was treated with imacillin. At admission to hospital he was initially considered to have erythema multiforme, but the correct diagnosis was soon established as urticaria multiforme. He had a good re...... response to antihistamines. The diagnostic differences between urticaria multiforme and erythema multiforme are presented in this case report....

  6. Idiopathic scoliosis.

    Science.gov (United States)

    Yaman, Onur; Dalbayrak, Sedat

    2014-01-01

    Scoliosis refers to curves exceeding 10 degrees observed through posterioanterior direct radiography. In fact, the diagnosis for idiopathic scoliosis is accepted to exclude already available causes. The aim of this paper was to review the etiopathogenesis, classification systems and the treatment management of idiopathic scoliosis. A search in the National Library of Medicine (Pubmed) database using the key words 'idiopathic' and 'scoliosis' was performed. For the literature review, papers concerning the etiopathogenesis, classification and treatment were selected among these articles. A search in the National Library of Medicine (Pubmed) database using the key words 'idiopathic' and 'scoliosis' yielded 4518 articles published between 1947 and 2013. The main hypothesis put forward included genetic factors, hormonal factors, bone and connective tissue anomalies. King, Lenke, Coonrad and Peking Union Medical College (PUMC) classifications were the main classification systems for idiopathic scoliosis. Exercise, bracing and anterior, posterior or combined surgery when indicated are the choices for the treatment. Every idiopathic scoliosis case has to be managed to its own characteristics. It is the post-operative appearance that the surgeons are perhaps the least interested but the adolescent patients the most interested in. The aim of scoliosis surgery is to restore the spine without neurological deficit.

  7. Blood lipid, glucose and uric acid levels in patients with chronic spontaneous urticaria%慢性自发性荨麻疹患者血脂、空腹血糖与尿酸水平的测定

    Institute of Scientific and Technical Information of China (English)

    孙瑞凤; 齐婧; 连石; 朱威

    2016-01-01

    Serum triglyceride ( TG ) , total cholesterol ( TC ) , low density lipoprotein cholesterol ( LDL-C) , high density lipoprotein cholesterol ( HDL-C) , uric acid ( UA) levels and fasting blood glucose ( FBG) were measured in 67 patients with chronic spontaneous urticaria ( CSU ) and 66 healthy subjects ( controls).Results showed that the rates of increased serum TG and FBG levels in CSU patients were higher than those in controls ( 19% vs.6%,χ2 =5.309, P 0.05).The rate of rising FBG in CSU patients accompanied by angioedema(4/9)was higher than that in CSU patients without angioedema(7%,χ2 =7.181,P<0.05).%回顾分析2013年12月1日至2015年1月1日诊治的67例慢性自发性荨麻疹( CSU)患者的血清TG、TC、LDL-C、HDL-C、空腹血糖和尿酸水平,并与66例健康体检者比较。 CSU伴TG升高率(19%,13/67)高于对照组和空腹血糖升高率(12%,8/67)均高于对照组(6%,4/66;1%,1/66),差异均有统计学意义(χ2=5.309,P<0.05;χ2=4.194,P <0.05);CSU患者中 TC 升高率(7%,5/67)、LDL-C升高率(4%,3/67)、HDL-C降低率(6%,4/67)、尿酸升高率(6%,4/67),与对照组[3%(2/66)]、1%(1/66)、3%(2/66)、1%(1/66)]相比,差异均无统计学意义(均P>0.05)。 CSU伴发血管性水肿者的空腹血糖升高比例(4/9)高于CSU不伴发血管性水肿者(7%,4/58),差异有统计学意义(χ2=7.181,P<0.05)。提示CSU患者可伴有TG或空腹血糖升高,伴发血管性水肿者可伴有空腹血糖升高。

  8. 依巴斯汀治疗慢性荨麻疹临床疗效的Meta分析%Effect and Safety of Ebastine on Chronic Urticaria:A Meta-analysis of Randomized Controlled Trials

    Institute of Scientific and Technical Information of China (English)

    徐翔; 杨燕; 梁东辉; 马红利; 牛香群

    2011-01-01

    目的:评价依巴斯汀治疗慢性荨麻疹临床疗效及不良反应.方法:计算机检索Cochrane图书馆、PubMed、EMbase、中国知网和万方数据库.检索时间均为建库至2011年2月.收集以依巴斯汀与其他药物对照治疗慢性荨麻疹的随机对照临床试验(RCT).评价纳入文献的研究质量,提取有效数据,采用RevMan 5.0软件进行Meta分析.结果:共纳入12个研究,包括1 567例慢性荨麻疹患者.Meta分析结果显示,依巴斯汀治疗慢性荨麻疹临床疗效较其他抗组胺药高;依巴斯汀联合用药或其他抗组胺药联合用药治疗慢性荨麻疹临床疗效比单一应用依巴斯汀的疗效高,但复发率比较差异无统计学意义;依巴斯汀治疗慢性荨麻疹的不良反应与依巴斯汀联合用药或其他抗组胺药联合用药比较,差异无统计学意义.结论:依巴斯汀能有效治疗慢性荨麻疹,不良反应少.由于慢性荨麻疹病因复杂,且本次研究仍有局限性,还需要更多大样本、设计严格的随机临床对照试验加以证实.%Objective: To evaluate the efficacy and safety of ebastine on patients with chronic urticaria ( CU ). Method:The electronic databases (the Cochrane,Library, PubMed, Embase, CNKI and WANFANG DATA ) were searched in order to retrieve randomized controlled trials( RCT) about comparing ebastine with other drug therapy for CU. The related references were traced to obtain the information. The Jadad' s scale and Cochrane collaboration' s RevMan 5.0 soft-ware were used to assess the trial methodological quality and data analyses. Result: 12 trials involving 1 567 patients were included. The Meta-analysis results showed that the efficacy of ebastine was better than that of the treatment with other antihistamine drugs, the effect of ebastine combination therapy or other antihistaminic combination therapy were better than that of the treatment only with ebastine, the difference between the groups of the combination therapy

  9. 枸地氯雷他定与依匹斯汀治疗慢性荨麻疹随机对照研究%Desloratadine citrate disodium versus epinastine for the treatment of chronic urticaria: a randomized controlled trial

    Institute of Scientific and Technical Information of China (English)

    闫毅; 刘瑞珍; 徐德钢

    2015-01-01

    Objective To evaluate the efficacy and safety of desloratadine citrate disodium versus epinastine for the treatment of chronic urticaria (CU).Methods A randomized,double-blind,double-dummy controlled clinical trial was conducted.Patients with CU were divided into test group and control group to be treated by oral desloratadine citrate disodium (8.8 mg/d) and epinastine (10 mg/d) respectively once a day for 28 days.All the patients were followed up after starting treatment.Therapeutic effect was evaluated,and adverse reactions were observed.Results One hundred and fifty-seven patients were enrolled in this study,and 142 patients were valid for evaluation of efficacy and safety at the end of study.After treatment for 28 days,there was no significant difference between the test group and control group in response rate (81.16 % vs.78.08 %,P > 0.05) or incidence rate of adverse reactions (13.89 % vs.12.16 %,P> 0.05).Conclusion Desloratadine citrate disodium is effective and safe for the treatment of CU.%目的 探讨枸地氯雷他定和依匹斯汀治疗慢性荨麻疹的疗效和安全性.方法 随机、双盲、双模拟和对照研究.试验组服枸地氯雷他定胶囊每日1次,每次8.8 mg,对照组依匹斯汀胶囊每日1次,每次10 mg,均连续服用28 d.于用药后随访,观察疗效和不良反应.结果 入选病例157例,可评价疗效和安全性病例142例.经28 d治疗后,枸地氯雷他定组有效率81.16%、依匹斯汀组有效率78.08%,两组比较差异无统计学意义(P>0.05).枸地氯雷他定组和对照组药物相关性不良反应发生率分别为13.89%和12.16%,两组比较差异无统计学意义(P>0.05).结论 枸地氯雷他定治疗慢性荨麻疹安全有效.

  10. Qualidade de vida em urticária crônica: inquérito em ambulatório público universitário, Botucatu (Brasil Quality of life in chronic urticaria: a survey at a public university outpatient clinic, Botucatu (Brazil

    Directory of Open Access Journals (Sweden)

    Maria Regina Cavariani Silvares

    2011-10-01

    Full Text Available OBJETIVO: Avaliar o impacto da urticária crônica na qualidade de vida dos pacientes de ambulatório universitário a partir do questionário DLQI (Dermatology Life Quality Index. MÉTODOS: Inquérito sobre o impacto na qualidade de vida infligido pela urticária crônica a partir do questionário DLQI validado para a língua portuguesa. Pacientes foram entrevistados durante suas consultas em ambulatório especializado, entre maio de 2009 e maio de 2010, em serviço público brasileiro (Botucatu-SP. Os escores do DLQI foram analisados segundo subgrupos: idade, gênero, escolaridade, tempo de doença e presença de angioedema. RESULTADOS: Foram entrevistados 100 pacientes com urticária crônica. Predominou o gênero feminino (86%, a idade média foi de 41,8 anos, duração média da doença foi de seis anos e angioedema ocorreu em 82% dos pacientes. O escore médio do DLQI foi de 13,5, caracterizando grave impacto à qualidade de vida, superior a hanseníase, psoríase, eczema atópico e carcinoma basocelular. Presença de angioedema se associou a maiores escores: 14,5 x 9,9 (p OBJECTIVE: To evaluate the impact of chronic urticaria on quality of life of outpatients through the university questionnaire Dermatology Life Quality Index (DLQI. METHODS: Survey of the impact on quality of life caused by chronic urticaria, using the DLQI questionnaire validated for the Portuguese language. Patients were interviewed during visits to a specialized outpatient clinic between May 2009 and May 2010 at a Brazilian public service (Botucatu-SP. DLQI scores were analyzed according to the following subgroups: age, gender, education, disease duration, and presence of angioedema. RESULTS: We interviewed 100 patients with chronic urticaria. There was a female predominance (86%, mean age 41.8 years, mean disease duration of 6 years, and angioedema occurrence in 82% of patients. The mean DLQI score was 13.5, characterized by serious impact on quality of life, higher

  11. Urticaria pigmentosa en el adulto

    Directory of Open Access Journals (Sweden)

    Jhon Alexander Ávila Rueda

    2012-08-01

    Full Text Available La urticaria pigmentosa es una de las formas más comunes de las mastocitosis, las cuales corresponden a una serie de procesos caracterizados por un aumento anormal de los mastocitos en diversos órganos y tejidos corporales. En la urticaria pigmentosa la manifestación es exclusiva de la piel, caracterizada por la presencia de lesiones maculopapulares de 2.5 a 5 mm de diámetro, de un color que puede oscilar entre rojo y café, distribuyéndose generalmente en tronco y extremidades respetando palmas y plantas. Cerca de la mitad de los lesiones presenta rubor localizado, prurito y ampollas. Su incidencia y prevalencia son desconocidas; sin embargo, su aparición es más común en niños que en adultos. El diagnóstico depende en gran manera de un adecuado examen físico complementado con estudios de laboratorio e histopatología. El tratamiento de elección constituye la administración de antihistamínicos orales.

  12. Detection of plasma RANTES, eotaxin, TNF-α and LTB4 in patients with chronic urticaria%慢性荨麻疹患者血浆RANTES、嗜酸粒细胞趋化因子、TNF-α与白三烯B4水平的测定

    Institute of Scientific and Technical Information of China (English)

    史立宏; 李晓民; 李金勇; 牟华光

    2009-01-01

    Objective To investigate the plasma levels of regulated upon activation normal T cell expressed and secreted (RANTES), eotaxin, tumor necrosis factor (TNF)-α and leukotriene B4 (LTB4) in patients with chronic urticaria and their roles in the pathogenesis of chronic urticaria. Methods Forty-one patients with chronic urticaria were included into this study along with 20 normal human controls. Patients were graded into three groups, I.e. Mild group (n = 11), moderate group (n = 21) and severe group (n = 9), according to their symptom score. All patients were treated with mizolastine 10 mg per day for 4 weeks. ELISA was used to study the plasma levels of RANTES, eotaxin, TNF-α and LTB4 in normal controls and patients before and after treatment. Results The plasma levels of RANTES, eotaxin, TNF-α and LTB4 were (52.5 ± 10.2) g/L, (58.4 ± 16.1) g/L, (35.1 ± 9.6) ng/L and (109.4 ± 21.7) ng/L, respectively, in untreatedpatients with chronic urticaria, compared to (33.7 ± 9.4) g/L, (48.3 ± 13.6) g/L, (21.3 ± 8.9) ng/L and(77.8 ± 11.6) ng/L, respectively, in normal controls(P 0.05). Conclu-sions The plasma levels of RANTES, eotaxin, TNF-α and LTB4 are elevated in patients with chronic urticaria, and they exhibits a positive correlation tendency with disease activity. After treatment with mizolastine, a significant decrease is observed in the plasma levels of RANTES, eotaxin, TNF-α and LTB4, which hints that RANTES, eotaxin, TNF-α and LTB4 may play a certain role in the pathogenesis of chronic urticaria.%目的 探讨慢性荨麻疹患者血浆中调节激活正常T细胞表达和分泌的细胞因子(RANTES)、嗜酸粒细胞趋化因子(eotaxin)、TNF-α及白三烯B4(LTB4)的水平及其意义.方法 对41例慢性荨麻疹患者进行临床评价,按症状积分将病情分为轻型、中型、重型3级.应用咪唑斯汀10 mg每日1次,连续治疗4周.采用ELISA法测定20例健康志愿者与41例患者治疗前

  13. MRC chronic Dyspnea Scale: Relationships with cardiopulmonary exercise testing and 6-minute walk test in idiopathic pulmonary fibrosis patients: a prospective study

    Directory of Open Access Journals (Sweden)

    Roussos Charis

    2010-05-01

    Full Text Available Abstract Background Exertional dyspnea is the most prominent and disabling feature in idiopathic pulmonary fibrosis (IPF. The Medical Research Chronic (MRC chronic dyspnea score as well as physiological measurements obtained during cardiopulmonary exercise testing (CPET and the 6-minute walk test (6MWT are shown to provide information on the severity and survival of disease. Methods We prospectively recruited IPF patients and examined the relationship between the MRC score and either CPET or 6MWT parameters known to reflect physiologic derangements limiting exercise capacity in IPF patients Results Twenty-five patients with IPF were included in the study. Significant correlations were found between the MRC score and the distance (r = -.781, p 2 at the initiation and the end (r = -.542, p = 0.005 and r = -.713, p VO2 peak/kg (r = -.731, p 2 at peak exercise (r = -. 682, p 2 slope (r = .731, p 2 at AT (r = .630, p = 0.002 and the Borg scale at peak exercise (r = .50, p = 0.01 for the CPET. In multiple logistic regression analysis, the only variable independently related to the MRC is the distance walked at the 6MWT. Conclusion In this population of IPF patients a good correlation was found between the MRC chronic dyspnoea score and physiological parameters obtained during maximal and submaximal exercise testing known to reflect ventilatory impairment and exercise limitation as well as disease severity and survival. This finding is described for the first time in the literature in this group of patients as far as we know and could explain why a simple chronic dyspnea score provides reliable prognostic information on IPF.

  14. Colonic urticaria pattern due to early ischemia

    Energy Technology Data Exchange (ETDEWEB)

    Greenberg, H.M.; Goldberg, H.I.; Axel, L.

    1981-05-15

    The unusual radiographic pattern of bleb-like mounds on the surface of the colon mucosa, previously described as colonic urticaria, was seen in 3 patients in whom no allergic state was present. This urticaria-like pattern was due to colonic distention in all 3, and represented only submucosal edema on the gross and microscopic specimens. We hypothesize that this pattern is due to early changes of ischemia caused by colon distention.

  15. 儿童特发性血小板减少性紫癜急性转慢性危险因素分析%Risk factors of acute idiopathic thrombocytopenic purpura developing into chronic idiopathic thrombocytopenic purpura

    Institute of Scientific and Technical Information of China (English)

    王缉干; 罗建明

    2012-01-01

    目的 探讨影响小儿急性特发性血小板减少性紫癜(AITP)发展成慢性特发性血小板减少性紫癜(CITP)的危险因素.方法 选择2006年5月至2010年4月于广西医科大学一附院诊断AITP住院患儿138例,对患儿临床表现、实验室检查、治疗方案等16个相关因素分别进行单因素成组对照研究.对有意义的单因素,再运用非条件Logistic多因素回归模型分析,以期找到有意义的因素.结果 病程(患儿起病至治疗时间)、ORh(D)+型血、用含有大剂量丙种球蛋白的治疗方案、血小板上升正常时间都是影响AITP患儿转为慢性的主要因素,而与发病年龄、治疗初用血小板、血小板开始回升时间、性别、有无前驱显性感染、治疗前血小板数、血小板平均体积、血小板平均分布系数、骨髓巨核细胞数、幼稚巨核细胞数、颗粒型巨核细胞数、有无幼稚淋巴细胞数无关.结论 AITP患儿早期治疗时用有大剂量丙种球蛋白的治疗方案是改善预后的关键,治疗时血小板回升正常时间晚、ORh(D)+血型(相对于A和B血型)是转为慢性的高危因素.%Objectives To investigate the risk factors for children with acute idiopathic thrombocytopenic purpura (AITP) developing into chronic idiopathic thrombocytopenic purpura (CITP). Methods A total of 138 patients with AITP from May 2006 to April 2010 in the First Affiliated Hospital of Guangxi Medical University were Selected and telephoned for retrospective analysis. The 16 related factors, including clinical presentation, laboratory tests and treatment programs, were performed single case-control study. For those significant single factors, multi-factor non-conditional Logistic regression analysis was used to find meaningful factors. Results The main influencing factors were the onset-to-treatment time,0 Rh (D) + type blood, treatment with gamma globulin and platelets increasing to normal time. The age of onset, early treatment

  16. [Increasing incidence of angioedema without urticaria--clinical features].

    Science.gov (United States)

    Marković, Asja Stipić; Janzeković, Martina

    2011-01-01

    The causes of angioedema (AE), a self-limited, localized swelling of subcutaneous tissue or mucosa unaccompanied by urticaria, are diverse. The commonly applied label of "allergic" is frequently wrong and standard anti-allergic therapy can be ineffective. Types of AE could be categorized according to mediators which mediate vascular leakage: bradykinin AE (hereditary, acquired, angiotensin-converting enzyme inhibitor (ACEi)-related), histamine AE (allergic etiology), and various mediators mediated AE (pseudoallergic reaction to non-steroidal anti-inflammatory drugs). Idiopathic AE is a poorly understood syndrome. The growing relevance of AE without urticaria has been highlighted; angioedema is the most common cause of hospital admission among all acute allergic diseases. The diagnosis of AE is based on the presence of family history (hereditary), absence of family history with the onset during or after the fourth decade of life (acquired C1lnh deficiency), and treatment with ACEi (ACEi-related angioedema). About 0.1%-0.7% of patients taking ACEi develop angioedema as a well-documented but still frequently unrecognized side effect of drugs. Laboratory diagnosis is enabled by measuring serum levels of C1lnh antigen or C1lnh function. Type 1 (hereditary angioedema (HAE) was diagnosed when both antigenic and functional levels of C1lnh were below 50% of normal, and type 2 when functional levels of C1lnh were low, along with antigenic levels normal or higher. ACEi-related AE is diagnosed when AE recurs during therapy and disappears upon withdrawal. Symptoms may appear several years after therapy introduction. Severe acute attacks should be treated with C1lnh concentrate and icatibant, a selective and specific antagonist of bradykinin B2 receptors. Prophylaxis with attenuated androgens (danazol, stanazolol, oxandrolone) is effective in preventing symptom development.

  17. Severe Urticaria Following Erythromycin Therapy

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    Anada S. Prasad

    1960-01-01

    Full Text Available Enythromycin is believed to cause no serlous reactions after large doses, nausea, rarely vomiting and occasionally abdominal pain and diarrhea may occur, (Herrell, 1954. According to' Kagan and Faller (1955 no allergic reaction to' erythromycin has been reported. Phlebitis and thrombosis have been observed, (Shoe maker & Yow, 1954. In a report by Solomon and Johnson, (1955 toxic reactions were recorded as being uncommon. In a large series of cases, only one patient had a rash, another had fever possibly due to the drug, nne had nausea and vomiting and 4 had loose bowel movements while under therapy. Among the 122 patients treated with erythromcin, therapy was stopped owing to side effects in only one. My patient had severe urticaria within 24 hours of beginning therapy with erythromycin and a positive skin test was observed. It was believed to be an allergic reaction caused by the drug.

  18. The clinical significance of immunological contact urticaria to processed grains

    Directory of Open Access Journals (Sweden)

    Michael Ismail

    2012-01-01

    Full Text Available Contact urticaria, is characterized by an urticarial wheal-and-flare reaction at the site of contact by an allergen. Immunological contact urticaria, while less common than non-immunological contact urticaria, has more potentially serious consequences, and therefore, its recognition and treatment is important. Immunological contact urticaria is a type I hypersensitivity reaction. Potential complications include organ system involvement other than skin and even anaphylaxis and death. A vast majority of immunological contact urticaria is work-related. We will discuss the definition of immunological contact urticaria, the mechanism of the contact urticarial reaction, contact urticaria in the occupational setting, and the role of grains in contact urticaria. Testing and treatment are also briefly discussed.

  19. Behavioral Problems in Juvenile Idiopathic Arthritis: A Controlled Study to Examine the Risk of Psychopathology in a Chronic Pediatric Disorder

    Science.gov (United States)

    Chamanara, Elham; Raeeskarami, Seyed-Reza

    2016-01-01

    Children with juvenile idiopathic arthritis (JIA) are prone to the problems that can delay their psychosocial development; however, the existing literature has not reached a consensus on the psychological problems related to JIA. A total of 51 children and adolescents with JIA and 75 healthy controls aged 6 to 18 years were examined using the Child Behavioral Checklist (CBCL). Our results represented that 70 percent of JIA group reached “borderline clinical” range or “clinical” range in internalizing problems, while this percentage in the control group was 18 percent. In addition, our results indicated that JIA group has gotten significantly higher scores (more than twofold) in externalizing behaviors compared to control group. Furthermore, children with JIA showed higher rate of anxiety/depression, withdrawal/depression, somatic complaints, rule breaking behaviors, and aggressive behaviors as well as thought and social problems compared to control group (p < 0.001). As a conclusion, children and adolescents with JIA compared to healthy controls may show higher rate of both internalizing and externalizing problems. Furthermore, our novel findings on externalizing, social, and thought problems in JIA warrant further investigation on affected children who may be at greater risk of future psychopathologies. PMID:27656678

  20. Galactose-α-1,3-galactose and Delayed Anaphylaxis, Angioedema, and Urticaria in Children

    Science.gov (United States)

    Kennedy, Joshua L.; Stallings, Amy P.; Platts-Mills, Thomas A.E.; Oliveira, Walter M.; Workman, Lisa; James, Haley R.; Tripathi, Anubha; Lane, Charles J.; Matos, Luis; Heymann, Peter W.

    2013-01-01

    BACKGROUND AND OBJECTIVE: Despite a thorough history and comprehensive testing, many children who present with recurrent symptoms consistent with allergic reactions elude diagnosis. Recent research has identified a novel cause for “idiopathic” allergic reactions; immunoglobulin E (IgE) antibody specific for the carbohydrate galactose-α-1,3-galactose (α-Gal) has been associated with delayed urticaria and anaphylaxis that occurs 3 to 6 hours after eating beef, pork, or lamb. We sought to determine whether IgE antibody to α-Gal was present in sera of pediatric patients who reported idiopathic anaphylaxis or urticaria. METHODS: Patients aged 4 to 17 were enrolled in an institutional review board–approved protocol at the University of Virginia and private practice allergy offices in Lynchburg, VA. Sera was obtained and analyzed by ImmunoCAP for total IgE and specific IgE to α-Gal, beef, pork, cat epithelium and dander, Fel d 1, dog dander, and milk. RESULTS: Forty-five pediatric patients were identified who had both clinical histories supporting delayed anaphylaxis or urticaria to mammalian meat and IgE antibody specific for α-Gal. In addition, most of these cases had a history of tick bites within the past year, which itched and persisted. CONCLUSIONS: A novel form of anaphylaxis and urticaria that occurs 3 to 6 hours after eating mammalian meat is not uncommon among children in our area. Identification of these cases may not be straightforward and diagnosis is best confirmed by specific testing, which should certainly be considered for children living in the area where the Lone Star tick is common. PMID:23569097

  1. Evaluation of D-dimer serum levels among patients with chronic urticaria, psoriasis and urticarial vasculitis Avaliação dos níveis séricos de D-dímeros entre doentes com urticária crônica, psoríase e urticária vasculite

    Directory of Open Access Journals (Sweden)

    Paulo Ricardo Criado

    2013-06-01

    Full Text Available BACKGROUND: It has been demonstrated that neutrophils, eosinophils and monocytes, under appropriated stimulus, may express tissue factor and therefore, activate the extrinsic pathway of coagulation. We performed a transversal and case-control study of patients with chronic urticaria and patients with psoriasis, in our outpatient clinic to evaluate the production of D-dimer. OBJECTIVE: To evaluate D-dimer serum levels in patients with chronic urticaria and its possible correlation with disease activity. PATIENTS AND METHODS: The study was conducted from October 2010 until March 2011. We selected 37 consecutive patients from our Allergy Unit and Psoriasis Unit, and divided them into three groups for statistical analysis: (i 12 patients with active chronic urticaria (CU; (ii 10 patients with chronic urticaria under remission and (iii 15 patients with psoriasis (a disease with skin inflammatory infiltrate constituted by neutrophils, lymphocytes and monocytes. Another five patients with urticarial vasculitis were allocated in our study, but not included in statistical analysis. The serum levels of D-dimer were measured by Enzyme Linked Fluorescent Assay (ELFA, and the result units were given in ng/ml FEU. RESULTS: Patients with active chronic urticaria had the highest serum levels of D-dimer (p FUNDAMENTOS: Tem sido demonstrado que os neutrófilos, eosinófilos e monócitos, sob estímulo apropriado, podem expressar fator tecidual e, portanto, ativar a via extrínseca da coagulação. Realizamos um estudo transversal e caso-controle de pacientes com urticária crônica e pacientes com psoríase em nosso ambulatório para avaliar a produção de dímero-D. OBJETIVO: Avaliar níveis de dímero-D em pacientes com urticária crônica e sua possível correlação com a atividade da doença. PACIENTES E MÉTODOS: O estudo foi conduzido de outubro de 2010 até março de 2011. Nós selecionamos 37 pacientes consecutivos da Unidade de Alergia e Unidade de

  2. Treatment Algorithm for Chronic Idiopathic Constipation and Constipation-Predominant Irritable Bowel Syndrome Derived from a Canadian National Survey and Needs Assessment on Choices of Therapeutic Agents

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    Yvonne Tse

    2017-01-01

    Full Text Available Background. Chronic idiopathic constipation (CIC and constipation-predominant irritable bowel syndrome (IBS-C are common functional lower gastrointestinal disorders that impair patients’ quality of life. In a national survey, we aimed to evaluate (1 Canadian physician practice patterns in the utilization of therapeutic agents listed in the new ACG and AGA guidelines; (2 physicians satisfaction with these agents for their CIC and IBS-C patients; and (3 the usefulness of these new guidelines in their clinical practice. Methods. A 9-item questionnaire was sent to 350 Canadian specialists to evaluate their clinical practice for the management of CIC and IBS-C. Results. The response rate to the survey was 16% (n=55. Almost all (96% respondents followed a standard, stepwise approach for management while they believed that only 24% of referring physicians followed the same approach. Respondents found guanylyl cyclase C (GCC agonist most satisfying when treating their patients. Among the 69% of respondents who were aware of published guidelines, only 50% found them helpful in prioritizing treatment choices and 69% of respondents indicated that a treatment algorithm, applicable to Canadian practice, would be valuable. Conclusion. Based on this needs assessment, a treatment algorithm was developed to provide clinical guidance in the management of IBS-C and CIC in Canada.

  3. Eysenck's Two Big Personality Factors and Their Relationship to Depression in Patients with Chronic Idiopathic Pain Disorder: A Clinimetric Validation Analysis.

    Science.gov (United States)

    Bech, Per; Lunde, Marianne; Møller, Stine Bjerrum

    2012-01-01

    Aim. The clinimetric aspects of Eysenck's two big personality factors (neuroticism and extraversion) were originally identified by principal component analysis but have been insufficiently analysed with item response theory models. Their relationship to states of melancholia and anxiety was subsequently analysed. Method. Patients with chronic idiopathic pain disorder were included in the study. The nonparametric item response model (Mokken) was compared to the coefficient alpha to validate the anxiety and depression subscales within the neuroticism scale and the extraversion and introversion subscales within the extraversion scale. When measuring states of depression and anxiety, the Melancholia Scale and the Hamilton Anxiety Scale were used. Results. We identified acceptable subscales of anxiety and depression in the Eysenck factor of neuroticism and extraversion versus introversion subscales within the Eysenck factor of extraversion. Focusing on the item of "Does your mood often go up and down?" we showed a statistically significant association with melancholia and anxiety for patients with a positive score on this item. Conclusion. Within the Eysenck factor of neuroticism it is important to differentiate between the anxiety and depression subscales. The clinimetric analysis of the Eysenck factor of extraversion identified valid subscales.

  4. Dieulafoy Lesion in the Ascending Colon Presenting with Gastrointestinal Bleeding and Severe Anemia Complicated by a Coexisting Severe Resistant Chronic Idiopathic Thrombocytopenic Purpura

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    Sherif Ali Eltawansy

    2014-01-01

    Full Text Available Background. GI (gastrointestinal bleeding can be due to a variety of etiologies ranging from being common like bleeding peptic ulcer disease or esophageal varices. One of the rarely documented causes is the Dieulafoy lesion which is known as an abnormally large ectatic artery that penetrates the gut wall, occasionally eroding through the mucosa causing massive bleeding. In addition to that, we refer to the uncommon presentation of Dieulafoy lesion itself as it is well known to be found in the stomach, esophagus, duodenum, and jejunum but not the ascending colon as in our case. The patient had a coexisting ITP (idiopathic thrombocytopenic purpura that was resistant to different therapies. Case Report. We report a case of a 48-year-old Egyptian female known for chronic ITP resistant to treatment. The patient presented with bright red bleeding per rectum and severe life threatening anemia. Endoscopic study showed a Dieulafoy lesion. Endoscopic clipping was successful in controlling the bleeding. Conclusion. Dieulafoy lesion is a rare reason for GI bleeding and can present in common or unexpected places. Also extreme caution should be used in patients with bleeding tendency due to different reasons, like ITP in our case.

  5. Translocation t(3;12(q26;q21 In Jak2V617F Point Mutation Negative Chronic Idiopathic Myelofibrosis: A Case Report

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    S. Mešanović

    2014-06-01

    Full Text Available The myeloproliferative diseases (MPDs or myelo-proliferative neoplasms (MPNs are a group of diseases of the bone marrow in which excess cells are produced. Chronic idiopathic myelofibrosis (CIMF is a stem cell defect characterized by splenomegaly with multiorgan extramedullary hematopoiesis, immature peripheral blood granulocytes and erythrocytes and progressive bone marrow fibrosis. The most common chromosomal abnormalities seen in CIMF patients include numerical changes of chromosomes 7, 8 and 9, and structural changes of 1q, 5q, 13q and 20q. At least 75.0% of patients with bone marrow abnormalities have one or more of these chromosomal anomalies. Detection of the Janus kinase 2 (JAK2 mutation may be a potential major breakthrough for understanding the pathobiology of MPNs, and is an essential part of the diagnostic algorithm. In this study, we describe a JAK2V617F mutation negative CIMF patient who has the chromosomal translocation t(3;12(q26;q21 in her karyotype.

  6. Aquagenic urticaria: diagnostic and management challenges

    Science.gov (United States)

    Rothbaum, Robert; McGee, Jean S

    2016-01-01

    Aquagenic urticaria (AU) is a rare inducible form of physical urticaria, which occurs in response to cutaneous exposure to water, including sweat and tears. Patients present with characteristic 1–3 mm folliculocentric wheals with surrounding 1–3 cm erythematous flares within 20–30 minutes following skin contact with water. In rare cases, there are concomitant systemic symptoms, such as wheezing or shortness of breath. The pathogenesis of AU is poorly understood at this time, and it appears to be mediated in both a histamine-dependent and independent manner. Diagnosis is based on eliciting a thorough clinical history combined with a water challenge test. Some patients may need to undergo further testing to exclude other physical urticarias. Rarely, multiple physical urticarias can be present in one patient, which can complicate diagnosis and treatment. Currently, the first-line therapy for AU is an oral administration of nonsedating, second-generation H1 antihistamines, but many patients may require further interventions to have adequate symptomatic control. In this review, we discuss the diagnostic and management challenges of AU. We review the key diagnostic features that differentiate AU from other physical urticarias. We additionally describe a therapeutic ladder for the treatment of AU and the rationale supporting these treatments. PMID:27942227

  7. Mastitis crónica granulomatosa idiopática: reporte de un caso Idiopathic chronic granulomatous mastitis: a case report

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    Juan Takano

    2010-12-01

    Full Text Available La mastitis cónica granulomatosa idiopática es una enfermedad rara que se presenta en mujeres, preferentemente en edad reproductiva, con características clínicas, mamográficas, ecográficas y citológicas sugestivas de cáncer mamario. Se informa un caso de patología mamaria en paciente mujer de 35 años de edad, portadora de tumoración eritematosa, sensible, localizada en mama izquierda. La lesión fue tratada como "mastitis" con antibióticos y corticoides durante dos semanas. La persistencia de tumoración y sensibilidad, así como los controles mamográficos y ecográficos sugestivos de neoplasia, decidieron la extirpación quirúrgica. El diagnóstico histopatológico fue de mastitis crónica granulomatosa idiopática.Idiopathic chronic granulomatous mastitis is a rare disease in women at the reproductive life with clinic, mammographic, echographic and cytological characteristics suggestive of breast cancer. We report a case of breast pathology in a 35 years old woman who had a sensitiveness and eritematous tumor localized in the left breast. With the diagnosis of "mastitis", she was treated with antibiotics and corticoids for two weeks. Because the lesion and the sensitiveness persist and the mammographic and ecographic controls were suggestive of malignancy, the tumor was surgically removing. The histopathological diagnosis was idiopatic chronic granulomatous mastitis.

  8. Is Delayed Pressure Urticaria Associated with Increased Systemic Release of sCD40L?

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    T. Jasinska

    2013-01-01

    Full Text Available Background. Elevated levels of soluble CD40 Ligand (sCD40L were found in serum but not in plasma of patients with chronic spontaneous urticaria (CU. What is important is that sCD40L has proinflammatory properties, and its elevated plasma level may indicate increased risk of cardiovascular events. These observations should stimulate further evaluation of sCD40L in different forms of urticaria. Aim. In the present study, sCD40L plasma level was investigated in delayed pressure urticaria (DPU. Methods. As platelets are predominant and variable sources of sCD40L, we investigated sCD40L concentration in platelet-poor plasma (PPP, which seems the best way to minimize the potential contribution of these cells to the ligand level. Results. Plasma sCD40L concentration was significantly increased in the DPU group compared to the healthy controls. Conclusions. It seems that DPU is associated with increased systemic release of sCD40L, which is believed to derive predominantly from activated platelets. The present study as well as the earlier contributions suggest that distinct cells activity, including platelets, may be identified in different types of urticaria.

  9. Serum Specific IgE to Thyroid Peroxidase Activates Basophils in Aspirin Intolerant Urticaria.

    Science.gov (United States)

    Shin, Yoo Seob; Suh, Dong-Hyeon; Yang, Eun-Mi; Ye, Young-Min; Park, Hae-Sim

    2015-06-01

    Thyroid antibodies are frequently observed in urticaria patients, but their roles in urticaria are not clearly elucidated. We investigated the role of serum specific IgE to thyroid peroxidase (TPO) in patients with aspirin intolerant acute urticaria (AIAU) and aspirin intolerant chronic urticaria (AICU). We recruited 59 AIAU and 96 AICU patients with 69 normal controls (NC). Serum specific IgE to TPO was measured by manual direct ELISA, and CD203c expressions on basophil with additions of TPO were measured to prove a direct role of TPO in effector cells. The prevalences of serum specific IgE to TPO were significantly higher in AIAU (15.2%) and AICU groups (7.5%) compared to NC (0%, P=0.018: P=0.013, respectively). Flow cytometry showed CD203c induction in a dose dependent manner with serial additions of TPO in some AIAU and AICU patients having high specific IgE to TPO. Our findings show that the prevalence of serum specific IgE to TPO was significantly higher in both AIAU and AICU patients than in NC. It is suggested that specific IgE to TPO play a pathogenic role in AIAU and AICU.

  10. The EAACI/GA(2) LEN/EDF/WAO Guideline for the definition, classification, diagnosis, and management of urticaria: the 2013 revision and update.

    Science.gov (United States)

    Zuberbier, T; Aberer, W; Asero, R; Bindslev-Jensen, C; Brzoza, Z; Canonica, G W; Church, M K; Ensina, L F; Giménez-Arnau, A; Godse, K; Gonçalo, M; Grattan, C; Hebert, J; Hide, M; Kaplan, A; Kapp, A; Abdul Latiff, A H; Mathelier-Fusade, P; Metz, M; Nast, A; Saini, S S; Sánchez-Borges, M; Schmid-Grendelmeier, P; Simons, F E R; Staubach, P; Sussman, G; Toubi, E; Vena, G A; Wedi, B; Zhu, X J; Maurer, M

    2014-07-01

    This guideline is the result of a systematic literature review using the 'Grading of Recommendations Assessment, Development and Evaluation' (GRADE) methodology and a structured consensus conference held on 28 and 29 November 2012, in Berlin. It is a joint initiative of the Dermatology Section of the European Academy of Allergy and Clinical Immunology (EAACI), the EU-funded network of excellence, the Global Allergy and Asthma European Network (GA(2) LEN), the European Dermatology Forum (EDF), and the World Allergy Organization (WAO) with the participation of delegates of 21 national and international societies. Urticaria is a frequent, mast cell-driven disease, presenting with wheals, angioedema, or both. The life-time prevalence for acute urticaria is approximately 20%. Chronic spontaneous urticaria and other chronic forms of urticaria do not only cause a decrease in quality of life, but also affect performance at work and school and, as such, are members of the group of severe allergic diseases. This guideline covers the definition and classification of urticaria, taking into account the recent progress in identifying its causes, eliciting factors and pathomechanisms. In addition, it outlines evidence-based diagnostic and therapeutic approaches for the different subtypes of urticaria. This guideline was acknowledged and accepted by the European Union of Medical Specialists (UEMS).

  11. Angioedema-Urticaria Due to Acitretin.

    Science.gov (United States)

    Solak, Berna; Metin, Nurcan; Erdem, Mustafa Teoman

    2016-01-01

    Acitretin is a synthetic oral retinoid that has been used for a number of dermatological diseases. Several side effects of acitretin have been reported such as teratogenicity, cheilitis, xerosis, dyslipidemia, and photosensitivity. Many drugs, mainly antibiotics and nonsteroidal anti-inflammatory drugs, can cause angioedema-urticaria. We present the case of angioedema-urticaria due to acitretin, confirmed by oral provocation test, in a 61-year-old man with psoriasis. To the best of our knowledge, only 1 case of angioedema due to oral acitretin has been reported in the literature so far. We report this case to draw attention that acitretin may cause angioedema-urticaria and to inform patients about this risk besides other side effects due to acitretin.

  12. Idiopathic Scoliosis

    OpenAIRE

    2014-01-01

    Introduction. Idiopathic scoliosis is a structural and lateral curvature of the spine for which a currently recognizable cause has not been found and there is no basic evidence for physical and radiographic pathology. Complications. Scoliosis could be a cause of the back pain, deformities, respiratory and cardiology problems. There is a higher risk for decreasing of bone mineral density. Diagnosis and Management. Physical examination, radiography and stereophotogrametry are used in diag...

  13. Critical appraisal of bilastine for the treatment of allergic rhinoconjunctivitis and urticaria

    OpenAIRE

    Sadaba B; Azanza JR; Gomez-Guiu A; Rodil R

    2013-01-01

    Belen Sadaba, Jose Ramon Azanza, Almundena Gomez-Guiu, Raquel RodilClinical Pharmacology Service, Clinica Universidad de Navarra, Navarra, SpainAbstract: Bilastine is a second generation antihistamine indicated for the treatment of seasonal or perennial allergic rhinoconjunctivitis and chronic urticaria with a daily dose of 20 mg, in adults and children over 12 years of age. The efficacy of bilastine has been shown to be similar to that of the comparator drugs for the control of the nasal and...

  14. Acupuncture Treatment for 35 Cases of Urticaria

    Institute of Scientific and Technical Information of China (English)

    TAO Sha

    2009-01-01

    @@ In TCM it is held that urticaria is mostly due to weak constitution with deficiency of qi and blood, or prolonged illness that causes consumption of qi and blood. Such constitution can result in formation of wind due to blood deficiency, and internal-external lack of resistance due to qi-deficiency, which gives chances to pathogenic wind to invade the body, hence the occurrence of urticaria. Therefore, this disease is a complicated one with deficiency in the origin and excessiveness of pathogen.

  15. Microarray analysis of altered gene expression of basophils in chronic idiopathic urticaria%慢性特发性荨麻疹患者嗜碱粒细胞差异表达基因的研究

    Institute of Scientific and Technical Information of China (English)

    马一平; 姚煦; 林麟; 崔盘根

    2010-01-01

    目的:检测慢性特发性荨麻疹(CIU)患者外周血嗜碱粒细胞基因表达谱.方法:分离提取2例CIU患者和2名健康人外周血嗜碱粒细胞,提取总RNA;利用cRNA标记方法对样品进行荧光标记,然后用于芯片杂交;用LuxScan 10K/A双通道激光扫描仪进行芯片扫描;采用LuxScan 3.0图像分析软件对芯片图像进行分析;然后对芯片上的数据用Lowess方法进行归一化;最后以差异为2倍的标准来确定差异表达基因.结果:CIU患者嗜碱粒细胞与健康对照组相比存在差异表达基因共计30个.其中表达上调基因12个,表达下调基因8个,功能不明基因10个.结论:CIU患者和正常人嗜碱粒细胞的一些基因表达差异可能与CIU发病有关.

  16. Efficacy of Citrate Desloratadine with Tripterygium Treatment of Chronic Idiopathic Urticaria%枸地氯雷他定联合雷公藤多甙片治疗慢性特发性荨麻疹的疗效

    Institute of Scientific and Technical Information of China (English)

    郑伟军; 陈晓阳; 杨鲁英

    2015-01-01

    目的:探讨枸地氯雷他定联合雷公藤多甙片对慢性特发性荨麻疹的治疗效果。方法选取160例慢性特发性荨麻疹患者按随机数字表法分成研究组和对照组各80例。对照组采用枸地氯雷他定进行治疗,研究组采用枸地氯雷他定和雷公藤多甙片联合进行治疗。对比两组的治疗效果、不良反应、复发率及治疗前后的生活质量和睡眠情况。结果研究组治疗的总有效率高于对照组(P<0.05);两组不良反应发生率差别不明显(P>0.05);研究组复发率低于对照组(P<0.05);两组治疗前生活质量得分和睡眠质量得分无明显差别(P>0.05);研究组治疗后生活质量得分及睡眠质量得分均低于对照组(P<0.01)。结论枸地氯雷他定联合雷公藤多甙片对慢性特发性荨麻疹进行治疗不但可有效提高临床疗效和降低复发,且还可改善患者的生活质量和睡眠,且不良反应少,是安全而理想的治疗方式。

  17. Juvenile idiopathic arthritis

    Directory of Open Access Journals (Sweden)

    Krupa H Bhatt

    2014-01-01

    Full Text Available Juvenile Idiopathic Arthritis (JIA is the most chronic musculoskeletal disease of pediatric population. The chronic course of disease has a great impact on oral health. Temporomandibular joint is involved in JIA causing limited mouth opening with progressive open bite, retrognathia, microgenia and bird like appearance. Joints of upper and lower extremities are also involved. Effect on upper limb function leads to difficulty with fine motor movements required for brushing and flossing. This increases incidence of caries and periodontal disease in children. The cause of JIA is still poorly understood and none of the available drugs for JIA can cure the disease. However, prognosis has improved as a result of progress in disease classification and management. The dental practitioner should be familiar with the symptoms and oral manifestations of JIA to help manage as multidisciplinary management is essential.

  18. The influence of combination of Chinese traditional and western medicine continuing nursing care on treatment outcome and quality of life of patients with chronic urticaria%中西医结合延续护理对慢性荨麻疹患者治疗效果及生命质量的影响

    Institute of Scientific and Technical Information of China (English)

    杨茜; 邓永琼; 李雨欣; 杨晓琳; 杨文信

    2015-01-01

    Objective To explore the influence of combination of Chinese traditional and western medicine continuing nursing care on treatment outcome and quality of life of patients with chronic urticaria.Methods 96 confirmed chronic urticaria patients were selected and divided into the control group and the observation group with 48 patients in each group according to random digit table.The control group was given with routine nursing mode.The observation group received combination of Chinese traditional and western medicine continuing nursing care.The treatment lasted for 12 months.Treatment effect and Dermatology Life Qudity Index (DLQI) evaluation were executed at the end of the 3rd,6th and 12th months.The relapse was inquired 2 months after the intervention by follow-up.Results The total effective rates in the control group and the observation group at the end of the 3rd,6th and 12th months were 75.6% (34/45),80.0% (36/45),82.2% (37/45) and 87.0% (40/46),91.3% (42/46),93.5% (43/46),the results showed significant difference,P < 0.05.DLQI scores at the end of the 3rd,6th and 12th months in the control group and the observation group were (7.82±1.95),(7.04±1.58),(6.56±0.88) scores and (6.85±1.56),(5.71±1.03),(3.42±0.78) scores,the differences were significant,P<0.05.The relapse interval time was (24.75±5.07) days and (38.20±7.22) days,the difference was statistically significant (P<0.01).Conclusions Combination of Chinese traditional and western medicine continuing nursing care can significantly improve treatment outcome of chronic urticaria,reduce relapse rate,increase quality of life for patients with chronic urticaria,and it is better than routine nursing care and is worthy of being popularized.%目的 探讨中西医结合延续护理对慢性荨麻疹患者治疗效果及生命质量的影响.方法 将96例确诊为慢性荨麻疹的患者按照随机数字表法随机分为对照组和观察组各48例.对照组患者给予常规护理,观

  19. Idiopathic Scoliosis

    Directory of Open Access Journals (Sweden)

    Jens Ivar Brox

    2014-07-01

    Full Text Available Idiopathic scoliosis (IS is a lifetime condition and is defined as a structural, lateral rotated curvature of the spine of >10° on standing coronal plane radiographs. It should be distinguished from other causes of scoliosis. It can be classified as infantile, juvenile, and adolescent according to age. As a rule of thumb, about 80% of all curves are idiopathic, right convex thoracic, and present in otherwise healthy girls at the beginning of puberty. A family member most commonly detects scoliosis. The structural asymmetry of the spine is best observed by asking the patient to bend forward. IS is often seen in more than one member of a family, but the aetiology remains unknown. Multiple genes are likely to be involved with incomplete penetrance and variable expressivity. Early detection by screening allows for monitoring curve progression and timely initiation of bracing, but school screening is controversial and practises vary worldwide. Most patients have minor scoliosis and treatment is generally not recommended for patients with curves 45°. Scoliosis surgery was not successful until the introduction of Harrington’s instrumentation in the 1960s. Modern instrumentation has evolved from the Cotrel-Dubousset system in the 1980s, and a variety of methods are available today. Although scoliosis may be a burden, long-term studies suggest that a good quality of life is maintained in most patients.

  20. Prediction of melatonin efficacy by pretreatment dim light melatonin onset in children with idiopathic chronic sleep onset insomnia.

    Science.gov (United States)

    van der Heijden, Kristiaan B; Smits, Marcel G; van Someren, Eus J W; Boudewijn Gunning, W

    2005-06-01

    Research has shown efficacy of melatonin treatment to advance sleep-wake rhythms in insomnia. In healthy adults, direction and magnitude of the phase shift depends on the timing of administration relative to the phase position of the circadian system. Therefore, in the present study we investigated whether in children with chronic sleep onset insomnia (SOI) efficacy of melatonin treatment in the early evening could be predicted from dim light melatonin onset (DLMO), a phase marker of the circadian system. We combined data of two previously published double blind, randomized, placebo-controlled trials in 110 participants, aged 6-12 years. Sleep was actigraphically estimated, and saliva collected, at baseline and in the third week of a 4-week treatment period with 5 mg melatonin or placebo at 18:00 or 19:00 hours. Primary outcome measures were pre- to post-treatment changes in dim light melatonin onset (DeltaDLMO), sleep onset (DeltaSO), sleep latency (DeltaSL), and total sleep duration (DeltaTSD). Melatonin advanced DLMO with +1:12 h (P melatonin-treated group, but not in the placebo-treated group, pretreatment DLMO was significantly related to DeltaDLMO [F(1, 29) = 7.28, P = 0.012] and DeltaSO [F(1, 25) = 7.72, P = 0.010]. The time interval between treatment administration and pretreatment DLMO (INT) was only significantly related to DeltaSO [F(1,26) = 5.40, P = 0.028]. The results suggest that in children with SOI, the efficacy of early evening melatonin to advance sleep onset and endogenous melatonin onset increases the later the pretreatment DLMO is.

  1. NSAID-sensitive antihistamine-induced urticaria/angioedema.

    Science.gov (United States)

    Cimbollek, S; Ortega Camarero, M; Avila, R; Quiralte, J; Prados, M

    2011-01-01

    We present a case of urticaria caused by antihistamines in a patient with nonsteroidal anti-inflammatory drug (NSAID) sensitivity. A 35-year-old man experienced, on 2 separate occasions, immediate generalized urticaria during treatment with ibuprofen and naproxen, respectively. A single-blind, placebo-controlled oral challenge (SBPCOC) with piroxicam was carried out, and resulted in urticaria and angioedema 3 hours later. Two hours after initial clinical resolution, the patient developed multiple wheals on the trunk and upper limbs. He described similar delayed reactions after oral antihistamine administration on previous occasions. SBPCOCs with acetaminophen and etoricoxib were performed, with good tolerance. Skin prick and patch tests with loratadine and cetirizine were negative. After an SBPCOC with loratadine, the patient developed generalized urticaria 90 minutes after intake. Tolerance to fexofenadine 180 mg was confirmed. We describe the first case of a possible new subset of antihistamine urticaria, and suggest calling this NSAID-sensitive antihistamine-induced urticaria/angioedema.

  2. Adrenergic urticaria: review of the literature and proposed mechanism.

    Science.gov (United States)

    Hogan, Sara R; Mandrell, Joshua; Eilers, David

    2014-04-01

    Adrenergic urticaria is a rare type of stress-induced physical urticaria characterized by transient outbreaks of red papules surrounded by halos of hypopigmented, vasoconstricted skin. First described in 1985, there are 10 reported cases of adrenergic urticaria in the English-language medical literature. Episodes are caused by various triggers, including emotional upset, coffee, and chocolate, during which serum catecholamines and IgE are elevated, whereas histamine and serotonin levels remain within normal limits. The precise mechanisms leading to the pathogenesis of adrenergic urticaria have yet to be elucidated. Diagnosis can be made by intradermal injection of epinephrine or norepinephrine, which reproduces the characteristic rash, or by clinical observation. Trigger avoidance and oral propranolol are currently the best known treatments for adrenergic urticaria. Nonspecific therapies, including tranquilizers and antihistamines, may also ease symptoms. This article explores the pathophysiology of adrenergic urticaria and proposes a mechanism by which propranolol treats the condition.

  3. An overview of the novel H1-antihistamine bilastine in allergic rhinitis and urticaria.

    Science.gov (United States)

    Jáuregui, Ignacio; García-Lirio, Eduardo; Soriano, Ana María; Gamboa, Pedro M; Antépara, Ignacio

    2012-01-01

    Currently available second-generation H1-antihistamines include a wide group of drugs with a better therapeutic index (or risk-benefit ratio) than the classic antihistamines, although their properties and safety profiles may differ. Bilastine is a newly registered H1-antihistamine for the oral treatment of allergic rhinitis and urticaria, with established antihistaminic and antiallergic properties. Clinical studies in allergic rhinitis and chronic urticaria show that once-daily treatment with bilastine 20 mg is effective in managing symptoms and improving patient's quality of life, with at least comparable efficacy to other nonsedative H1-antihistamines. As far as studies in healthy volunteers, clinical assays and clinical experience can establish, bilastine's safety profile is satisfactory, since it lacks anticholinergic effects, does not impair psychomotor performance or actual driving, and appears to be entirely free from cardiovascular effects.

  4. Caffeine as a cause of urticaria-angioedema

    OpenAIRE

    Linda Tognetti; Francesco Murdaca; Michele Fimiani

    2014-01-01

    We report the case of a young woman presenting with recurrent urticaria. The episodes occurred both in and out of the workplace. On three occasions it presented as urticaria-angioedema, requiring emergency care on one occassion. A thorough clinical history along with serological and allergological tests allowed a diagnosis of caffeine-induced urticaria-angioedema. We advised the patient to follow a caffeine-free diet and to avoid all caffeine or methylxanthine-containing drugs. After two year...

  5. [Idiopathic interstitial pneumonias in 2016].

    Science.gov (United States)

    Debray, M-P; Borie, R; Danel, C; Khalil, A; Majlath, M; Crestani, B

    2017-02-01

    Idiopathic interstitial pneumonias comprise 8 clinicopathological entities, most of them with a chronic course and various prognosis. Idiopathic pulmonary fibrosis is the most frequent and most severe of these. Computed tomography has an important role for its diagnosis. It can identify the corresponding pathological pattern of usual interstitial pneumonia in about 50 percent of cases. It can suggest differential diagnosis in other cases, most frequently fibrosing nonspecific interstitial pneumonia and chronic hypersensitivity pneumonitis. Imaging features should be integrated to clinical and available pathologic data during multidisciplinary team meetings involving physicians with a good knowledge of interstitial diseases. Some cases may be unclassifiable, but these could later be reclassified as new data may occur or imaging features may change. Surgical lung biopsy is being less frequently performed and an emerging less invasive technique, lung cryobiopsy, is under evaluation. Pleuroparenchymal fibroelastosis is a distinct entity only recently described, with uncertain prevalence and prognosis that seems being quite often associated to another pattern of interstitial pneumonia.

  6. Relationship between coagulation factors and urticaria%凝血因子与荨麻疹的关系

    Institute of Scientific and Technical Information of China (English)

    梁碧华; 朱慧兰

    2009-01-01

    荨麻疹是一种常见的、复发性的皮肤病.其发病机制复杂,至今尚未完全清楚.近年来有学者提出荨麻疹发病可能与凝血状态有关,并对凝血酶原片段F1+2、D二聚体、因子Ⅶ和因子Ⅻ等凝血因子进行相关研究,认为慢性荨麻疹患者体内存在外源性凝血级联反应激活以及纤溶状态,凝血酶生成可能在荨麻疹的发病中起着作用.抗凝治疗在荨麻疹药物治疗中显示出一定的临床应用前景.%Urticaria is a common, recurrent and refractory skin disease. The exact pathogenic mechanism of urticaria is complex and unclear. It has been proposed that the development of urticaria is associated with coagulation status. Related studies on thrombinogen fragment F (1+2), D dimmer, factor Ⅶ and factor Ⅻ revealed the activation of extrinsic pathway of coagulation cascade and signs of fibrinolysis in patients with chronic urticaria. Thromhin generation may play a key role in the pathogenesis of urticaria. And anticoagulant drugs have exhibited a good prospect in the medication of urticaria.

  7. Idiopathic short stature

    Directory of Open Access Journals (Sweden)

    Vlaški Jovan

    2013-01-01

    Full Text Available Growth is a complex process and the basic characteristic of child- hood growth monitoring provides insight into the physiological and pathological events in the body. Statistically, the short stature means departure from the values of height for age and sex (in a particular environment, which is below -2 standard deviation score, or less than -2 standard deviation, i.e. below the third percentile. Advances in molecular genetics have contributed to the improvement of diagnostics in endocrinology. Analysis of patients’ genotypes should not be performed before taking a classical history, detailed clinical examination and appropriate tests. In patients with idiopathic short stature specific causes are excluded, such as growth hormone deficiency, Turner syndrome, short stature due to low birth weight, intrauterine growth retardation, small for gestational age, dysmorphology syndromes and chronic childhood diseases. The exclusion of abovementioned conditions leaves a large number of children with short stature whose etiology includes patients with genetic short stature or familial short stature and those who are low in relation to genetic potential, and who could also have some unrecognized endocrine defect. Idiopathic short stature represents a short stature of unknown cause of heterogeneous etiology, and is characterized by a normal response of growth hormone during stimulation tests (>10 ng/ml or 20 mJ/l, without other disorders, of normal body mass and length at birth. In idiopathic short stature standard deviation score rates <-2.25 (-2 to -3 or <1.2 percentile. These are also criteria for the initiation of growth hormone therapy. In children with short stature there is also the presence of psychological and social suffering. Goals of treatment with growth hormone involve achieving normal height and normal growth rate during childhood.

  8. Clinical Evaluation of Inpatients with Acute Urticaria

    Directory of Open Access Journals (Sweden)

    Ayşe Serap

    2011-12-01

    Full Text Available Background and Design: To determine the clinical and etiological features of inpatients with acute urticaria and angioedema and to assess the need for laboratory tests. Material and Methods: We recruited 105 patients with acute urticaria and angioedema who were admitted to our inpatient unit. The lesions and the characteristics of the patients were analyzed. Routine diagnostic tests including complete blood count, thyroid function tests, hepatitis panel, stool parasite, total IgE levels, cultures, erythrocyte sedimentation rate, C-reactive protein, anti-nuclear antibody, and posterior anterior lung X-ray were ordered. A psychiatric consultation was obtained, when needed. The results were analyzed with SPSS 15.0 statistical software.Results: Among 105 patients, 28 (26.7% had urticaria, 7 (6.7% had angioedema, and 70 (66.7% suffered from both urticaria and angioedema. The most common accompanying symptoms were itching (91.4% and burning (34.3%. The most common systemic symptoms were fatigue (15.2% and headache (12.4%. The lesions usually appeared in the evening hours (24.8%. Twenty-five patients were waking up due to itching during the night. Some lesions were associated with physical activities. Systemic diseases accompanied the lesions in 12 patients (11%. In terms of etiological factors, 33 patients (22.5% had infections. Food- related lesions were encountered in 14 (13% patients. Thirty patients (28.5% had history of medication use. Stress was detected in 37.1% of the patients; anxiety was diagnosed in 3% of patients. The stool was positive for parasites in 10 (9% patients. Conclusion: Acute urticaria is a benign disorder. Although the underlying cause of urticaria can not always be identified, infections and medications are the most common causes. A comprehensive and detailed history is very important to discover the underlying cause. The diagnostic tests should be ordered according to the patient’s history. Conducting diagnostic tests

  9. Solar urticaria. Determinations of action and inhibition spectra.

    Science.gov (United States)

    Hasei, K; Ichihashi, M

    1982-05-01

    A 42-year-old woman acquired solar urticaria approximately ten minutes after exposure to sunlight. Urticaria developed from visible light emitted from a projector lamp after a similar time lag. Monochromatic rays between 400 and 500 nm induced immediate urticaria by irradiation, with four times the minimal urticarial dose. Urticaria that was induced by monochromatic rays of the projector lamp was completely inhibited by immediate reirradiation of test sites with light waves longer that 530 nm. Radiant heat exposure from an electric hair dryer at 50 degrees C had no suppressive effects on the development of urticarial lesions.

  10. [DRUGS-INDUCED URTICARIA AND ANGIOEDEMA].

    Science.gov (United States)

    Braire-Bourrel, Marion; Augey, Frédéric; Doutre, Marie-Sylvie

    2015-09-01

    Drug-induced urticaria and/or angioedema is a frequent issue encountered in family medicine. A specific collection of the anamnesis and of the general context is very important to appreciate the involved mechanism, allergic or not, and potential cofactors. If in doubt about an allergic mechanism, tests will be conducted, mostly under a hospital setting. Bradykinin-mediated angioedema, so much rare than histamine-mediated one, has to be known, because it is potentially lethal. It is often iatrogenic (ACE inhibitors especially). At the end of the allergology work-up, a course of action is proposed to the patient and his family practitioner as far as the rechallenge of the drug is concerned, In case of non-allergic urticaria, much more frequent than allergy, taking the drug is possible with a premedication with antihistamines.

  11. Melatonin improves health status and sleep in children with idiopathic chronic sleep-onset insomnia: a randomized placebo-controlled trial

    NARCIS (Netherlands)

    Smits, M.G.; van Stel, H.F.; van der Heijden, K.; Meijer, A.M.; Coenen, A.M.L.; Kerkhof, G.A.

    2003-01-01

    Objective: To investigate the effect of melatonin treatment on health status and sleep in children with idiopathic sleep-onset insomnia. Method: A randomized, double-blind, placebo-controlled trial was conducted in a Dutch sleep center, involving 62 children, 6 to 12 years of age, who suffered more

  12. Urticaria & angioedema: a rational approach to diagnosis and therapy.

    Science.gov (United States)

    Dreyfus, David H

    2013-01-01

    Urticaria and angioedema are common allergic manifestations and some forms of this disorder may be increasing in both prevalence and severity due to changes in medications, environment and other unknown factors. This review focuses on a rational approach to differential diagnosis and therapy of the most common forms of urticaria and angioedema.

  13. How not to miss autoinflammatory diseases masquerading as urticaria

    NARCIS (Netherlands)

    Krause, K.; Grattan, C.E.; Bindslev-Jensen, C.; Gattorno, M.; Kallinich, T.; Koning, H.D. de; Lachmann, H.J.; Lipsker, D.; Navarini, A.A.; Simon, A.; Traidl-Hoffmann, C.; Maurer, M.

    2012-01-01

    Urticarial skin reactions are one of the most frequent problems seen by allergists and clinical immunologists in daily practice. The most common reason for recurrent wheals is spontaneous urticaria. There are, however, several less common diseases that present with urticarial rash, such as urticaria

  14. [Exercise-induced urticaria and angioedema - case report].

    Science.gov (United States)

    Stelmach, Iwona; Sztafińska, Anna; Lechańka, Joanna; Balcerak, Joanna; Jerzyńska, Joanna

    2014-01-01

    Urticaria is a heterogeneous group of disorders, with various clinical manifestations and intensity of symptoms. Urticaria can be induced with a wide variety of environmental stimuli, such as cold, pressure, vibration, sunlight, exercise, temperature changes, heat, and water. In a select group of patients, exercise can induce a spectrum of urticaria symptoms, ranging from cutaneous pruritus and warmth, generalised urticaria, angioedema, and the appearance of such additional manifestations as collapse, upper respiratory distress, and anaphylaxis. Specific provocation tests should be carried out on an individual basis to investigate the suspected cause and proper diagnosis. Modification of activities and behaviour is the mainstay of treatment in patients with physical urticaria. The aim of this study was to emphasise that primary care paediatricians should be able to recognise physical urticaria, supply a patient with rescue medications, and refer him/her to a specialist. In the article, the authors present a 13-year-old girl with typical urticaria lesions and angioedema after exercise. According to the history, physical examination, and provocation test, exercise-induced urticaria and angioedema were diagnosed.

  15. 牛痘疫苗致炎兔皮提取物注射液自血联合枸地氯雷他定治疗慢性荨麻疹的疗效观察%To Observe the Effect of Extract From Rabbit Skin Inflamed by Vaccinia Virus From Blood Injection Combined With Desloratadine Citrate in the Treatment of Chronic Urticaria

    Institute of Scientific and Technical Information of China (English)

    卞曙晓; 胡雯; 王婷

    2015-01-01

    目的:观察牛痘疫苗致炎兔皮提取物注射液自血联合枸地氯雷他定治疗慢性荨麻疹的疗效。方法我科就诊的慢性荨麻疹患者160例,随机分为两组,单纯行枸地氯雷他定对照组,牛痘疫苗致炎兔皮提取物注射液自血联合枸地氯雷他定治疗组各80例,于治疗前、治疗结束即刻行血清IgE浓度检测,评价治疗前后症状、体征变化,治疗结束后行疗效评定。并随访3个月统计复发率。结果治疗组痊愈、显效、好转、无效依次为67.5%(54/80例)、22.6%(18/80例)、7.5%(6/80例)、2.5%(2/80例),对照组痊愈、显效、好转、无效依次为32.5%(26/80例)、45%(36/80例)、10.0%(8/80例)、12.5%(10/80例);治疗后3个月复发率分别为2.6%与15.7%。结论牛痘疫苗致炎兔皮提取物注射液自血联合枸地氯雷他定可明显提高治疗效果,降低复发率。%ObjectiveTo observe the curative effect for treatment of chronic urticaria by extracts from rabbit skin inlfamed by vaccinia virus for injection, autoblood in combination with desloratadine ditrate disodium. MethodsHaving 160 patients who suffered from chronic urticaria in this department, we randomly assigned them to 2 groups, namely 80 cases for the control group of desloratadine citrate disodium and the treatment group of extracts from rabbit skin inlfamed by vaccinia virus for injection respectively. Serum IgE concentration detection was carried out before and after treatment, and evaluation of change of symptom and sign as well. After the treatment, evaluation of therapeutic effects was carried out, and recurrence rate statistics was made followed by a three-month follow-up visit.ResultsThe rates of recovery, marked effect, improvement, and inefifcacy for the treatment group were 67.5%(54/80 cases), 22.6%(18/80 cases), 7.5%(6/80 cases), and 2.5%(2/80 cases) respectively, and that for the control group were 32.5%(26/80 cases), 45

  16. Treatment of allergic rhinitis and urticaria: a review of the newest antihistamine drug bilastine.

    Science.gov (United States)

    Wang, Xue Yan; Lim-Jurado, Margaret; Prepageran, Narayanan; Tantilipikorn, Pongsakorn; Wang, De Yun

    2016-01-01

    Allergic rhinitis and urticaria are common allergic diseases that may have a major negative impact on patients' quality of life. Bilastine, a novel new-generation antihistamine that is highly selective for the H1 histamine receptor, has a rapid onset and prolonged duration of action. This agent does not interact with the cytochrome P450 system and does not undergo significant metabolism in humans, suggesting that it has very low potential for drug-drug interactions, and does not require dose adjustment in renal impairment. As bilastine is not metabolized and is excreted largely unchanged, hepatic impairment is not expected to increase systemic exposure above the drug's safety margin. Bilastine has demonstrated similar efficacy to cetirizine and desloratadine in patients with seasonal allergic rhinitis and, in a Vienna Chamber study, a potentially longer duration of action than fexofenadine in patients with asymptomatic seasonal allergic rhinitis. It has also shown significant efficacy (similar to that of cetirizine) and safety in the long-term treatment of perennial allergic rhinitis. Bilastine showed similar efficacy to levocetirizine in patients with chronic spontaneous urticaria and can be safely used at doses of up to fourfold higher than standard dosage (80 mg once daily). The fourfold higher than standard dose is specified as an acceptable second-line treatment option for urticaria in international guidelines. Bilastine is generally well tolerated, both at standard and at supratherapeutic doses, appears to have less sedative potential than other second-generation antihistamines, and has no cardiotoxicity. Based on its pharmacokinetic properties, efficacy, and tolerability profile, bilastine will be valuable in the management of allergic rhinitis and urticaria.

  17. Epidemiology of idiopathic pulmonary fibrosis

    Directory of Open Access Journals (Sweden)

    Ley B

    2013-11-01

    Full Text Available Brett Ley, Harold R Collard Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of California San Francisco, San Francisco, California, USA Abstract: Idiopathic pulmonary fibrosis is a chronic fibrotic lung disease of unknown cause that occurs in adults and has a poor prognosis. Its epidemiology has been difficult to study because of its rarity and evolution in diagnostic and coding practices. Though uncommon, it is likely underappreciated both in terms of its occurrence (ie, incidence, prevalence and public health impact (ie, health care costs and resource utilization. Incidence and mortality appear to be on the rise, and prevalence is expected to increase with the aging population. Potential risk factors include occupational and environmental exposures, tobacco smoking, gastroesophageal reflux, and genetic factors. An accurate understanding of its epidemiology is important, especially as novel therapies are emerging. Keywords: idiopathic pulmonary fibrosis, epidemiology, incidence, prevalence, mortality, risk factors

  18. Critical appraisal of bilastine for the treatment of allergic rhinoconjunctivitis and urticaria

    Directory of Open Access Journals (Sweden)

    Sadaba B

    2013-05-01

    Full Text Available Belen Sadaba, Jose Ramon Azanza, Almundena Gomez-Guiu, Raquel RodilClinical Pharmacology Service, Clinica Universidad de Navarra, Navarra, SpainAbstract: Bilastine is a second generation antihistamine indicated for the treatment of seasonal or perennial allergic rhinoconjunctivitis and chronic urticaria with a daily dose of 20 mg, in adults and children over 12 years of age. The efficacy of bilastine has been shown to be similar to that of the comparator drugs for the control of the nasal and nonnasal symptoms of allergic rhinoconjunctivitis, while also showing a subjective improvement in the quality of life and in overall clinical impression. For chronic urticaria the symptoms (itching and the development of papules lessens from the second day of treatment onwards, in a similar way to other antihistamines used as comparators. Bilastine should not be administered at meal times to avoid interference with the absorption process. It is not distributed to the central nervous system, is scarcely metabolized, and elimination is through the kidneys and feces, with a 14-hour elimination half-life. It has no effect on cytochrome P450. During clinical development, bilastine was shown to be a drug that is adequately tolerated, with a similar effect to placebo with regard to drowsiness and changes in heart rate. In relation to its use, headaches were the most frequent adverse effect to be reported. No cardiotoxic effects have been observed, and the therapeutic dose does not alter the state of alertness.Keywords: bilastine, allergic rhinoconjunctivitis, chronic urticaria, second generation antihistamine, drowsiness, CYP450

  19. Resistance to Qian soup ZhuSheKa interface sp6 joint foot acupoint treatment of chronic urticaria nucleic acid bacteria polysaccharide 30 cases curative effects%抗荨湯联合足三里穴位注射卡介菌多糖核酸治疗慢性荨麻疹30例疗效观察

    Institute of Scientific and Technical Information of China (English)

    胡建农

    2011-01-01

    Objective: To observe Qian soup (bachelor since resistance points to ZhuSheKa sp6 joint foot fungus polysaccharide nucleic acid injection interface. Brand name: ji Sue, zhejiang million horses pharmaceutcal Co. Production. The curative effect of treating chronic urticaria. Methods Selected 60 cases were randomly divided into two groups: treatment group of 30 cases Qian soup to fight ZhuSheKa interface sp6 joint foot fungus polysaccharide acupuncture treatment of nucleic acid injection, four weeks. 30 cases in oral chlorobenzene that sensitivity to 4mg, three times/d, cimetidine 0. 2 g, 2 times a/d; Two groups of course are for 1 month, 2 months after the completion of course judge curative effect, and were followed up for half a year. Results The treatment group and control group 70% , 90% efficiency was statistically significant difference (P<0. OS ) -Conclusion Qian resistance points ZhuSheKa sp6 joint foot soup of nucleic acid injection dielectric bacteria polysaccharide treatment of chronic nettle has good curative effect, and clinical application.%目的:观察抗荨汤联合足三里穴位注射卡介菌多糖核酸注射液治疗慢性荨麻疹的疗效.方法:将入选的60例患者随机分为两组,各30例,治疗组予抗荨汤联合足三里穴位注射卡介菌多糖核酸注射液治疗,隔日1次;对照组予口服氯苯那敏4mg,3次/d,西咪替丁0.2g,2次/d;两组疗程均为1个月,疗程结束后2个月时判定疗效,并随访半年.结果:治疗组有效率90%,对照组70%,差异有统计学意义(P<0.05).结论:抗荨汤联合足三里穴位注射卡介菌多糖核酸注射液治疗慢性荨麻疗效好,值得临床选用.

  20. [Idiopathic pulmonary hemosiderosis with dendriform pulmonary ossification].

    Science.gov (United States)

    Barrera, Ana Madeleine; Vargas, Leslie

    2016-12-01

    Pulmonary ossification is a rare and usually asymptomatic finding reported as incidental in lung biopsies. Similarly, idiopathic pulmonary hemosiderosis is a rare cause of pulmonary infiltrates. We report the case of a 64-year old man with chronic respiratory symptoms in whom these two histopathological findings converged.

  1. Mineral Oil Aspiration Related Juvenile Idiopathic Arthritis

    OpenAIRE

    Nelson, Andrew D.; Fischer, Philip R.; Reed, Ann M.; Wylam, Mark E.

    2015-01-01

    We describe the development of rheumatoid factor-positive migratory polyarthritis in a 5-year-old male who had been administered bidaily oral mineral oil as a laxative since birth. Minor respiratory symptoms, radiographic and bronchoscopic findings were consistent with chronic lipoid pneumonia. We speculate that immune sensitization to mineral oil promoted the clinical syndrome of juvenile idiopathic arthritis.

  2. Treatment of allergic rhinitis and urticaria: a review of the newest antihistamine drug bilastine

    Directory of Open Access Journals (Sweden)

    Wang XY

    2016-04-01

    Full Text Available Xue Yan Wang,1 Margaret Lim-Jurado,2 Narayanan Prepageran,3 Pongsakorn Tantilipikorn,4 De Yun Wang5 1Department of Allergy, Beijing Shijitan Hospital, Capital Medical University, Beijing, People’s Republic of China; 2St Luke’s Medical Center, Quezon City, Manila, Philippines; 3Department of Otorhinolaryngology, Head & Neck Surgery, University Malaya Faculty of Medicine, Kuala Lumpur, Malaysia; 4Rhinology and Allergy Division, Department of Otorhinolaryngology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand; 5Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore Abstract: Allergic rhinitis and urticaria are common allergic diseases that may have a major negative impact on patients’ quality of life. Bilastine, a novel new-generation antihistamine that is highly selective for the H1 histamine receptor, has a rapid onset and prolonged duration of action. This agent does not interact with the cytochrome P450 system and does not undergo significant metabolism in humans, suggesting that it has very low potential for drug–drug interactions, and does not require dose adjustment in renal impairment. As bilastine is not metabolized and is excreted largely unchanged, hepatic impairment is not expected to increase systemic exposure above the drug’s safety margin. Bilastine has demonstrated similar efficacy to cetirizine and desloratadine in patients with seasonal allergic rhinitis and, in a Vienna Chamber study, a potentially longer duration of action than fexofenadine in patients with asymptomatic seasonal allergic rhinitis. It has also shown significant efficacy (similar to that of cetirizine and safety in the long-term treatment of perennial allergic rhinitis. Bilastine showed similar efficacy to levocetirizine in patients with chronic spontaneous urticaria and can be safely used at doses of up to fourfold higher than standard dosage (80 mg once daily. The

  3. Cough in idiopathic pulmonary fibrosis

    Directory of Open Access Journals (Sweden)

    Mirjam J.G. van Manen

    2016-09-01

    Full Text Available Many patients with idiopathic pulmonary fibrosis (IPF complain of chronic refractory cough. Chronic cough is a distressing and disabling symptom with a major impact on quality of life. During recent years, progress has been made in gaining insight into the pathogenesis of cough in IPF, which is most probably “multifactorial” and influenced by mechanical, biochemical and neurosensory changes, with an important role for comorbidities as well. Clinical trials of cough treatment in IPF are emerging, and cough is increasingly included as a secondary end-point in trials assessing new compounds for IPF. It is important that such studies include adequate end-points to assess cough both objectively and subjectively. This article summarises the latest insights into chronic cough in IPF. It describes the different theories regarding the pathophysiology of cough, reviews the different methods to assess cough and deals with recent and future developments in the treatment of cough in IPF.

  4. Glucocorticoids in juvenile idiopathic arthritis.

    Science.gov (United States)

    Malattia, Clara; Martini, Alberto

    2014-05-01

    Although the use of corticosteroids in juvenile idiopathic arthritis (JIA) is now much more limited owing to the availability of methotrexate and biological agents, there are clinical scenarios where it is still indicated. For example, corticosteroids may be indicated for intraarticular injections to prevent joint deformities, as a "bridge" drug to relieve symptoms in polyarticular disease while waiting for methotrexate and biologics to exert their full therapeutic effects, and in the treatment of chronic iridocyclitis, macrophage activation syndrome, and systemic JIA, although the advent of interleukin (IL)-1 and IL-6 blockers has greatly reduced the latter indication.

  5. Idiopathic chondrolysis - diagnostic difficulties

    Energy Technology Data Exchange (ETDEWEB)

    Kozlowski, K.; Scougall, J.

    1984-07-01

    Four cases of idiopathic chondrolysis of the hip in three white girls and one Maori girl are reported. The authors stress the causes why a disease with characteristic clinical and radiographic appearances and normal biochemical findings presents diagnostic difficulties. It is suspected that idiopathic chondrolysis is a metabolic disorder of chondrocytes, triggered by environment circumstances in susceptible individuals. Idiopathic chondrolysis is probably one of the most common causes of coxarthrosis in women.

  6. [Cold-induced urticaria and angioedema. Classification, diagnosis and therapy].

    Science.gov (United States)

    Krause, K; Degener, F; Altrichter, S; Ardelean, E; Kalogeromitros, D; Magerl, M; Metz, M; Siebenhaar, F; Weller, K; Maurer, M

    2010-09-01

    The onset of wheals and/or angioedema following the exposure to cold may be associated with a number of different diseases. Most frequently this occurs in cold contact urticaria, a type of physical urticaria, which is characterized by a positive cold stimulation test. The clinical symptoms are based on cold-dependent mast cell activation with subsequent release of proinflammatory mediators. In cases of negative or atypical reaction to cold stimulation testing rare acquired atypical or familiar cold urticaria forms may be suspected. Strict avoidance of cold should be recommended as far as possible. As the underlying causes of cold contact urticaria are widely unknown, the symptomatic use of non-sedating antihistamines is the treatment of first choice. The very rare familiar cold auto-inflammatory syndrome (FCAS) is based on CIAS1/NLRP3 mutations and may be treated effectively by neutralization of pathogenic interleukin 1beta.

  7. Urticaria: "You're Probably Just Allergic to Something".

    Science.gov (United States)

    Smallwood, Jordan

    2016-11-01

    Urticaria is a common symptom seen in pediatric patients, and it has multiple allergic and nonallergic causes. Unfortunately, it is far too common that when children present acutely for urticaria, they are told that it is an "allergy." This statement often leads to increased anxiety while the patient waits to be evaluated by an allergist/immunologist. This article discusses the frequency that allergic reactions are involved in urticaria and provides examples of potential nonallergic causes. Additionally, the article discusses approaches to treatment that may be appropriate to initiate in the pediatrician's office or acute setting. This article is intended to provide a broader understanding of urticaria and its management in the outpatient or emergency setting so that we are able to tell our patients more than"you're probably just allergic to something." [Pediatr Ann. 2016;45(11):e399-e402.].

  8. A histopathological and electron microscopical observation of urticaria pigmentosa

    Directory of Open Access Journals (Sweden)

    Ke-jian Zhu

    1990-01-01

    Full Text Available In a case of urticaria pigmentosa, histopathological and electron microscopical observation of skin lesions before and after dermatographism were compared. The results showed that the shape, membranes, nuclei and granules of mast cells in the lesions before and after dermatographism are different. The prognosis, the clinical significance of dermato-graphism test and the pattern of degranulation in urticaria pigmentosa are discussed.

  9. Chlorhexidine urticaria: A rare occurrence with a common mouthwash

    Directory of Open Access Journals (Sweden)

    Sharma Anamika

    2009-01-01

    Full Text Available Chlorhexidine is a widely used antiseptic and disinfectant in medical and nonmedical environments. Compared to its ubiquitous use, allergic contact dermatitis from chlorhexidine has rarely been reported and so its sensitization rate seems to be low. The prevalence of contact urticaria and anaphylaxis due to chlorhexidine remains to be unknown. This case report presents a case of urticaria due to oral use of chlorhexidine. The adverse reaction was confirmed by skin prick test.

  10. 接触性荨麻疹%Contact urticaria

    Institute of Scientific and Technical Information of China (English)

    郑嵘君; 郑敏

    2009-01-01

    接触致敏物后出现皮肤发红、风团、瘙痒等表现,称为接触性荨麻疹.根据疾病的发生机制可分为非免疫性、免疫性和不明机制者.非免疫性接触性荨麻疹表现为接触局部出现皮损,往往在数小时内皮疹消退.而免疫性接触性荨麻疹除了局部表现外,常伴有呼吸道和消化道等其他系统受累.该疾病的病因复杂多样,病因治疗较为困难,特异性免疫疗法、抗IgE单克隆抗体可能为该病的治疗带来希望.%Contact urticaria refers to a wheal, itching and flare reaction following external contact with an allergen. According to the pathogenesis of contact urticaria, it can be described in three categories: non-immunological contact urticaria, immunological contact urticaria and undetermined contact urticaria. Non-immunological contact urticaria is typically characterized by local eruptions at the site of exposure that can disappear within several hours. Meanwhile, immunological contact urticaria is manifested not only as local skin lesions but also as the involvement of respiratory system, alimentary system, etc. Since the etiology of contact urticaria is complicated, etiological treatment is difficult, whereas specific immunotherapy and anti-IgE monoclonal antibody might benefit its treatment.

  11. Approaches to the diagnosis and management of patients with a history of nonsteroidal anti-inflammatory drug-related urticaria and angioedema.

    Science.gov (United States)

    Kowalski, Marek L; Woessner, Katharine; Sanak, Marek

    2015-08-01

    Nonsteroidal anti-inflammatory drug (NSAID)-induced urticarial and angioedema reactions are among the most commonly encountered drug hypersensitivity reactions in clinical practice. Three major clinical phenotypes of NSAID-induced acute skin reactions manifesting with angioedema, urticaria, or both have been distinguished: NSAID-exacerbated cutaneous disease, nonsteroidal anti-inflammatory drug-induced urticaria/angioedema (NIUA), and single NSAID-induced urticaria and angioedema. In some patients clinical history alone might be sufficient to establish the diagnosis of a specific type of NSAID hypersensitivity, whereas in other cases oral provocation challenges are necessary to confirm the diagnosis. Moreover, classification of the type of cutaneous reaction is critical for proper management. For example, in patients with single NSAID-induced reactions, chemically nonrelated COX-1 inhibitors can be safely used. However, there is cross-reactivity between the NSAIDs in patients with NSAID-exacerbated cutaneous disease and NIUA, and thus only use of selective COX-2 inhibitors can replace the culprit drug if the chronic treatment is necessary, although aspirin desensitization will allow for chronic treatment with NSAIDs in some patients with NIUA. In this review we present a practical clinical approach to the patient with NSAID-induced urticaria and angioedema.

  12. Critical appraisal of bilastine for the treatment of allergic rhinoconjunctivitis and urticaria.

    Science.gov (United States)

    Sadaba, Belen; Azanza, Jose Ramon; Gomez-Guiu, Almundena; Rodil, Raquel

    2013-01-01

    Bilastine is a second generation antihistamine indicated for the treatment of seasonal or perennial allergic rhinoconjunctivitis and chronic urticaria with a daily dose of 20 mg, in adults and children over 12 years of age. The efficacy of bilastine has been shown to be similar to that of the comparator drugs for the control of the nasal and nonnasal symptoms of allergic rhinoconjunctivitis, while also showing a subjective improvement in the quality of life and in overall clinical impression. For chronic urticaria the symptoms (itching and the development of papules) lessens from the second day of treatment onwards, in a similar way to other antihistamines used as comparators. Bilastine should not be administered at meal times to avoid interference with the absorption process. It is not distributed to the central nervous system, is scarcely metabolized, and elimination is through the kidneys and feces, with a 14-hour elimination half-life. It has no effect on cytochrome P450. During clinical development, bilastine was shown to be a drug that is adequately tolerated, with a similar effect to placebo with regard to drowsiness and changes in heart rate. In relation to its use, headaches were the most frequent adverse effect to be reported. No cardiotoxic effects have been observed, and the therapeutic dose does not alter the state of alertness.

  13. Norfloxacin-induced hypoglycemia and urticaria

    Directory of Open Access Journals (Sweden)

    Ajay Mishra

    2012-01-01

    Full Text Available Fluoroquinolone-induced hypoglycemia is not a common adverse drug reaction. However, it has been reported with most of the available agents and appears to be more common in elderly patients with a history of type 2 diabetes who are receiving oral sulfonylureas. The exact mechanism of this effect is unknown but is postulated to be a result of blockage of Adenosine 5′-Triphosphate (ATP-sensitive potassium channels in pancreatic β-cell membranes. This report highlights hypoglycemia with urticaria as an adverse drug reaction of norfloxacin in a middle aged non-diabetic patient. Clinicians should be alert about the possibility of its potential adverse effect in patients who are receiving norfloxacin therapy.

  14. Idiopathic pulmonary fibrosis.

    Science.gov (United States)

    Meltzer, Eric B; Noble, Paul W

    2008-01-01

    Idiopathic pulmonary fibrosis (IPF) is a non-neoplastic pulmonary disease that is characterized by the formation of scar tissue within the lungs in the absence of any known provocation. IPF is a rare disease which affects approximately 5 million persons worldwide. The prevalence is estimated to be slightly greater in men (20.2/100,000) than in women (13.2/100,000). The mean age at presentation is 66 years. IPF initially manifests with symptoms of exercise-induced breathless and dry coughing. Auscultation of the lungs reveals early inspiratory crackles, predominantly located in the lower posterior lung zones upon physical exam. Clubbing is found in approximately 50% of IPF patients. Cor pulmonale develops in association with end-stage disease. In that case, classic signs of right heart failure may be present. Etiology remains incompletely understood. Some environmental factors may be associated with IPF (cigarette smoking, exposure to silica and livestock). IPF is recognized on high-resolution computed tomography by peripheral, subpleural lower lobe reticular opacities in association with subpleural honeycomb changes. IPF is associated with a pathological lesion known as usual interstitial pneumonia (UIP). The UIP pattern consists of normal lung alternating with patches of dense fibrosis, taking the form of collagen sheets. The diagnosis of IPF requires correlation of the clinical setting with radiographic images and a lung biopsy. In the absence of lung biopsy, the diagnosis of IPF can be made by defined clinical criteria that were published in guidelines endorsed by several professional societies. Differential diagnosis includes other idiopathic interstitial pneumonia, connective tissue diseases (systemic sclerosis, polymyositis, rheumatoid arthritis), forme fruste of autoimmune disorders, chronic hypersensitivity pneumonitis and other environmental (sometimes occupational) exposures. IPF is typically progressive and leads to significant disability. The median

  15. Idiopathic pulmonary fibrosis

    Directory of Open Access Journals (Sweden)

    Noble Paul W

    2008-03-01

    Full Text Available Abstract Idiopathic pulmonary fibrosis (IPF is a non-neoplastic pulmonary disease that is characterized by the formation of scar tissue within the lungs in the absence of any known provocation. IPF is a rare disease which affects approximately 5 million persons worldwide. The prevalence is estimated to be slightly greater in men (20.2/100,000 than in women (13.2/100,000. The mean age at presentation is 66 years. IPF initially manifests with symptoms of exercise-induced breathless and dry coughing. Auscultation of the lungs reveals early inspiratory crackles, predominantly located in the lower posterior lung zones upon physical exam. Clubbing is found in approximately 50% of IPF patients. Cor pulmonale develops in association with end-stage disease. In that case, classic signs of right heart failure may be present. Etiology remains incompletely understood. Some environmental factors may be associated with IPF (cigarette smoking, exposure to silica and livestock. IPF is recognized on high-resolution computed tomography by peripheral, subpleural lower lobe reticular opacities in association with subpleural honeycomb changes. IPF is associated with a pathological lesion known as usual interstitial pneumonia (UIP. The UIP pattern consists of normal lung alternating with patches of dense fibrosis, taking the form of collagen sheets. The diagnosis of IPF requires correlation of the clinical setting with radiographic images and a lung biopsy. In the absence of lung biopsy, the diagnosis of IPF can be made by defined clinical criteria that were published in guidelines endorsed by several professional societies. Differential diagnosis includes other idiopathic interstitial pneumonia, connective tissue diseases (systemic sclerosis, polymyositis, rheumatoid arthritis, forme fruste of autoimmune disorders, chronic hypersensitivity pneumonitis and other environmental (sometimes occupational exposures. IPF is typically progressive and leads to significant

  16. 9 CFR 311.22 - Hogs affected with urticaria, tinea tonsurans, demodex follicurlorum, or erythema.

    Science.gov (United States)

    2010-01-01

    ... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Hogs affected with urticaria, tinea... OTHERWISE ADULTERATED CARCASSES AND PARTS § 311.22 Hogs affected with urticaria, tinea tonsurans, demodex follicurlorum, or erythema. Carcasses of hogs affected with urticaria (nettle rash), tinea tonsurans,...

  17. Role of bilastine in the management of allergic rhinitis and urticaria: an Asia-Pacific consensus statement.

    Science.gov (United States)

    Mösges, Ralph; Lee, Dennis Lip Yen; Abong, Jovilia; Siasoco, Bella; Chow, Steven Kw; Leong, Jern-Lin; Singh, Harvinder; Kuljit, S; Campomanes, Benjamin

    2016-01-01

    The prevalence of allergic diseases is increasing globally, most particularly in middle- to low-income countries. This article examines the burden of allergic rhinitis and chronic urticaria in the Asia-Pacific region, unmet clinical needs, and the potential role of bilastine in the management of these conditions. An International Advisory Group meeting was convened in association with the Asian Pacific Society of Respirology Annual Congress in November 2014, followed by a literature review, and consensus-based outcomes from the meeting and literature review are described. Regional estimates of the prevalence of allergic rhinitis range from 10% to 50%, while little is known regarding the burden of urticaria in the Asia-Pacific region. A survey of allergy patients in the region identified fast, complete, and long-lasting symptom relief as the medication attributes most important to patients. International treatment guidelines for allergic rhinitis and urticaria advocate the first-line use of second-generation, no-sedating H1-antihistamines, such as bilastine, over their first-generation counterparts and a range of these agents are available to Asia-Pacific patients. The newer agents possess many of the properties of an "ideal" antihistamine (once daily administration, rapid and complete symptom relief, limited potential for drug-drug interactions, minimal side effects). The burgeoning prevalence of allergic diseases in the Asia-Pacific region and the uncontrolled symptoms that these patients experience demand a new antihistamine that offers the highest number of positive features according to the international guidelines.

  18. Acute urticaria and angioedema: diagnostic and treatment considerations.

    Science.gov (United States)

    Frigas, Evangelo; Park, Miguel A

    2009-01-01

    Urticaria is defined as wheals consisting of three features: (i) central swelling of various sizes, with or without surrounding erythema; (ii) pruritus or occasional burning sensations; and (iii) the skin returning to normal appearance, usually within 1-24 hours. Angioedema is defined as: (i) abrupt swelling of the lower dermis and subcutis; (ii) occasional pain instead of pruritus; (iii) commonly involving the mucous membranes; and (iv) skin returning to normal appearance, usually within 72 hours. Acute urticaria and angioedema is defined by its duration (urticaria and angioedema. The most common causes are infections, medications, and foods. The best tools in the evaluation of these patients are a comprehensive history and physical examination. There are a variety of skin conditions that may mimic acute urticaria and angioedema and the various reaction patterns associated with different drugs. Oral antihistamines are first-line treatment. In the event of a life-threatening reaction involving urticaria with angioedema, epinephrine may be needed to stabilize the patient. This review focuses on the value of a comprehensive clinical evaluation at the onset of symptoms. It underscores the importance of coordination of care among physicians, and the development of an action plan for evidence-based investigations, diagnosis, and therapy.

  19. Adolescent Idiopathic Scoliosis

    Directory of Open Access Journals (Sweden)

    Safak Ekinci

    2014-06-01

    Full Text Available Scoliosis is called idiopathic when no other underlying disease can be identified. The etiology of adolescent idiopathic scoliosis (AIS is still unknown despite many years of research effort. Theories on AIS's etiology have included mechanical, hormonal, metabolic, neuromuscular, growth, and genetic abnormalities. Skeletally immature patients with adolescent idiopathic scoliosis are at risk of curve progression. The adolescent onset of severe idiopathic scoliosis has traditionally been evaluated using standing posteroanterior radiographs of the full spine to assess lateral curvature with the Cobb method. Scoliosis in children of school age and above primarily occurs in girls. The therapeutic goal in children is to prevent progression. In children, scoliosis of 20 and deg; or more should be treated with a brace, and scoliosis of 45 and deg; or more with surgery. [Arch Clin Exp Surg 2014; 3(3.000: 174-182

  20. Review of idiopathic pancreatitis

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Recent advances in understanding of pancreatitis and advances in technology have uncovered the veils of idiopathic pancreatitis to a point where a thorough history and judicious use of diagnostic techniques elucidate the cause in over 80% of cases. This review examines the multitude of etiologies of what were once labeled idiopathic pancreatitis and provides the current evidence on each. This review begins with a background review of the current epidemiology of idiopathic pancreatitis prior to discussion of various etiologies. Etiologies of medications, infections, toxins,autoimmune disorders, vascular causes, and anatomic and functional causes are explored in detail. We conclude with management of true idiopathic pancreatitis and a summary of the various etiologic agents. Throughout this review, areas of controversies are highlighted.

  1. The genetic epidemiology of idiopathic scoliosis

    OpenAIRE

    Gorman, Kristen Fay; Julien, Cédric; Moreau, Alain

    2012-01-01

    Purpose Idiopathic scoliosis is a complex developmental syndrome defined by an abnormal structural curvature of the spine. High treatment costs, chronic pain/discomfort, and the need for monitoring at-risk individuals contribute to the global healthcare burden of this musculoskeletal disease. Although many studies have endeavored to identify underlying genes, little progress has been made in understanding the etiopathogenesis. The objective of this comprehensive review was to summarize geneti...

  2. Acute symptoms of drug hypersensitivity (urticaria, angioedema, anaphylaxis, anaphylactic shock).

    Science.gov (United States)

    Limsuwan, Ticha; Demoly, Pascal

    2010-07-01

    Drug hypersensitivity reactions (HSRs) are the adverse effects of drugs which, when taken at doses generally tolerated by normal subjects, clinically resemble allergy. Immediate-reaction of drug HSRs are those that occur less than 1 hour after the last drug intake, usually in the form of urticaria, angioedema, rhinitis, conjunctivitis, bronchospasm, and anaphylaxis or anaphylactic shock. Acute urticarial and angioedema reactions are common clinical problems frequently encountered by internists and general practitioners. They are not specific to drug allergic reaction, and can be caused by various pathogenic mechanisms. Despite the benign course of urticaria and angioedema, a mucocutaneous swelling of the upper respiratory tract could be life-threatening by itself or a feature of anaphylaxis. This article reviews acute symptoms of drug HSR-related urticaria, angioedema, anaphylaxis, and anaphylactic shock, and how clinicians should approach these problems.

  3. TREATMENT OF 100 CASES OF ACUTE URTICARIA WITH ELECTROACUPUNCTURE

    Institute of Scientific and Technical Information of China (English)

    钟鸿; 武哲丽

    2004-01-01

    Objective: To observe the therapeutic effect of clinical treatment of acute urticaria chiefly by electroacupuncture (EA). Methods: A total of 180 outpatients with acute urticaria were randomized into treatment group and control group. 100 cases in the treatment group were were managed by chlorpheniramine maleate and Vitamin C. Results: After 3 days' treatment, of the 100 and 80 cases in treatment and control groups, 79 and 53 were cured, 10 and 6 markedly effective, 5 and 8 effective, and 6 and 13 failed, with the effective rates being 94.00% and 83.75% respectively. The therapeutic effect of electroacupunture was significantly superior to that of medication(P<0.05). Conclusion: The was a more effective therapy for acute urticaria.

  4. Late Onset of Acute Urticaria after Bee Stings

    Directory of Open Access Journals (Sweden)

    Yuko Asai

    2016-12-01

    Full Text Available Here we report the cases of five patients with a late onset of acute urticaria after a bee sting. The ages of the five Japanese patients ranged from 33 to 86 years (median: 61. All patients had no history of an allergic reaction to bee stings. The onset of urticaria was 6–14 days (median: 10 after a bee sting. Although four of the patients did not describe experiencing a bee sting at their presentation, the subsequent examination detected anti-bee-specific IgE antibodies. So, we think a history of a bee sting should thus be part of the medical interview sheet for patients with acute urticaria, and an examination of IgE for bees may help prevent a severe bee-related anaphylactic reaction in the future.

  5. 枸地氯雷他定与阿伐斯汀递减疗法治疗慢性荨麻疹的疗效比较%Comparison of the Efficacy of Desloratadine Citrate Disodium and Acrivastine Decremental Therapy in the Treatment of Chronic Urticaria

    Institute of Scientific and Technical Information of China (English)

    董东; 何小亮; 杨德勇; 王晓霞

    2015-01-01

    目的:比较枸地氯雷他定与阿伐斯汀递减疗法治疗慢性荨麻疹的疗效和安全性.方法:132例慢性荨麻疹患者随机分为A组(62例)和B组(70例).A组患者第1~2周口服枸地氯雷他定片8.8 mg,每日1次;第3~4周给予8.8 mg,每2日1次;第5~6周给予8.8 mg,每3日1次;第7~8周给予8.8 mg,每4日1次;第9~10周给予8.8 mg,每5日1次.B组患者第1~2周口服阿伐斯汀胶囊8 mg,每日3次;第3~4周给予8 mg,每日2次;第5~6周给予8 mg,每日1次;第7~8周给予8 mg,每2日1次;第9~10周给予8 mg,每3日1次.两组患者疗程均为10周.观察两组患者的临床疗效,治疗前后的血浆组胺水平和症状体征总积分,并随访两组患者停药4周后的复发情况及不良反应发生情况.结果:两组患者总有效率、不良反应发生率比较,差异均无统计学意义(P>0.05).治疗后,两组患者血浆组胺水平和症状体征总积分均显著低于同组治疗前,差异均有统计学意义(P0.05).A组患者复发率显著低于B组,差异均有统计学意义(P0.05). After treatment,the total scores of signs and symptoms in 2 groups were significantly lower than before,the difference was statistically significant(P0.05). The recurrence rate in group A was significantly lower than group B,the difference was sta-tistically significant(P<0.05). CONCLUSIONS:Both efficacy and safety of desloratadine citrate disodium and acrivastine decre-mental therapy in the treatment of chronic urticaria are good,however,desloratadine citrate disodium is better than acrivastine in re-ducing recurrence rate.