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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. Vitamin D deficiency in chronic idiopathic urticaria.

    OpenAIRE

    2015-01-01

    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 urt...

  3. 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)....

  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. 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.

  10. Chronic urticaria: recent advances.

    Science.gov (United States)

    Greaves, Malcolm W; Tan, Kian Teo

    2007-10-01

    Chronic urticaria is an umbrella term, which encompasses physical urticarias, chronic "idiopathic" urticaria and urticarial vasculitis. It is important to recognize patients with physical urticarias as the investigation and treatment differs in important ways from patients with idiopathic chronic urticaria or urticarial vasculitis. Although relatively uncommon, urticarial vasculitis is an important diagnosis to make and requires histological confirmation by biopsy. Underlying systemic disease and systemic involvement, especially of the kidneys, should be sought. It is now recognized that chronic "idiopathic" urticaria includes a subset with an autoimmune basis caused by circulating autoantibodies against the high affinity IgE receptor (FceR1) and less commonly against IgE. Although the autologous serum skin test has been proven useful in prompting search for and characterization of circulating wheal-producing factors in chronic urticaria, its specificity as a screening test for presence of functional anti-FceR1 is low, and confirmation by demonstration of histamine-releasing activity in the patient's serum must be the benchmark test in establishing this diagnosis. Improved screening tests are being sought; for example, ability of the chronic urticaria patient's serum to evoke expression of CD 203c on donor human basophils is showing some promise. The strong association between autoimmune thyroid disease and autoimmune urticaria is also an area of ongoing research. Drug treatment continues to be centered on the H1 antihistamines, and the newer second-generation compounds appear to be safe and effective even in off-label dosage. Use of systemic steroids should be confined to special circumstances such as tapering regimens for acute flare-ups. Use of leukotriene antagonists is becoming popular, but the evidence for efficacy is conflicting. Cyclosporin is also effective and can be used in selected cases of autoimmune urticaria, and it is also effective in non

  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. Chronic urticaria: new management options

    OpenAIRE

    Greenberger, Paul A.

    2014-01-01

    Chronic urticaria is defined as episodic or daily hives lasting for at least 6 weeks and impairs quality of life. Two main subtypes include chronic idiopathic (spontaneous) urticaria and inducible (physical) urticaria, but some patients have urticarial vasculitis. “Autoimmune chronic urticaria” implies the presence of histamine releasing or mast cell activating autoantibodies to IgE or FcϵRI, the high affinity receptor on mast cells and basophils. In patients not readily controlled with label...

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

    OpenAIRE

    Sami Ozturk; Fuat Erel; A.Zafer Caliskaner; Mehmet Karaayvaz; Mustafa Gulec; Ozgur Kartal

    2007-01-01

    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 o...

  14. Diagnostic dilemmas in chronic urticaria.

    Science.gov (United States)

    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.

  15. Correlation of serum antithyroid microsomal antibody and autologous serum skin test in patients with chronic idiopathic urticaria

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    Snehal Balvant Lunge

    2015-01-01

    Full Text Available Background: About 25-45% of patients of chronic urticaria (CU have been stated to have histamine releasing autoantibodies in their blood. The term autoimmune urticaria is increasingly being accepted for this subgroup of patients. Review of the literature suggests high autologous serum skin test (ASST positivity and presence of antithyroid microsomal antibodies in patients with autoimmune urticaria. Aims: To study prevalence of ASST positivity and antithyroid microsomal antibodies in chronic "idiopathic" urticaria and to study the correlation between the two parameters. Methods: All patients of chronic idiopathic urticaria satisfying inclusion/exclusion criteria were enrolled in the study after written informed consent. Patients of CU secondary to infections and infestations, physical urticaria including dermatographism, mastocytosis, urticarial vasculitis and those on treatment with immunosuppressive drugs for urticaria were excluded from the study. In all of these patients, complete blood count; ASST, serum T3/T4/thyroid stimulating hormone levels, antithyroid microsomal antibody (AMA levels were done. Statistical analysis was done by Chi-square test, Fisher exact test and Kappa statistics. Results: Study included 24 males and 26 females with mean age of 39.54 years. Majority of patients belonged to 20-40 years of age. Females showed more ASST positivity. A total of 12 out of 50 (24% patients showed positive ASST. A total of four out of 12 (33.33% had positive ASST and raised AMA levels. Conclusion: Only 25% of patients of chronic idiopathic urticaria had positive ASST. ASST and AMA levels were positively correlated in our study. Further studies are required to authenticate this association.

  16. Chronic urticaria: new management options.

    Science.gov (United States)

    Greenberger, Paul A

    2014-01-01

    Chronic urticaria is defined as episodic or daily hives lasting for at least 6 weeks and impairs quality of life. Two main subtypes include chronic idiopathic (spontaneous) urticaria and inducible (physical) urticaria, but some patients have urticarial vasculitis. "Autoimmune chronic urticaria" implies the presence of histamine releasing or mast cell activating autoantibodies to IgE or FcϵRI, the high affinity receptor on mast cells and basophils. In patients not readily controlled with labeled dosages of second generation H1 receptor antagonists (antihistamines), there is evidence for reduction of urticaria using up to 4 fold increases in labeled dosages. The biologic modifier, omalizumab, helps to reduce lesions of chronic urticaria within 1-2 weeks. PMID:25383135

  17. A comparative study of efficacy of cetirizine versus astemizole in chronic idiopathic urticaria

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    Vijay M

    1994-01-01

    Full Text Available Efficacy of Cetirizine and Astemizole was compared in 50 cases of chronic Idiopathic urticaria. Patients were divided into 2 groups viz A and B. Before starting the therapy, routine investigations were carried out to rule out any septic focus. Prior to treatment, 1 week before all medications were withdrawn. Cetirizine and Astemizole, 10mg each, were given as a single daily morning dose for 1 month and patients were followed up for 1 month. 40% excellent response was observed with Cetirizine while 20% excellent response with Astemizole. Good response was observed in 32% patients with Cetirizine and 28% with Astemizole. No side effects were observed except sedation, 8% in Cetirizine group and 20% with Astemizole group.

  18. 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...

  19. Pathogenesis of chronic urticaria.

    Science.gov (United States)

    Kaplan, A P; Greaves, M

    2009-06-01

    Chronic urticaria is defined as the presence of urticaria (hives) for at least 6 weeks with the assumption that it occurs daily or close to it. If we eliminate physical urticarias and urticarial vasculitis from consideration, the remainder can be divided into autoimmune chronic urticaria (45%) and idiopathic chronic urticaria (55%). The autoimmune subgroup is associated with the IgG anti-IgE receptor alpha subunit in 35-40% of patients and IgG anti-IgE in an additional 5-10%. These autoantibodies have been shown to activate blood basophils and cutaneous mast cells in vitro with augmentation of basophil activation by complement and release of C5a, in particular. Binding methods (immunoblot and ELISA) yield positives in many autoimmune diseases as well as occasional normal subjects or patients with other forms of urticaria but most such sera are non-functional. Activation of basophils or mast cells causing histamine release is quite specific for chronic urticaria and defines the autoimmune subgroup. Although pathogenicity is not formally proven, the antibodies cause wealing upon intradermal injection, and removal of the autoantibody leads to remission. A cellular infiltrate is seen to be characterized by mast cell degranulation and infiltration of CD4+ T lymphocytes, monocytes, neutrophils, eosinophils, and basophils. The intensity of the infiltrate and clinical severity of the disease (including accompanying angio-oedema) is more severe in the autoimmune subpopulation. This latter group also has a higher evidence of human leucocyte antigen DR alleles associated with autoimmunity and a 25% incidence of antithyroid antibodies with diagnosed hypothyroidism in some. Hypo-responsiveness of patients' basophils to anti-IgE and hyperresponsiveness to serum defines another subpopulation (at least 50%) that overlaps the idiopathic and autoimmune subgroups. Hypo-responsiveness to anti-IgE has been shown to be associated with elevated levels of cytoplasmic phosphatases that

  20. 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.

  1. Chronic idiopathic urticaria, psychological co-morbidity and posttraumatic stress: the impact of alexithymia and repression.

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    Hunkin, Victoria; Chung, Man Cheung

    2012-12-01

    The objective of this study was to investigate the interrelationship between chronic idiopathic urticaria (CIU), psychological co-morbidity, posttraumatic stress, repression and alexithymia. 89 participants with CIU and 105 without CIU responded to an online questionnaire. Both groups completed the general health questionnaire-12, the perceived stress scale, the posttraumatic stress diagnostic scale and the Toronto alexithymia scale-20 and were categorised into four defence mechanism groups (repressive, defensive, high-anxious, low-anxious). CIU participants also completed the Skindex-17 and a self-report severity measure. CIU participants reported higher levels of alexithymia than the control group and their defence mechanism was most likely to be categorised as defensive, with conscious self-image management reported alongside high manifest anxiety. Partial least squares analysis revealed significant paths between posttraumatic stress and CIU severity and psychological co-morbidity. Posttraumatic stress was associated with alexithymia and type of defence mechanism. Only being in the high-anxious group partially mediated the relationship between posttraumatic stress and CIU severity. In conclusion, there is evidence for a relationship between CIU and trauma. The severity of posttraumatic symptoms varies depending upon alexithymic traits and defence mechanisms used. Disease severity and psychological co-morbidity are differentially influenced by the relationships between trauma, alexithymic traits and defence mechanisms. PMID:22362490

  2. 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

  3. 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.

  4. Correlation of serum antithyroid microsomal antibody and autologous serum skin test in patients with chronic idiopathic urticaria

    OpenAIRE

    Snehal Balvant Lunge; Milind Borkar; Sushil Pande

    2015-01-01

    Background: About 25–45% of patients of chronic urticaria (CU) have been stated to have histamine releasing autoantibodies in their blood. The term autoimmune urticaria is increasingly being accepted for this subgroup of patients. Review of the literature suggests high autologous serum skin test (ASST) positivity and presence of antithyroid microsomal antibodies in patients with autoimmune urticaria. Aims: To study prevalence of ASST positivity and antithyroid microsomal antibodies in chronic...

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

    Science.gov (United States)

    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.

  6. 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

  7. [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.

  8. [Inducible urticaria and chronic spontaneous urticaria].

    Science.gov (United States)

    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.

  9. 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...

  10. Update on the treatment of chronic urticaria.

    Science.gov (United States)

    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.

  11. 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......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...

  12. Advances in Understanding and Managing Chronic Urticaria.

    Science.gov (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  14. Chronic urticaria and Helicobacter pylori

    Directory of Open Access Journals (Sweden)

    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

  15. 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. PMID:26361716

  16. 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.

  17. 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.

  18. Autoimmunity in chronic urticaria and urticarial vasculitis.

    Science.gov (United States)

    Napoli, D C; Freeman, T M

    2001-07-01

    In contrast to acute urticaria, etiology cannot be identified in most cases of chronic urticaria. Recent evidence suggests that a subset of patients with chronic urticaria may have an autoimmune basis for their condition. The demonstration of antithyroid autoantibodies in some patients with chronic idiopathic urticaria (CIU) provides support for an association. However, the discovery of a positive skin test response to intradermal injection of autologous serum in as many as 60% of patients with CIU led to the identification of autoantibodies to IgE and the alpha-chain of the high-affinity IgE receptor, Fc epsilon RI alpha. Additional studies have demonstrated that some of these autoantibodies are capable of releasing histamine from donor basophils and mast cells. This article reviews the literature that addresses a possible autoimmune etiology in a subset of patients with CIU. Urticarial vasculitis is differentiated from chronic urticaria based on clinical features and biopsy findings of leukocytoclastic vasculitis. Most cases of urticarial vasculitis are secondary to an underlying systemic disease. The presence of autoantibodies has also been demonstrated in a subset of patients with primary urticarial vasculitis. This article briefly reviews some of this data. PMID:11892055

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

    Directory of Open Access Journals (Sweden)

    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.

  20. 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.......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....

  1. Fibromyalgia syndrome in chronic urticaria patients

    OpenAIRE

    Aylin Gözübüyükoğulları; Duru Tabanlıoğlu Onan; Nuran Allı

    2014-01-01

    Background and Design: The aim of our study was to determine the frequency of fibromyalgia syndrome in chronic urticaria patients. Materials and Methods: The study was carried out with the participation of 100 chronic urticaria patients and 61 control group patients. Chronic urticaria patients were investigated for the etiology of urticaria and the autologous serum skin test was performed in those patients. Both the chronic urticaria patients and the controls were evaluated for fibromyalgi...

  2. 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.

  3. 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. PMID:27334777

  4. 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.

  5. The role of helicobacter pylori infection in the pathogenesis of chronic urticaria

    International Nuclear Information System (INIS)

    Objective: To determine the prevalence of H. pylori infection in patients with idiopathic chronic urticaria (ICU) and to see if eradication of the bacterium affects the course of the urticaria. Patients and Methods: One hundred patients with idiopathic chronic urticaria and 43 healthy subjects (matched for age and sex) underwent serological testing for H. pylori infection. All patients with idiopathic chronic urticaria were examined for Helicobacter pylori infection with the /sup 13/C-urea test as well as the serological testing. Gastric biopsy was obtained from 36 patients. Patients with proven Helicobacter pylori infection were given treatment for 2 weeks. Six weeks afterwards they were tested again for Helicobacter pylori infection, and their urticaria was clinically assessed. Results: There was no significant difference in the seroprevalence of H. pylori infection between : idiopathic chronic urticaria patients and healthy subjects. Helicobacter pylori was detected in 76% of patients and 69.8% of controls. Out of the 76 patients treated, only 24 showed complete remission of their urticaria after successfully eradicating Helicobacter pylori infection, the others only having some improvement in their symptoms. Conclusion: Patients with idiopathic chronic urticaria have similar high rates of H. pylori infection as healthy subjects. Bacterium eradication is associated with improvement of urticaria symptoms, suggesting a possible role of Helicobacter pylori in the pathogenesis of this skin disorder. (author)

  6. Incidence of dental caries in chronic urticaria

    Directory of Open Access Journals (Sweden)

    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.

  7. Treatment of Chronic Spontaneous Urticaria

    OpenAIRE

    Kaplan, Allen P

    2012-01-01

    Chronic spontaneous urticaria is defined as persistent symptoms of urticaria for 6 weeks or more. It is associated with autoimmunity in approximately 45 percent of patients. Therapy is often difficult however the initial approach should employ high-dose non-sedating antihistamines; 4-6 tablets/day may be necessary. It has been shown that the response to 4 tablets/day exceeds 3, and exceeds 2, which exceeds 1. However the dose that corresponds to the maximal dose of first generation antihistam...

  8. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  10. 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...... task force report. Allergy 2010; DOI: 10.1111/j.1398-9995.2010.02496.x. ABSTRACT: 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...

  11. Oral Mirtazapine in Persistent Chronic Urticaria

    Directory of Open Access Journals (Sweden)

    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

  12. Treatment of refractory chronic urticaria

    Directory of Open Access Journals (Sweden)

    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.

  13. 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

  14. TNF-Alpha Inhibitors for Chronic Urticaria

    DEFF Research Database (Denmark)

    Sand, Freja Lærke; Thomsen, Simon Francis

    2013-01-01

    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...... 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........ Twelve (60%) patients obtained complete or almost complete resolution of urticaria after onset of therapy with either adalimumab or etanercept. Further three patients (15%) experienced partial response. Duration of treatment ranged between 2 and 39 months. Those responding completely or almost completely...

  15. Relation between chronic urticaria and thyroid autoimmunity

    Directory of Open Access Journals (Sweden)

    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

  16. 慢性荨麻疹与幽门螺旋杆菌感染相关性的探讨%The investigation of the relationship of Chronic idiopathic urticaria and Helicobacter pylori infection

    Institute of Scientific and Technical Information of China (English)

    麻荣武; 胡鲜香

    2009-01-01

    Objective To investigate the relationship of chronic idiopathic urticaria(CIU) and Helicobacter pylori(Hp). Methods The Helicobacter pylori stool antigens(HpSA) from 59 Chronic idiopathic urticaria patients and 65 cases of the healthy control group were detected with monoclonal antibody. And besides antihistamine, the patients with positive HpSA were treated with the eradication of Hp. And the patients with negative HpSA were only treated with antihistamine. Results There were 46 cases among 59 Hp patients showed positive HPSA, the ratio was 77.96%. And the cured was 41 cases (As cure rate was 89.13%). After the treatment, all 13 cases of the CIU patients with negative HpSA recrudesced in different degree. Conclusions CIU partly occurs related to Hp infection. On CIU patients with unknown pathogeny, Hp infection should be examined. If the examination indicates Hp infection, the patients should be treated with antihistamine, and be carried out the eradication of the Hp.%目的 探讨慢性荨麻疹(chronic idiopathic urticaria,CIU)与幽门螺旋杆菌(Helicobacter pylori,HP)的关系.方法 采用单克隆抗体对59例慢性荨麻疹患者及65例健康对照组的粪便Hp抗原进行检测,对粪便Hp抗原检测阳性患者除给予抗组胺治疗外,同时给予根除HP治疗.对粪便HP抗原检测阴性患者单给予抗组胺治疗.结果 59例慢性荨麻疹患者有46例粪便Hp抗原阳性,阳性率77.96%.治愈41例(治愈率89.13%).13例HP粪便抗原阴性慢性荨麻疹患者治疗后全部不同程度复发.结论 部分慢性荨麻疹发病与HP感染有关,对于病因不明的慢性荨麻疹患者,要给予检测是否有HP感染,检测提示HP感染,在给予抗组织胺药的同时,应同时进行根除HP治疗.

  17. 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.

  18. Methotrexate: a useful steroid-sparing agent in recalcitrant chronic urticaria.

    Science.gov (United States)

    Perez, A; Woods, A; Grattan, C E H

    2010-01-01

    Background Reports of methotrexate for chronic urticaria are anecdotal. Objectives To assess the effectiveness of methotrexate in steroid-dependent chronic urticaria, its impact on steroid reduction and any differences in response between patients with and without functional autoantibodies. Methods A retrospective case-note review of 16 patients with steroid-dependent chronic urticaria treated with methotrexate was carried out. Ten patients had chronic ordinary/spontaneous urticaria (CU), including three with associated delayed-pressure urticaria; four patients had normocomplementaemic urticarial vasculitis (UV); and two patients had idiopathic angio-oedema without weals. Median disease duration before methotrexate was 48.5 months (range 12-164). All were unresponsive to antihistamines and second-line agents, except prednisolone. Eleven were assessed for autoimmune urticaria with the basophil histamine release assay (n = 5), autologous serum skin test (n = 5) or both (n = 1). Response to methotrexate was scored: no benefit; some benefit (fewer weals and symptomatic improvement but no steroid reduction); considerable benefit (improvement with steroid reduction); or clear (no symptoms, off steroids but on antihistamines). Results Twelve of 16 patients (eight CU, three UV, one idiopathic angio-oedema) responded. Three showed some benefit, seven considerable benefit and two cleared. Four of eight responders and three out of three nonresponders showed evidence of functional autoantibodies. The dose to achieve a steroid-sparing effect was 10-15 mg weekly (cumulative dose range 15-600 mg, median 135 mg). Methotrexate was well tolerated. Conclusions Methotrexate may be a useful treatment for steroid-dependent chronic urticaria. Functional autoantibodies do not correlate with response. The beneficial effects of methotrexate may be anti-inflammatory and immunosuppressive. It may therefore benefit chronic urticaria independently of the pathogenic mechanism, whether autoimmune

  19. Chronic Urticaria: The Necessity of Laboratory Examination

    Directory of Open Access Journals (Sweden)

    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.

  20. 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.

  1. 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.

  2. Mysterious chronic urticaria caused by Blastocystis spp.?

    Science.gov (United States)

    Lepczyńska, Małgorzata; Chen, Wen-Chieh; Dzika, Ewa

    2016-03-01

    Species of the genus Blastocystis, which are single-cell, intestinal protozoan parasites of humans and animals, remain mysterious, with unclear clinical and epidemiologic significance. In recent years, many researchers have suggested a possible connection between Blastocystis spp. infection and chronic urticaria. In the present article, we review the literature and discuss the possible associations between the clinical symptomatology and pathogenicity of this organism in terms of its subtypes, morphologic forms, genetic diversity, and interactions with other intestinal microbiota. PMID:26469206

  3. Probiotics and refractory chronic spontaneous urticaria.

    Science.gov (United States)

    Nettis, E; Di Leo, E; Pastore, A; Distaso, M; Zaza, I; Vacca, M; Macchia, L; Vacca, A

    2016-09-01

    Background. In chronic spontaneous urticaria (CSU) first-line therapy with an antihistamine-based regimen may not achieve satisfactory control in patients. Thus, a continuing need exists for effective and safe treatments for refractory CSU. Aim. To evaluate the clinical efficacy and safety of an intake of a combination of 2 probiotics (Lactobacillus salivarius LS01 and Bifidobacterium breve BR03) in patients with CSU who remain symptomatic despite concomitant H1-antihistamine therapy. Methods. This report analyzes the effects of therapy with two probiotic strains on the clinical progress of 52 unselected patients with difficulty to treat CSU underwent to medical examination in two Italian specialist urticaria Clinics between September 2013 and September 2014. A mixture of Lactobacillus LS01 and Bifidobacterium BR03 were administered in each patient twice daily for 8 weeks. To evaluate patients' improvement with probiotics, urticaria activity score over 7 days (UAS7) was used at baseline and at week 8 in addition to a 5-question urticaria quality of life questionnaire. Results. Fifty-two patients with CSU were included in this study (10 male and 42 female, age range 19-72 years). Mean disease duration was 1.5 years. Fourteen patients discontinued treatment, so evaluable population consisted of 38 patients. Nine of the 38 patients experienced mild clinical improvement during probiotic treatment (23.7%); one patient reported significant clinical improvement (2.6%) and one patient had complete remission of urticaria (2.6%). Twenty-seven patients did not have improvement in symptoms (71.1%). No side effects during the course of therapy were reported. Conclusions. A combination of Lactobacillus salivarius LS01 and Bifidobacterium breve BR03 administered twice daily for 8 weeks might reduce the symptoms scores and improve quality of life scores in a part of patients with CSU who remained symptomatic despite treatment with H1 antihistamine mostly in subjects with allergic

  4. Unusual urticarias.

    Science.gov (United States)

    Black, A K

    2001-11-01

    Typical urticarial lesions are transient cutaneous swellings of sudden onset, often itchy, persisting for less than 24 hours and resolving to leave normal appearing skin. Angioedema lesions are similar subcutaneous lesions. Atypical urticarias persist for longer than 24 hours, may be painful and bruised in appearance and accompanied with severe systemic symptoms. Conditions where prolonged weals are present include delayed pressure urticaria and urticarial vasculitis. These conditions do not respond well to antihistamine therapy. In delayed pressure urticaria, weals appear after a delay of hours at sites of sustained pressure on the skin and occur in association with ordinary chronic 'idiopathic' urticaria. Weals of urticarial vasculitis show histological features of venulitis, and can be accompanied by arthralgia and abdominal pain. Rarely, the condition is due to infective or autoimmune disease. Urticarial diseases, sometimes with features of urticarial vasculitis, and with associated systemic features include Schnitzler's Syndrome, Still's disease and Muckle-Wells syndrome. The latter syndrome is linked with chromosome 1q44, as is autosomal dominant cold urticaria, an unusual physical urticaria. Persistent cholinergic erythema, a variant of cholinergic urticaria, has been mistaken for a drug eruption or cutaneous mastocytosis. Rarely, food and exercise induced urticaria and anaphylaxis occur when exercise follows a specific food or any meal within a few hours. The early stages of inflammatory disease may be mistaken for urticaria and angioedema, but lesions usually persist for longer than 48 hours and are accompanied by epidermal changes. PMID:11770721

  5. 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.

  6. 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.

  7. 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.

  8. 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

    . Observations: Three patients with idiopathic solar urticaria underwent phototesting with UV-B and UV-A radiation. The minimal urticarial dose (MUD) was determined 15 minutes after irradiation. The patients were subsequently tested with 5 times the MUD, and the reaction was graded every minute for 15 minutes......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......). 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...

  9. 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.

  10. Idiopathic chronic eosinophilic pneumonia

    OpenAIRE

    Cordier Jean-François; Marchand Eric

    2006-01-01

    Abstract Idiopathic chronic eosinophilic pneumonia (ICEP) is characterized by subacute or chronic respiratory and general symptoms, alveolar and/or blood eosinophilia, and peripheral pulmonary infiltrates on chest imaging. Eosinophilia is present in most cases, usually in excess of 1000/mm3. In absence of significant blood eosinophilia, a diagnosis of ICEP is supported by the demonstration of bronchoalveolar lavage eosinophilia. ICEP is typically associated with eosinophil counts higher than ...

  11. H1-antihistamines for chronic spontaneous urticaria.

    Science.gov (United States)

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

    2014-01-01

    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

  12. Gender-related differences in chronic urticaria.

    Science.gov (United States)

    Cassano, Nicoletta; Colombo, Delia; Bellia, Gilberto; Zagni, Emanuela; Vena, Gino A

    2016-10-01

    Chronic urticaria (CU) is a common skin disorder with important repercussion on the quality of life (QoL) and a relevant socioeconomic impact. CU is included among the skin diseases that exhibit a significant female preponderance, with an average female to male ratio of nearly 2-4/1. In recent years, an ever-growing interest in gender medicine has been registered and the assessment of gender differences has increasingly become an attractive issue in clinical research. Unfortunately, there are only limited data relative to the study of CU in the perspective of gender medicine. However, apart from the predilection for females, an in-depth evaluation of the available literature shows the existence of other interesting gender-related differences in CU. The aim of this article is to review the current knowledge on gender differences in CU under different points of view, including pathophysiology, epidemiology, clinical and prognostic features, association with comorbidities, psychological aspects and QoL.

  13. 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.

  14. 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

  15. 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

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

    Directory of Open Access Journals (Sweden)

    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.

  17. 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.

  18. 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。

  19. 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.

  20. Frequency of autoimmune thyroid disease in chronic urticaria

    International Nuclear Information System (INIS)

    To determine the frequency of autoimmune thyroid disease in diagnosed cases of chronic urticaria (CU) and the association between hypothyroidism and chronic urticaria if any. Study Design: Non-interventional, descriptive study. Place and Duration of Study: Department of Physiology, Dow University of Health Sciences, Karachi, from December 2004 to January 2006. Methodology: The patients were selected from Department of Dermatology and Medical Units of Civil Hospital, Jinnah Postgraduate Medical Centre, the Aga Khan Hospital and community clinics. A total number of 60 patients were enrolled in this study. In all patients, serum antithyroid autoantibodies (anti thyroglobulin and anti microsomal/thyroperoxidase), thyroid profile (serum TSH, T3 and FT4), complete blood count, erythrocyte sedimentation rate and IgE levels were carried out. The proportions were compared using chi-square test with significance at p < 0.05. Results: Forty seven (78%) patients were found to have chronic urticaria (history and laboratory reports). Out of 47 patients with diagnosis of CU, elevated titres of anti thyroglobulin (TGA) and anti microsomal antibodies (TMA) were found to be present in 20 (42.6%) and 27 (57.4%) patients respectively. Serum TSH level (thyroid stimulating hormone) was increased and T3, FT4 were decreased in 20 (42.6%) patients (p < 0.001). A total number of 20 (42.5%) patients were found to be hypothyroid with chronic urticaria of greater than 6 weeks duration. Conclusion: This study shows a statistically significant association between hypothyroidism and chronic urticaria. Full thyroid profile (serum thyroid autoantibodies, serum TSH, T3 and FT4) is highly recommended in patients with diagnosis of chronic urticaria. (author)

  1. Chronic urticaria treated with soft nasal filters

    Directory of Open Access Journals (Sweden)

    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.

  2. 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.

  3. Vitamin D Supplements Improve Urticaria Symptoms and Quality of Life in Chronic Spontaneous Urticaria Patients

    OpenAIRE

    Boonpiyathad, Tadech; Pradubpongsa, Panitan; Sangasapaviriya, Atik

    2014-01-01

    Vitamin D plays an important role in the immune system; decreased serum vitamin D concentrations have been linked to dysregulated immune function. Low vitamin D status is probably associated with chronic spontaneous urticaria (CSU). We evaluated the prevalence of low vitamin D status, and the clinical response and quality of life following vitamin D supplementation, in a prospective case-control study with 60 CSU patients and 40 healthy individuals. Serum 25-hydroxy vitamin D (25(OH)D) concen...

  4. Idiopathic chronic eosinophilic pneumonia

    Directory of Open Access Journals (Sweden)

    Cordier Jean-François

    2006-04-01

    Full Text Available Abstract Idiopathic chronic eosinophilic pneumonia (ICEP is characterized by subacute or chronic respiratory and general symptoms, alveolar and/or blood eosinophilia, and peripheral pulmonary infiltrates on chest imaging. Eosinophilia is present in most cases, usually in excess of 1000/mm3. In absence of significant blood eosinophilia, a diagnosis of ICEP is supported by the demonstration of bronchoalveolar lavage eosinophilia. ICEP is typically associated with eosinophil counts higher than lymphocyte counts in the bronchoalveolar lavage. ICEP is a rare disorder of unknown cause. Its exact prevalence remains unknown. ICEP may affect every age group but is rare in childhood. It is twice as frequent in women as in men. One third to one half of the ICEP patients have a history of asthma. The mainstay of treatment of ICEP is systemic corticosteroids. Response to oral corticosteroid therapy is dramatic and has led to the consideration of corticosteroid challenge as a diagnostic test for ICEP. Nevertheless, relapses or development of severe asthma are frequent when tapering or withdrawing treatment. Long-term oral corticosteroid therapy is necessary in up to half of the patients.

  5. 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

  6. 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.

  7. 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.

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

    OpenAIRE

    Sevgi Akarsu; Turna İlknur; Özlem Özbağçıvan; Emel Fetil

    2015-01-01

    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 patie...

  9. 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 ...

  10. 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.

  11. 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. PMID:26648083

  12. Clinical significance of changes of serum gastrin levels in patients with chronic eczema or chronic urticaria

    International Nuclear Information System (INIS)

    Objective: To study the clinical significance of changes of serum levels of gastrin in patients with chronic eczema or chronic urticaria. Methods: Serum gastrin levels were, 37 patients with chromic urticaria and 43 controls. Results: Serum gastrin levels in patients with chronic exzema (102.95 ± 27.33 ng/L) and patients with chronic urticaria (109.87 ± 33.64 ng/L) were both significantly higher than those in controls (61.72 ± 20.38 ng/L, both P<0.01). Difference between the levels in the two patients groups was not significant. Conclusion: The high gastrin levels in those patients might reflect the presence of helicobacter pylori infections; eradication of which might be helpful for treatment of these chronic dermatologic disorders. (authors)

  13. 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 antihistamine treatment within 3 months (231.0 ± 39.1 vs 205.1 ± 40.4 μg/mL, P antihistamines. Serum clusterin can be a prognostic marker to determine the responsiveness to antihistamine treatment in patients with CSU. PMID:27175709

  14. 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.

  15. Hives (Urticaria)

    Science.gov (United States)

    ... Triggers Allergens and Allergic Asthma Tobacco Smoke Air Pollution Respiratory Infections Flu (Influenza) Exercise Asthma Symptoms Asthma ... Idiopathic Urticaria , or CIU. Medical Review October 2015. Skin Allergies Eczema Contact Dermatitis Hives Swelling Skin Allergies ...

  16. Basophil Activation Test with Food Additives in Chronic Urticaria Patients

    OpenAIRE

    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 te...

  17. 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. PMID:26996116

  18. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  20. [Association of chronic urticaria with Helicobacter pylori-induced antrum gastritis].

    Science.gov (United States)

    Bohmeyer, J; Heller, A; Hartig, C; Wetenberger-Treumann, M; Huchzermeyer, H; Otte, H G; Stadler, R

    1996-02-01

    In spite of its high incidence, not much is known about the etiology of chronic urticaria. We performed gastroscopic evaluation of 10 patients in whom no cause for chronic urticaria had been found. In 8 of these 10 patients, Helicobacter pylori was identified in the gastric mucosa. The chronic urticarial lesions disappeared within a few days after starting therapy with amoxicillin and omeprazol. PMID:8868453

  1. 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.

  2. 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.

  3. 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

  4. 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.

  5. [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.

  6. Evaluation of D-dimer serum levels among patients with chronic urticaria, psoriasis and urticarial vasculitis*

    OpenAIRE

    Criado, Paulo Ricardo; Antinori, Lidi Che Leon; Maruta, Celina Wakisaka; dos Reis, Vitor Manoel Silva

    2013-01-01

    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 a...

  7. 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.

  8. 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...

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

    Directory of Open Access Journals (Sweden)

    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.

  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

    Directory of Open Access Journals (Sweden)

    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. Chronic urticaria: pathophysiology and etiology, or the what and why.

    Science.gov (United States)

    Schocket, Alan L

    2006-01-01

    Chronic urticaria (CU) is a relatively common but vexing disease. The pathophysiology is based on the cutaneous mast cell release of mediators, predominantly histamine. Release can be induced via specific immunoglobulin E (IgE), components of complement activation and nonspecifically by various compounds including endogenous peptides, endorphins, and enkephalins. In >30% of CU patients, autoimmune phenomena have been found, characterized by positive autologous serum skin test, antibodies to the alpha-subunit of the basophil IgE receptor, to IgE itself, and, perhaps, the most clinically relevant, thyroid autoimmunity. Studies suggest that the products of the activated immune system can lower the cutaneous mast cell release threshold, possibly allowing activation by endogenous compounds. The resulting release of mediators produces the clinical picture of recurrent hives. Although the goal of management of CU is the identification of a treatable cause, in most CU patients, especially adults, a cause is not frequently found. Identified causes include drugs, foods, infections, immune complex production leading to urticarial vasculitis, autoantibody production, and underlying autoimmune disease, particularly autoimmune thyroiditis. The treatment of the thyroiditis with suppressive doses of thyroid hormone often results in the remission of the CU. Given the marginally effective and sometimes dangerous medical therapy available for CU, a systematic and thorough approach to identify a treatable cause in difficult CU patients is warranted. PMID:16724623

  13. Periostin and Interleukin-13 Are Independently Related to Chronic Spontaneous Urticaria.

    Science.gov (United States)

    Bae, Youin; Izuhara, Kenji; Ohta, Soichiro; Ono, Junya; Hong, Gwan Ui; Ro, Jai Youl; Park, Gyeong Hun; Choi, Jeong Hee

    2016-09-01

    Chronic spontaneous urticaria (CSU) is a complex idiopathic disease of the skin with various cellular infiltrations. Although mast cells are key effector cells in the pathogenesis of CSU, CD4+ T helper 2 cells also have particular roles in the development and maintenance of CSU. Periostin is known as a downstream molecule of interleukin (IL)-4 and IL-13, key cytokines of type 2 immune responses. In this study, we examined periostin and IL-13 levels in the sera of patients with CSU (n=84) and healthy normal controls (NCs, n=43). Periostin levels were significantly lower in the CSU group than in NCs (71.4±21.8 vs 85.1±22.4 ng/mL, P=0.04). Periostin levels were also lower in the severe CSU group than those in mild CSU (59.7±18.0 vs 73.4±22.0 ng/mL, P=0.04). However, IL-13 levels were significantly higher in patients with CSU than in NCs (508.5±51.2 vs 200.7±13.3 pg/mL, P=0.001). In conclusion, periostin and IL-13 may be independently related to the pathogenesis of CSU. PMID:27334784

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

    Directory of Open Access Journals (Sweden)

    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.

  15. 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

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

    Directory of Open Access Journals (Sweden)

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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. 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.

  20. 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.

  1. 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。

  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. [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. PMID:25539679

  4. Comparison of Efficacy and Dermatology Life Quality Index of Pharmacological Monotherapy and Combined Therapy in Patients with Chronic Idiopathic Urticaria%抗组胺药不同用药方法治疗慢性特发性荨麻疹疗效及患者生活质量

    Institute of Scientific and Technical Information of China (English)

    陈嫚轩; 刘玲玲

    2011-01-01

    目的:比较抗组胺药单一用药、联合用药2种方法治疗慢性特发性荨麻疹(CIU)的疗效及对患者生活质量改善的影响.方法:收集本院门诊确诊为CIU患者161例,对其临床资料进行回顾性分析.将患者分为抗组胺药单一用药组和联合用药组.疗程均为4周,治疗后第2、4周进行随访.应用荨麻疹活动性评分(UAS)标准按0-3级进行症状、体征评分,并根据症状、体征积分下降指数进行整体疗效评估;利用皮肤病生活质量指数(DLQI)调查问卷评价患者生活质量改善情况.结果:161例CIU患者中单一用药组107例,联合用药组54例;治疗4周结束时,联合用药组有效率为72.3%,单一用药组为72.9%,2组差异无统计学意义(X2=0.008,P=0.928);联合用药组治愈率为51.9%,高于单一用药组的40.2%,2组差异无统计学意义(X2=1.98,P=0.159);UAS评分,2组差异无统计学意义(P>0.05);治疗后2组DLQI评分均下降,联合用药组DLQI评分改善优于单一用药组,2组差异无统计学意义(P=0.052).结论:非镇静类H1受体拮抗剂单一用药及联合用药治疗慢性特发性荨麻疹的疗效相似,联合用药治愈率较高,控制及缓解症状的持久性相对更好,生活质量改善较为明显.%Objective To compare the clinical efficacy and the improvement of quality of life between the two treatment groups by using non-sedative Hl-antihistamine agents as monotherapy and combined therapy in chronic idiopathic urticaria (CIU) patients. Methods 161 CIU patients with comprehensive clinical data diagnosed in outpatient were collected. Clinical data of patients were retrospectively analyzed. The 161 patients were divided in two treatment groups, monotherapy group, only using one kind of non-sedative Hl-antihistamine agent (QD) and combined therapy group, combined using one kind of non-sedative Hl-antihistamine agent ( QD) with other medication. The duration of therapy was four weeks. Patients were evaluated before

  5. Investigation of the roles of the substances in serum lipids and their constitutive fatty acids in chronic urticaria.

    Science.gov (United States)

    Kobayashi, S

    1989-06-01

    The newly-generated lipid mediators include products of arachidonate metabolism, prostaglandins and leukotrienes. In this study, serum lipids and fatty acids, including arachidonic acid (C20:4) were examined in 12 normal subjects (6 males and 6 females) and 23 subjects with chronic urticaria (6 males and 17 females), including 17 who made an excellent or good recovery (4 males and 13 females). The results indicated a relationship between chronic urticaria and serum lipids and fatty acids. The omega 6 (n-6) and omega 3 (n-3) series of polyunsaturated fatty acids and lipid peroxidation were suggested that may be one of the mediators in chronic urticaria. Pantethine, glutathione and ascorbic acid were effective in controlling chronic urticaria. PMID:2794222

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

    OpenAIRE

    Dytyatkovska Ye.M.

    2014-01-01

    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 ...

  7. 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

  8. 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.

  9. 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. PMID:27014952

  10. 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.

  11. 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.

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

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    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.

  13. 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.

  14. 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. PMID:12396958

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

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    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.

  16. 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

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

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    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.

  18. PATTERN OF PATCH TEST ALLERGEN POSITIVITY IN CHRONIC URTICARIA PATIENTS IN A TERTIARY CARE HOSPITAL IN TELANGANA

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    Nayeem Sadath Haneef

    2016-06-01

    Full Text Available CONTEXT Patch test is the gold standard for detection of causative allergens in allergic contact dermatitis. Though chronic urticaria is a multifactorial condition, a sizeable number of such patients are thought to be due to various contact allergens. Hence, a hospital based prospective study of patch test positivity to various allergens was conducted in patients suffering from chronic urticaria. AIMS To evaluate the pattern of allergen positivity in chronic urticaria patients by patch test using Indian Standard Series. SETTINGS & DESIGN Prospective investigational study was conducted at Dermatology, Venereology and Leprosy department of a tertiary care hospital attached to a postgraduate training institute in Telangana state of India. METHODS & MATERIAL Thirty chronic urticaria patients, above 18 years of age were evaluated with patch test of Indian standard series. Two of these patients had prior history of contact sensitivity to rubber and paraphenylenediamine. Patch test was done by application of allergens of Indian standard series over upper back. Patch test site was examined after 48 hours and after 72 hours. Patch test was considered positive if erythema, erythematous papules or vesicles were found at the site of application of corresponding allergen. RESULTS Patch test was positive in 4 out of 30 patients of chronic urticaria, fragrance, black rubber mix, paraphenylenediamine and parthenium being the allergens in 1 patient each. Patients with positive patch test to black rubber mix and paraphenylenediamine had prior history of contact allergy. CONCLUSION Patch test is a simple, noninvasive, inexpensive and useful diagnostic test in a difficult to evaluate condition of chronic urticaria, irrespective of feasibility of avoidance of potential allergens.

  19. 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.

  20. 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;

    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...... observed to induce highly significant MMP-9 and TNFα release from donor PBMCs when compared to sera from healthy controls (pUrticaria assessment score (UAS) did not appear to correlate with release levels for histamine, TNFa or MMP-9 in either group but in the ASST+ group, the ASST score appeared...

  1. Turkish version of the chronic urticaria quality of life questionnaire: cultural adaptation, assessment of reliability and validity.

    Science.gov (United States)

    Kocatürk, Emek; Weller, Karsten; Martus, Peter; Aktas, Selin; Kavala, Mukaddes; Sarigul, Sükran; Baiardini, Ilaria; Canonica, Giorgio W; Brzoza, Zenon; Kalogeromitros, Dimitrios; Maurer, Marcus

    2012-07-01

    Chronic spontaneous urticaria has a substantial impact on patients' quality of life. The first disease-specific tool to assess quality of life impairment in this condition, the Chronic Urticaria Quality of Life Questionnaire (CU-Q2oL), was developed recently. The aim of this study was to adapt the original Italian version to the Turkish language and to evaluate its reliability, validity, and sensitivity to change. The Turkish version was developed by performing forward- and back-translation. It was then applied to 140 consecutive patients with chronic spontaneous urticaria, along with the Dermatology Life Quality Index and the Skindex-29. Disease activity was assessed using the Urticaria Activity Score. Sensitivity to change was measured in 101 patients, who completed the instruments twice at intervals of 4 weeks. Confirmatory factor analysis demonstrated that the six-scale structure of the original Italian version ("pruritus", "swelling", "impact on life activities", "sleep problems", "limits", "looks") can be retained in the Turkish instrument. Analysis regarding convergent validity showed good correlations of the Turkish CU-Q2oL with the other instruments. In addition, it was found to discriminate well between patients with different levels of urticaria activity, and to be sensitive to change. In conclusion, the Turkish version of CU-Q2oL is a reliable, valid, and sensitive instrument, which will help to characterize better the clinical impact of chronic spontaneous urticaria and treatment outcomes in Turkish patients. Its identical scale structure to that of other CU-Q2oL instruments makes it ideal for cross-cultural comparisons and for its application in future national and multinational studies. PMID:21918791

  2. 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.

  3. 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...

  4. [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.

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

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    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.

  6. Identification of the etiologies of chronic urticaria in children: a prospective study of 94 patients.

    Science.gov (United States)

    Jirapongsananuruk, Orathai; Pongpreuksa, Sureerat; Sangacharoenkit, Preeda; Visitsunthorn, Nualanong; Vichyanond, Pakit

    2010-05-01

    The etiologies of chronic urticaria (CU) in childhood remains incompletely understood because of limited data in children. The objective of this study was to examine some of the possible etiologies of CU in children by focusing on the functional autoantibody to FcepsilonRIalpha and IgE, thyroid autoimmunity, urticarial vasculitis, parasitic infestation and food allergy. Children 4-15 yr of age with CU were investigated for complete blood count, erythrocyte sedimentation rate (ESR), antinuclear antibody (ANA), CH(50), free-T4 (FT(4)), thyroid stimulating hormone (TSH), anti-thyroglobulin and anti-microsomal antibody, autologous serum skin test (ASST), skin prick tests (SPT) for foods, food challenges, and stool examination for parasites. Ninety-four children who met the criteria for CU were recruited. Patients with physical urticaria were excluded. Eosinophilia and elevated ESR were found in 23% and 13%, respectively. High ANA titers were found in 2%. None of these patients had clinical features of urticarial vasculitis, abnormal CH(50) level, abnormal TSH and FT(4). Anti-thyroglobulin and anti-microsomal antibodies were not detected. Positive ASST was found in 38%. There were no differences in medication requirement and CU remission between patients with positive and negative ASST. Parasites were found in 5% without clinical correlation. SPT to foods was positive in 35%. Positive food challenges were found in six/nine patients with positive history of food allergy and two/seven patients with negative history. Food avoidance was beneficial to the subgroup of patients with positive history of food allergy only. PMID:19555353

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

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    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.

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

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

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    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.

  11. Urticarial Reactions: Vascular Erythema, Urticaria, Vasculitis

    OpenAIRE

    Sibbald, R. Gary

    1987-01-01

    Vascular erythemas, including urticaria and vasculitis, represent diagnostic and therapeutic challenges. A careful systemic approach to history and physical examination should be followed by appropriate investigations to rule out systemic disease. Chronic urticaria patients should be physically tested to identify cholinergic, dermagraphic, and cold-induced responses. Food diaries and careful drug history may be important to identify exacerbating factors in chronic urticaria.

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

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    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.

  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. Interval shifts in basophil measures correlate with disease activity in chronic spontaneous urticaria.

    Science.gov (United States)

    Oliver, E T; Sterba, P M; Saini, S S

    2015-05-01

    Chronic spontaneous urticaria (CSU) significantly impacts the quality of life of those affected through symptoms of pruritus and recurrent skin lesions. In active CSU disease, reduced IgE-mediated basophil histamine release (HR) and basopenia are observed. We sought to examine the relationship between interval changes in basophil measures and shifts in patient-reported disease impairment. Simultaneous symptom and basophil evaluations were completed at two sequential study visits, and interval changes in measures were compared between visits for each subject (n = 38). These measures included Skindex-29, current itch and hives scores, total leukocyte histamine content (an indirect measure of blood basophil presence), and basophil HR in response to anti-IgE and formyl-methionine-leucine-phenylalanine. Overall, interval improvements in disease measures in CSU subjects were associated with increased basophil numbers (total leukocyte histamine content) and IgE-mediated HR. This suggests these measures are potential biomarkers for CSU disease improvement and further implicates a role for basophils in CSU. PMID:25631394

  15. Urticaria mimickers in children.

    Science.gov (United States)

    Mathur, Anubhav N; Mathes, Erin F

    2013-01-01

    Acute urticaria is a self-limited cutaneous condition marked by transient, erythematous, and pruritic wheals. It is a hypersensitivity response that is often secondary to infection, medications, or food allergies in children. In contrast, the urticarial "mimickers" described in this review article are often seen in the context of fever and extracutaneous manifestations in pediatric patients. The differential diagnosis ranges from benign and self-limited hypersensitivity responses to multisystem inflammatory diseases. Establishing the correct diagnosis of an urticarial rash in a pediatric patient is necessary to both prevent an unnecessary work up for self-limited conditions and to appropriately recognize and evaluate multisystem inflammatory disorders. Herein, we describe two cases to illustrate the clinical manifestations, laboratory findings, histopathology and differential diagnoses for several mimickers of acute urticaria including: urticaria multiforme, serum sickness like reaction, Henoch-Schönlein purpura, acute hemorrhagic edema of infancy, systemic onset juvenile idiopathic arthritis, cryopyrin associated periodic syndromes, and urticarial vasculitis. PMID:24552410

  16. 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.

  17. 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.

  18. Comorbidity and pathogenic links of chronic spontaneous urticaria and systemic lupus erythematosus--a systematic review.

    Science.gov (United States)

    Kolkhir, P; Pogorelov, D; Olisova, O; Maurer, M

    2016-02-01

    Chronic spontaneous urticaria (CSU) is a common mast cell-driven disease characterized by the development of wheals (hives), angioedema (AE), or both for > 6 weeks. It is thought that autoimmunity is a common cause of CSU, which is often associated with autoimmune thyroiditis, whereas the link to other autoimmune disorders such as systemic lupus erythematosus (SLE) has not been carefully explored. Here, we systematically reviewed the existing literature for information on the prevalence of CSU in SLE (and vice versa) and we examined the possible clinical and pathogenetic relationship between CSU and SLE. The prevalence of CSU and CSU-like rash in SLE was investigated by 42 independent studies and comorbidity in adult patients reportedly ranged from 0% to 21.9% and 0.4% to 27.5%, respectively (urticarial vasculitis: 0-20%). In children with SLE, CSU was reported in 0-1.2% and CSU-like rash in 4.5-12% (urticarial vasculitis: 0-2.2%). In contrast, little information is available on the prevalence of SLE in patients with CSU, and more studies are needed to determine the rate of comorbidity. Recent insights on IgG- and IgE-mediated autoreactivity suggest similarities in the pathogenesis of CSU and SLE linking inflammation and autoimmunity with the activation of the complement and coagulation system. Future studies of patients with either or both conditions could help to better define common pathomechanisms in CSU and SLE and to develop novel targeted treatment options for patients with CSU and SLE. PMID:26545308

  19. Toxocara Canis IgG Seropositivity in Patients with Chronic Urticaria

    Directory of Open Access Journals (Sweden)

    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. 

  20. 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. PMID:26547714

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

    OpenAIRE

    Kiran Godse; Murlidhar Rajagopalan; Mukesh Girdhar; Sanjiv Kandhari; Bela Shah; Chhajed, Prashant N.; Sushil Tahiliani; D S Krupa Shankar; Vijay Somani; Vijay Zawar

    2016-01-01

    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 recommend...

  2. 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

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

    Directory of Open Access Journals (Sweden)

    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.

  6. 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

  7. Idiopathic anaphylaxis.

    Science.gov (United States)

    Greenberger, Paul A

    2007-05-01

    Idiopathic anaphylaxis is a prednisone-responsive condition without external cause, but it can coexist with food-, medication-, or exercise-induced anaphylaxis. Mast cell activation may occur at night or after foods that have been eaten with impunity many times previously. Idiopathic anaphylaxis can be classified into frequent (if there are six or more episodes per year or two episodes in the last 2 months) or infrequent (if episodes occur less often). Idiopathic anaphylaxis-generalized consists of urticaria or angioedema associated with severe respiratory distress, syncope or hypotension, and gastrointestinal symptoms. Idiopathic anaphylaxis-angioedema consists of massive tongue enlargement or severe pharyngeal or laryngeal swelling with urticaria or peripheral angioedema. The differential diagnosis of idiopathic anaphylaxis is reviewed, and treatment approaches are presented. PMID:17493503

  8. 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...... and subsequently determined the frequency of HR-Urticaria-positive sera from a larger population of CU patients....

  9. 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。

  10. [Surgical treatment of chronic idiopathic constipation].

    Science.gov (United States)

    Menguy, R; Chey, W

    We review current experience with surgical treatment of severe constipation due to primary inertia of the colon. Over the last 10 years, we have operated 18 patients (14 females and 4 males) with severe constipation. The surgical procedure was either nearly total colonectomy with ascending colon/rectum anastomosis (8 cases) or total colonectomy with ileorectal anastomosis (9 cases). In one patient, coloproctectomy was performed with an ileoanal anastomosi. Indications for surgery were based on results of barium emena and functional evaluation of defecation. Results were satisfactory in all patients. In several patients however, we noted that the motility of other levels of the digestive tract was also impaired. Colonectomy was introduced as a treatment for chronic constipation nearly a century ago and although very few indications have been retained in the recent this procedure has now become an acceptable surgical approach in a limited number of well-though-out cases. PMID:7729199

  11. Solar urticaria

    Directory of Open Access Journals (Sweden)

    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

  12. 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.

  13. Clinical study of the relationship between Helicobacter pylori and chronic urticaria and prurigo chronica multiformis: effectiveness of eradication therapy for Helicobacter pylori.

    Science.gov (United States)

    Akashi, Rei; Ishiguro, Naoko; Shimizu, Satoru; Kawashima, Makoto

    2011-08-01

    Eighty two patients with chronic urticaria and 17 patients with prurigo chronica multiformis were referred to our department from October 2004 to February 2007 and were tested for Helicobacter pylori antigen using the polyclonal H. pylori stool antigen test (enzyme-linked immunosorbent assay method). H. pylori antigen was detected in 25 (30.5%) of the 82 patients with chronic urticaria and in 10 (58.8%) of the 17 patients with prurigo chronica multiformis. Those findings were not significantly higher than the positive rate for H. pylori stool antigen in healthy age-matched controls. In patients positive for H. pylori antigen, seven of the 25 with chronic urticaria had complications of gastritis (six patients) or gastric ulcers (one patient). Three of the 10 patients with prurigo chronica multiformis had complications of gastritis (two patients) or gastric ulcers (one patient). We examined the therapeutic efficacy of antibacterial treatment for the 17 patients with chronic urticaria and the eight patients with prurigo chronica multiformis who were positive for H. pylori antigen and accepted the treatment based on informed consent. We evaluated the effectiveness of treatment by scoring the skin conditions and by using the Skindex-16, a measure of quality of life. The eradication therapy for H. pylori was more effective for treating prurigo chronica multiformis and the skin symptoms started to improve within 3-14 days after the therapy. However, that therapy was not always effective for treating chronic urticaria. We suggest that H. pylori may be an important pathogenetic factor, especially for prurigo chronica multiformis, and that eradication therapy should be considered to treat intractable cases. PMID:21352335

  14. 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

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

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    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.

  17. 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

  18. 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

  19. 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.

  20. 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.

  1. 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.

  2. 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

  3. Itch in Urticaria Management.

    Science.gov (United States)

    Deza, Gustavo; Giménez-Arnau, Ana M

    2016-01-01

    Urticaria is a common skin disorder defined by the occurrence of itchy and even painful wheals, angioedema, or both. The lifetime prevalence for its acute and chronic form is 20 and 1%, respectively. The patients' quality of life is impaired because of itch, disfigurement, and high associated comorbidity. To understand the pathophysiology of the wheal in order to ensure a correct therapeutic approach is critical. Mast cells are the primary effector cells in urticaria, which produce and secrete a variety of inflammatory mediators, mainly histamine. Their peripheral effects are responsible for the signs and symptoms of the disease, such as cutaneous swelling and pruritus. Management of itch in urticaria includes both nonpharmacological (avoidance or minimization of aggravating factors) and pharmacological treatments. The main therapeutic objective is to obtain complete relief of signs (hives and angioedema) and symptoms (pruritus) as quickly as possible. Licensed and up-dosed nonsedating H1-antihistamines are currently the first- and second-line therapies according to the European guidelines. When antihistamines are not enough, other treatments include anti-IgE antibodies, mast cell modulators, mast cell mediator blockers, and immunomodulators. As the knowledge of the pathogenesis of urticaria improves, the development of alternative therapies targeting these pathways may improve the patient's quality of life through the control of the pruritus, its main symptom. PMID:27578075

  4. 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.

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

    Science.gov (United States)

    Godse, Kiran; Rajagopalan, Murlidhar; Girdhar, Mukesh; Kandhari, Sanjiv; Shah, Bela; Chhajed, Prashant N; Tahiliani, Sushil; Shankar, D S Krupa; Somani, Vijay; Zawar, Vijay

    2016-01-01

    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. PMID:26955580

  6. 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.

  7. 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.

  8. Urticaria Multiforme

    OpenAIRE

    Emer, Jason J.; Bernardo, Sebastian G.; Kovalerchik, Olga; Ahmad, Moneeb

    2013-01-01

    Urticaria multiforme is a benign cutaneous hypersensitivity reaction seen in pediatric patients that is characterized by the acute and transient onset of blanchable, annular, polycyclic, erythematous wheals with dusky, ecchymotic centers in association with acral edema. It is most commonly misdiagnosed as erythema multiforme, a serum-sickness-like reaction, or urticarial vasculitis. Since these three diagnoses represent distinct clinical entities with unique prognoses and management strategie...

  9. 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。

  10. 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。

  11. Idiopathic portal hypertension and chronic arsenic poisoning. Report of a case.

    Science.gov (United States)

    Chainuvati, T; Viranuvatti, V

    1979-01-01

    We report a case of idiopathic portal hypertension which is related to chronic arsenic poisoning. Only 7 cases have been reported previously. The patient presented with bleeding esophageal varices. Splenomegaly and hyperkeratosis of palms and soles were later noted and led to the discovery of chronic arsenic poisoning. The hemodynamic studies revealed a gradient between the splenic pulp pressure and hepatic wedge pressure which is consistent with presinusoidal hypertension. The liver histology revealed only mild portal fibrosis. Arsenic poisoning is one cause of idiopathic protal hypertension.

  12. 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.

  13. 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.

  14. 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.

  15. 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.

  16. 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.

  17. Chronic idiopathic thrombocytopenic purpura: present strategy, guidelines and new insights

    NARCIS (Netherlands)

    W. Stevens; H. Koene; J.J. Zwaginga; G. Vreugdenhil

    2006-01-01

    Idiopathic thrombocytopenic purpura. (ITP) is an immune-mediated thrombocytopenia. The diagnosis is made after exclusion of other secondary causes of thrombocytopenic disorders. The primary treatment goal is to prevent severe bleeding rather than achieve normal platelet counts. In adults ITP usually

  18. 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.

  19. 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

  20. 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.

  1. 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.

  2. [Round Table: Urticaria and angioedema: introduction and classification].

    Science.gov (United States)

    Alonso Lebrero, E

    1999-01-01

    Urticaria and angioedema are common diseases in children and adults. Approximately 15-25% of the population will have urticaria or angioedema at least once in their life-time. Urticaria is characterized as the appearance of erythematous, circumscribed, elevated, pruritic, edematous swelling of the upper dermal tissue. Erythematous swelling of the deeper cutaneous and subcutaneous tissue is called angioedema. In angioedema lesions are less pruritic but pain and burning are common. Urticaria may occur in any part of the body, whereas angioedema often involves face, extremities or genitalia. In contrast to other forms of edema there are not symmetric distribution. Urticaria and angioedema are often associated. Urticaria is considered acute if symptoms are present for less than 6 weeks, but usually in childhood lesions disappear in a few days. In chronic urticaria symptoms are longer than 6 weeks; if the episodes were of shorter duration than the symptoms-free periods urticaria is considered recurrent. Acute urticaria has been reported to be the common type in childhood and chronic urticaria is more frequent in adults. Acute urticaria is usually a self-limited benign disease in young children. Nevertheless it is an uncomfortable nuisance, interfering daily activities and sleep, and produces psychosocial impact in patients and parents (an altered self-image is always an alarming situation). Urticaria is a frequent cause of emergency room visit but few patients need to be admitted. Urticaria has long been believed to be an allergic disease but clinically it has rare been proved to be so. The basic mechanism involves the release of diverse vasoactive mediators that arise from the activation of cells or enzymatic pathways. Histamine is the best known of these substances, and elicits the classic triple response consisting of vasodilatation (erythema), increased vascular permeability (edema) and an axon reflex that increases reaction. In contrast to simple symptoms and easy

  3. 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.

  4. 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

  5. Montelukast: Chronic Urticaria.

    Science.gov (United States)

    Generali, Joyce A; Cada, Dennis J

    2015-07-01

    This Hospital Pharmacy feature is extracted from Off-Label Drug Facts, a publication available from Wolters Kluwer Health. Off-Label Drug Facts is a practitioner-oriented resource for information about specific drug uses that are unapproved by the US Food and Drug Administration. This new guide to the literature enables the health care professional or clinician to quickly identify published studies on off-label uses and determine if a specific use is rational in a patient care scenario. References direct the reader to the full literature for more comprehensive information before patient care decisions are made. Direct questions or comments regarding Off-Label Drug Uses to jgeneral@ku.edu. PMID:26448669

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

    OpenAIRE

    Maryam Maghbool; Masood Maghbool; Mehdi Shahriari; Mehran Karimi

    2009-01-01

    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...

  7. 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.

  8. EAACI/GA(2)LEN/EDF/WAO guideline: definition, classification and diagnosis of urticaria

    DEFF Research Database (Denmark)

    Zuberbier, T; Asero, R; Bindslev-Jensen, C;

    2009-01-01

    (2)LEN), the European Dermatology Forum (EDF) and the World Allergy Organization (WAO). Urticaria is a frequent disease. The life-time prevalence for any subtype of urticaria is approximately 20%. Chronic spontaneous urticaria and other chronic forms of urticaria do not only cause a decrease......This guideline, together with its sister guideline on the management of urticaria [Zuberbier T, Asero R, Bindslev-Jensen C, Canonica GW, Church MK, Giménez-Arnau AM et al. EAACI/GA(2)LEN/EDF/WAO Guideline: Management of urticaria. Allergy, 2009; 64:1427-1443] is the result of a consensus reached...... during a panel discussion at the 3rd International Consensus Meeting on Urticaria, Urticaria 2008, a joint initiative of the Dermatology Section of the European Academy of Allergology and Clinical Immunology (EAACI), the EU-funded network of excellence, the Global Allergy and Asthma European Network (GA...

  9. 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

    OpenAIRE

    Paulo Ricardo Criado; Lidi Che Leon Antinori; Celina Wakisaka Maruta; Vitor Manoel Silva dos Reis

    2013-01-01

    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 dis...

  10. Treatment options for chronic idiopathic (immune) thrombocytopenic purpura.

    Science.gov (United States)

    George, J N

    2000-01-01

    The goal of treatment for idiopathic (immune) thrombocytopenic purpura (ITP) is to prevent serious bleeding. Traditionally, corticosteroids have been used as first-line therapy followed by splenectomy. Experience with splenectomy over 60 years shows that approximately two thirds of patients achieve normal platelet counts during the initial observation, but that thrombocytopenia often recurs with longer follow-up. We know that long-term use of corticosteroids can lead to significant morbidities; there is no consensus regarding the appropriate timing or indications for splenectomy. To address the Issue of appropriate use of splenectomy, we designed a multicenter clinical trial that will randomize patients to either standard care, involving prednisone followed by splenectomy, or to a novel regimen of limited prednisone treatment followed by WinRho SDF (Nabi, Boca Raton, FL) (anti-D) therapy to maintain the platelet count in a safe range for 1 year. Anti-D can be administered easily in an outpatient setting with few side effects and can provide predictable, transient increases in platelet count. The hypothesis is that prolonged maintenance therapy with a nontoxic regimen may increase the percentage of patients who will experience a spontaneous remission from thrombocytopenia, thereby avoiding an invasive and permanent surgical procedure, splenectomy, and its potentially life-threatening sequelae. PMID:10676922

  11. 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.

  12. Diminished Cellular Immune Response to Carbonic Anhydrase II in Patients with Sjogren's Syndrome and Idiopathic Chronic Pancreatitis

    Directory of Open Access Journals (Sweden)

    Onishi S

    2004-07-01

    Full Text Available CONTEXT: A serum antibody to carbonic anhydrase II has been reported in patients with Sjögren’s syndrome and idiopathic chronic pancreatitis. OBJECTIVE: To evaluate cellular immune response to carbonic anhydrase II in patients with Sjögren’s syndrome and idiopathic chronic pancreatitis. PATIENTS: Idiopathic chronic pancreatitis (n=23, Sjögren’s syndrome (n=12, alcoholic chronic pancreatitis (n=3 and normal controls (n=13. MAIN OUTCOME MEASURES: Proliferation assay of peripheral blood mononuclear cells. RESULTS: Notable increased proliferation of the mononuclear cells upon stimulation with carbonic anhydrase II was observed in 2 patients with idiopathic chronic pancreatitis (9% and 2 patients with Sjögren’s syndrome (17% but not in patients with alcoholic chronic pancreatitis nor in normal controls. Among the four study groups, there was no significant difference in the prevalence rate of the positive proliferative responses (P=0.444. CONCLUSION: Carbonic anhydrase II may not be a major target antigen for the immunological process in the pathogenesis of Sjögren’s syndrome and idiopathic chronic pancreatitis. Serum antibody to carbonic anhydrase II may be detected in these patients as a consequence of the immune reaction against other antigens which mimic carbonic anhydrase II.

  13. "Association between the Polymorphism of TGF-β1 Gene Promoter (-509C>T and Idiopathic Chronic Urticaria "

    Directory of Open Access Journals (Sweden)

    Sara Hosseini-Farahabadi

    2006-09-01

    These results do suggest an influence of genetic variability at the promoter of TGF-β1 gene (-509C>T on the occurrence of ICU. This polymorphism has been shown as a useful genetic change in our study. Further work is required to confirm this result.

  14. Chronic idiopathic axonal neuropathy and pain, treated with the endogenous lipid mediator palmitoylethanolamide: a case collection

    Directory of Open Access Journals (Sweden)

    Keppel Hesselink JM

    2013-09-01

    Full Text Available J M Keppel Hesselink Faculty of Medicine, University Witten/Herdecke, Germany Abstract: Chronic idiopathic axonal polyneuropathy is a frequent diagnosis in patients suffering from idiopathic polyneuropathy and neuropathic pain. No guidelines exist on how to treat these patients. To date, there are no results available from randomized clinical trials, and mostly classical neuropathic analgesics are prescribed, such as amitriptyline and gabapentine. However, the usefulness of these drugs is limited, as many patients remain in pain despite treatment, or suffer debilitating side effects. Palmitoylethanolamide (PEA is a new analgesic compound, tested in more than 4,000 patients in various clinical trials in a variety of patients suffering from various neuropathic pain states. It is available in Europe and the USA as a food supplement under the brand name PeaPure, and it is available for medical purposes in Italy and Spain under brand names Normast and Pelvilen. We present a case series of seven patients with an electrophysiological confirmed diagnosis of chronic idiopathic axonal polyneuropathy, suffering from neuropathic pains, mostly refractory to previous analgesics. In all these patients, PEA reduced pain significantly, without side effects. PEA can be administered in addition to other analgesics, without negative drug–drug interactions, or can be used as a stand-alone analgesic. Due to a favorable ratio between efficacy and safety, PEA should be considered more often as a treatment for neuropathic pain. Keywords: CIAP, polyneuropathy, treatment, neuropathic

  15. 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.

  16. 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.

  17. 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…

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

    Directory of Open Access Journals (Sweden)

    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

  20. 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.

  1. 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.

  2. 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。

  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. 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.

  6. [Keratoderma palmoplantaris varians (striata et areata), a form of chronic idiopathic acrokeratosis described by Degos].

    Science.gov (United States)

    Padial, A; Morales, V; Armario-Hita, J C; Ingunza, J L; Fernández-Vozmediano, J M

    2008-03-01

    We report a case of a 15-year-old boy with hyperkeratotic lesions that were linear or striated on the palms and nummular on the soles. He was the only family member known to be affected, suggesting that the condition could be attributed to a de novo mutation or the recessive form of keratoderma palmoplantaris striata, described by Degos as chronic idiopathic acrokeratosis. The lesions did not improve with topical treatments (keratolytic agents, emollients, or corticosteroids) or oral retinoids. We observed that scratching of the affected areas was the main reason for deterioration of the lesions. PMID:18346435

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

    Directory of Open Access Journals (Sweden)

    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

  8. 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

  9. Elevated Plasma Level of Interferon-λ1 in Chronic Spontaneous Urticaria: Upregulated Expression in CD8+ and Epithelial Cells and Induction of Inflammatory Cell Accumulation

    Science.gov (United States)

    Wang, S. F.; Gao, X. Q.; Xu, Y. N.; Li, D. N.; Wang, H. Y.

    2016-01-01

    Interferon- (IFN-) λ1 is regarded as a potent bio-active molecule in innate immunity. However, little is known about its role in chronic spontaneous urticaria (CSU). We therefore investigated expression of IFN-λ1 in CSU, its cellular location, and its influence on inflammatory cell accumulation by using flow cytometry analysis, skin tissue dispersion, immunohistochemical stain, and a mouse peritoneal inflammation model. The results showed that level of IFN-λ1 was 2.0-fold higher in plasma of the patients with CSU than the level in healthy control (HC) subjects. Among leukocytes examined, only CD8+ T cells expressed more IFN-λ1 in CSU blood. Double labeling immunohistochemical staining revealed that IFN-λ1+ inflammatory cells such as mast cells, eosinophils, B cells, neutrophils, and macrophages were mainly located in dermis, whereas epidermis tissue highly expressed IFN-λ1. IFN-λ1 induced a dose-dependent increase in number of eosinophils, lymphocytes, mast cells, macrophages, and neutrophils in the peritoneum of mice at 6 h following injection, which was inhibited by pretreatment of the animals with anti-intercellular adhesion molecule- (ICAM-) 1 and/or anti-L-selectin antibodies. In conclusion, IFN-λ1 is likely to play a role in the pathogenesis of CSU. Blocking IFN-λ1 production may help to reduce the accumulation of inflammatory cells in the involved CSU skin.

  10. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  12. The EAACI/GA(2) LEN/EDF/WAO Guideline for the definition, classification, diagnosis, and management of urticaria

    DEFF Research Database (Denmark)

    Zuberbier, T; Aberer, W; Asero, R;

    2014-01-01

    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...

  13. 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

  14. 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

  15. 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

    2009-01-01

    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. PMID:21589818

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

    Directory of Open Access Journals (Sweden)

    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.

  17. 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。

  18. 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。

  19. 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.

  20. 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.

  1. 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.

  2. 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.

  3. 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 .

  4. 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.

  5. 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.

  6. 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。

  7. 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.

  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

    OpenAIRE

    N. Galassi; N. Riera; Rey, G.; M. M. E. Bracco; A. Malbran

    2003-01-01

    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...

  9. Pressure challenge test and histopathological inspections for 17 Japanese cases with clinically diagnosed delayed pressure urticaria

    OpenAIRE

    Morioke, Satoshi; Takahagi, Shunsuke; Iwamoto, Kazumasa; Shindo, Hajime; Mihara, Shoji; Kameyoshi, Yoshikazu; Hide, Michihiro

    2010-01-01

    Delayed pressure urticaria (DPU) is characterized by deep dermal wheals that appear in response to a local continuous pressure. Although it has been reported to complicate as many as 40% of cases of Caucasian patients with chronic urticaria, no definitive cases of Asian/Japanese patients have been reported in English literature. Here, we identified 17 cases of DPU, among 540 Japanese patients with urticaria (3.1%), based on careful history taking, pressure challenge test and, ideally, skin bi...

  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. 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。

  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. 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

  14. Complex cytogenetic findings in the bone marrow of a chronic idiopathic myelofibrosis patient

    Directory of Open Access Journals (Sweden)

    Tuğçe Bulakbaşı Balcı

    2010-06-01

    Full Text Available Chronic idiopathic myelofibrosis is a myeloproliferative disorder characterized by splenomegaly, myeloid metaplasia and reactive bone marrow fibrosis. Karyotype analysis of the bone marrow is an integral part of the diagnosis, especially as a discriminative tool in ruling out reactive conditions. The frequency of clonal cytogenetic anomalies in this disease is the highest among its group, varying between 30 and 75%. Among these, trisomy 1q, 20q-, 13q- and +8 are the most common aberrations. Here we report a 66-year-old male patient whose bone marrow biopsy revealed signs of chronic myeloproliferative changes and dysmegakaryopoiesis. He was administered hydroxyurea treatment, splenic radiotherapy and multiple transfusions. The patient worsened in the following months and the second bone marrow biopsy revealed myelofibrosis. Cytogenetic analysis of this bone marrow sample revealed a complex karyotype reported to be 46,XY,del(9(q22q34,t(8;17;21(q22;q21;q22[23]/46,XY[2], with a previously undefined three-way translocation and deletion in chromosome 9. The patient died shortly thereafter.

  15. 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.

  16. Extensive Molecular Analysis Suggested the Strong Genetic Heterogeneity of Idiopathic Chronic Pancreatitis

    Science.gov (United States)

    Sofia, Valentina Maria; Da Sacco, Letizia; Surace, Cecilia; Tomaiuolo, Anna Cristina; Genovese, Silvia; Grotta, Simona; Gnazzo, Maria; Petrocchi, Stefano; Ciocca, Laura; Alghisi, Federico; Montemitro, Enza; Martemucci, Luigi; Elce, Ausilia; Lucidi, Vincenzina; Castaldo, Giuseppe; Angioni, Adriano

    2016-01-01

    Genetic features of chronic pancreatitis (CP) have been investigated extensively, mainly by testing genes associated to the trypsinogen activation pathway. However, different molecular pathways involving other genes may be implicated in CP pathogenesis. A total of 80 patients with idiopathic chronic pancreatitis (ICP) were investigated using a Next-Generation Sequencing (NGS) approach with a panel of 70 genes related to six different pancreatic pathways: premature activation of trypsinogen, modifier genes of cystic fibrosis phenotype, pancreatic secretion and ion homeostasis, calcium signaling and zymogen granules (ZG) exocytosis, autophagy and autoimmune pancreatitis-related genes. We detected mutations in 34 out of 70 genes examined; of the 80 patients, 64 (80.0%) were positive for mutations in one or more genes and 16 (20.0%) had no mutations. Mutations in CFTR were detected in 32 of the 80 patients (40.0%) and 22 of them exhibited at least one mutation in genes of other pancreatic pathways. Of the remaining 48 patients, 13/80 (16.3%) had mutations in genes involved in premature activation of trypsinogen and 19/80 (23.8%) had mutations only in genes of the other pathways: 38 (59.3%) of the 64 patients positive for mutations showed variants in two or more genes. Our data, although to be extended with functional analysis of novel mutations, suggest a high rate of genetic heterogeneity in CP and that trans-heterozygosity may predispose to the ICP phenotype. PMID:27264265

  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. PrimiOtic and PrimiOtic Plus: novel probiotic for primates suffering from idiopathic chronic diarrhea.

    Science.gov (United States)

    Lecker, Jaime L; Froberg-Fejko, Karen

    2015-10-01

    Idiopathic chronic diarrhea of nonhuman primates is a major gastrointestinal disorder and a leading cause of serious morbidity in nonhuman primates kept in captivity. Many animals are not responsive to traditional treatments. Millions of dollars are spent annually on diagnosis and supportive care of these animals. Probiotics like Bio-Serv's PrimiOtic and PrimiOtic Plus can help to reduce the incidence of diarrhea in captive nonhuman primates by supporting the natural microflora in the gut. PMID:26398619

  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. 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.

  1. Chronic Recurrent Multifocal Osteomyelitis with Concomitant Features of Juvenile Idiopathic Arthritis

    Directory of Open Access Journals (Sweden)

    Elena Tsitsami

    2011-01-01

    Full Text Available We report a case of a 13-year-old girl with chronic recurrent multifocal osteomyelitis (CRMO who developed severe arthritis in four different joints within the first year from the onset of the disease. Her multiple vertebrae lesions showed significant amelioration after a 2-month treatment with prednisolone. In parallel, the initial severe symmetrical arthritis of both knees showing overt synovitis and joint effusion, in the absence of lesions in the metaphyses of the femur or the tibia, responded remarkably well in intra-articular triamcinolone hexacetonide injections. However, upon discontinuation of prednisolone, the patient developed severe arthritis of her right ankle and the proximal interphalangeal joint of her right middle finger. Thus, prednisolone was reinitiated combined with methotrexate, and the patient went into remission, which persists one year after prednisolone tapering. The appearance of arthritis in both knees in the absence of bone lesions and the emergence of severe arthritis of the ankle after remission of spinal bone lesions suggest that CRMO and juvenile idiopathic arthritis may coexist and be causally related.

  2. 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.

  3. Impact of Helicobacter pylori Eradication Therapy on Platelet Counts in Patients With Chronic Idiopathic Thrombocytopenic Purpura.

    Science.gov (United States)

    Amiri, Mohamadreza

    2016-01-01

    This study was a before and after clinical evaluation of Helicobacter pylori eradication on platelet counts in a group of 23 patients with chronic Idiopathic (Autoimmune) thrombocytopenic purpura (CITP). H. pylori infection was identified in patients by a (13)C-urea breath test and confirmed by an H. pylori stool antigen test. Eradication was conducted in patients testing positive. Infected (n = 10) and uninfected (n = 13) patient groups did not differ with respect to age, gender, history of previous splenectomy, treatment with anti-D, current treatment with corticosteroids, or initial platelet counts. H pylori eradication was successful in eight infected CITP patients, with two patients not responsive to treatment. Compared to the uninfected group, patients in the infected group who responded to eradication therapy had significantly increased platelet counts after six months (56.2 ± 22.2 vs. 233 ± 85.6 ×10(3) million cells/L; P < 0.01), whereas platelet counts in the non-responding patients and uninfected group did not differ after this period of time. H. pylori eradication promotes significant platelet count improvement in patients with CITP. Thus, all patients with CITP should be tested and treated for H. pylori infections. PMID:26925898

  4. 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

  5. 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.

  6. 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.

  7. 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.

  8. 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.

  9. 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.

  10. 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.

  11. 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.

  12. 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 .

  13. 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.

  14. 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.

  15. 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.

  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. 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

  18. 关注抗组胺药治疗慢性荨麻疹应用的策略%Concerned about the application strategy of antihistamines in chronic urticaria

    Institute of Scientific and Technical Information of China (English)

    郝飞; 钟华; 宋志强

    2012-01-01

    抗组胺药通过拮抗HI受体来阻断组胺与受体的结合,从而影响变态反应发生的过程,是治疗慢性荨麻疹的基本药物.最新研究表明,抗组胺药还可通过其他机制发挥更广泛的药理作用.本文就目前临床抗组胺药物选择及使用的策略进行探讨.%HI antihistamines, which prevent the proceeding of allergic inflammation through against histamine HI receptor, are morewidely used to treat chronic urticaria. In recent studies, HI antihistamines bring into more extensive pharmacological actions based on someother pathways. Therefore, clinical aplication strategy of HI antihistamines has been modified. This paper focus on some approachs to theseissues.

  19. 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.

  20. The Effect of Costimulatory Factors in the Pathogenesis of Chronic Idiopathic Thrombocytopenic Purpura

    Institute of Scientific and Technical Information of China (English)

    崔国惠; 刘筱萍; 姚军霞

    2003-01-01

    To investigate the effect of costimulatory factors in the pathogenesis of chronic idiopathic thrombocytopenic purpura (CITP), we examined the expression of CD80 on platelets and megakaryocytes in patients with CITP and the controls by FACS. By using CD80 monoclonal antibody (McAb) to inhibit interaction among cells which is mediated by costimulatory factors, we observed the effect of CD80 McAb on the growth and maturation of megakaryocytic progenitors of patients with CITP in vitro. The results showed the expression of CD80 on platelets and megakaryocytes in CITP group was significantly higher than that in controls (P<0.01). There was a significantly positive correlation between the expression of CD80 on platelets and serum PAIgG in CITP (r =0.86, P<0. 05). The mean of various clone numbers (CFU-MK, BFU-MK and mCFU-MK) in CITP were all lower than those in controls (P<0. 05). In megakaryoeytes co-cultured with CD80 McAb, there was an increasing tendency of the number of CFU-MK and big CFU-MK (the number of megakaryocyte with GPⅢa positive was more than 20) and mediate CFU-MK (the number of megakaryocyte with GPⅢa positive was 11- 20). When the concentration of CD80 McAb was 10 μg/L, there was a significant difference in the number of megakaryocytic colony formation (CFUMK, BFU-MK and mCFU-MK) between the group with CD80 McAb and that without it (P<0.05). These showed the abnormality of costimulatory factors had important effect in the pathogenesis of CITP.

  1. The Effect of Compound Glycyrrhizin Combined with Antihistamines on Chronic Urticaria%复方甘草酸苷联合抗组胺类药物治疗慢性荨麻疹的疗效

    Institute of Scientific and Technical Information of China (English)

    郑旭; 陀志国; 黄静; 高建明; 贾青

    2012-01-01

    Objective: To evaluate the effect of compound glycyrrhizin combined with antihistamines on chronic urticaria. Methods: 150 cases with chronic urticaria were randomly divided into treatment group and control group. The treatment group was given compound glycyrrhizin combined with cetirizine, while the control group was treated with cetirizine only. After 14 days, the urticaria activity score (UAS) and efficacy were evaluated by the end of one and two weeks. Results: The UAS in the both groups were lowered significantly after one and two weeks' treatment (P<0.05), and the two groups also showed significant difference by the end of one and two weeks (P<0.05). The total effective rate in the two groups at one week were 64.0% and 38.7%, respectively (P<0.05); And also at two weeks the total effective rate in treatment group was higher than that of control group (90.7% vs 61.3%, PO.05). Conclusions: Compound glycyrrhizin combined with antihistamines is an effective therapy for chronic urticaria, with rapid and high efficacy.%目的:观察复方甘草酸苷联合抗组胺类药物治疗慢性荨麻疹的临床疗效.方法:150例慢性荨麻疹患者随机分为治疗组和对照组,治疗组口服复方甘草酸苷片和西替利嗪片,对照组只给予西替利嗪片,疗程14d.评价1周和2周时的荨麻疹活动度评分表和临床疗效.结果:治疗1周末和2周末两组的荨麻疹活动度评分都明显下降,与治疗前比较差异具有统计学意义(P<0.05),两组1周末和2周末时比较差异具有统计学意义(P<0.05).1周末两组总有效率分别为64.0%和38.7%,差异具有统计学意义(P<0.05);2周末总有效率分别为90.7%和61.3%,差异具有统计学意义(P<0.05).结论:复方甘草酸苷联合西替利嗪片治疗慢性荨麻疹具有起效快、疗效高的特点.

  2. Idiopathic fibrosing pancreatitis: a rare cause of chronic obstructive jaundice in childhood

    Energy Technology Data Exchange (ETDEWEB)

    Park, Hye Seong; Kim, Hyun Sook; Kim, Hack Hee; Kim, Ok Hwa; Kim, Choon Yul; Bahk, Yong Whee [Catholic Medical College, Seoul (Korea, Republic of)

    1992-01-15

    We report a 14-months-old infant who had obstructive jaundice caused by idiopathic fibrosing pancreatitis. Ultrasonography and abdominal computed tomography showed dilatation of the intrahepatic ducts, common bile duct, and the pancreatic duct. Diffuse swelling of the pancreas was also noted on CT. At laparotomy, the head portion of the pancreas revealed a stony hard consistency, and proliferation of fibrotic tissue was confirmed pathologically. Idiopathic fibrosing pancreatitis is a very rare disease entity in childhood, but should be considered in the differential diagnosis of obstructive jaundice in children who demonstrate bile duct and pancreatic duct dilatation and/or diffuse pancreas swelling.

  3. T、B、NK细胞亚型与慢性荨麻疹发病机制的关系%T, B and NK lymphocyte subgroups in the pathogenesis of chronic urticaria

    Institute of Scientific and Technical Information of China (English)

    朱慧兰; 李润祥; 郭庆; 罗静英; 李振洁; 李嘉彦; 吴志华

    2008-01-01

    Objective To study the relationship of T, B and NK lymphocytes with the pathogenesis of chronic urticaria. Methods Flow cytometry was applied to assess the proportion of T, B and NK lymphocyte subgroups in the peripheral blood of 51 patients with chronic urticaria and 30 sex and age-matched human controls. The CD4:CD8 ratio was calculated. Moreover, the symptoms, disease course and response to antihistamines of these patients were evaluated by one physician. Results The percentage of CD8+ T and NK cells, CD4:CD8 ratio were (27.20±8.22)%, (21.20±10.84)% and 1.48±0.62, respectively, in these patients,(29.9±3.74)%, (17.5±3.56)%, 1.24±0.27, respectively, in the controls; the differences were significant between the two groups (all P<0.05). Decreased levels of CD3+ T cells, CD8+ T cells and B cells were noted in patients resistant to antihistamines compared with those responsive to antihistamines[(61.81±11.70)% vs (75.74±2.36)%, (24.00±7.79)% vs (34.22±9.30)%, (10.78±2.07)% vs (15.25±4.10)%, P<0.05, 0.01, 0.05, respectively)], while the CD4:CD8 ratio and percentage of NK cells were increased in antihistamine-resistant patients compared to those in antihistamine-sensitive patients [1.67±0.76 vs 1.17±0.41, (28.61±12.62)% vs (12.78±6.02)%, both P<0.01 ]. In these patients with chronic urticaria, the percentages of CD3+ T and CD8+ T cells were negatively correlated with the symptom scores (R = -0.31, -0.28, respectively, both P<0.05 ), while the percentage of B cells was positively correlated with the symptom scores and disease course (R = 0.53, 0.55, respectively, both P<0.01 ). Conclusions There is an abnormality in the proportion of T, B and NK lymphocyte subgroups in patients with chronic urticaria,which indicates that humoral immunity may be involved in the pathogenesis of chronic urticaria and the mechanism for responsiveness to antihistamine.%目的 探讨T、B、NK细胞亚型与慢性荨麻疹发病机制的关系.方法

  4. 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...... of patients with chronic spontaneous urticaria. Similar instruments for other forms of urticaria have yet to be developed and validated. Also, tools for assessing other chronic spontaneous urticaria PROs besides quality of life and symptoms are needed.......The aim of this Global Allergy and Asthma European Network (GA(2)LEN) consensus report is to provide recommendations and suggestions for assessing patient-reported outcomes (PROs) including health-related quality of life in patients with urticaria. We recommend that PROs should be used both...

  5. 抗组胺耐药慢性荨麻疹患者甲状腺自身抗体检测结果分析%Analysis of thyroid autoantibodies detection in patients with antihistamine-resistant chronic urticaria

    Institute of Scientific and Technical Information of China (English)

    黄珍; 刘万红; 侯占英

    2015-01-01

    目的:分析抗组胺耐药慢性荨麻疹患者的甲状腺自身抗体及甲状腺激素水平变化与意义。方法选取抗组胺耐药慢性荨麻疹患者40例为观察组,同期在我院做体检的健康者40例为对照组,检测两组受试者的甲状腺自身抗体和甲状腺各项功能指标,并进行自体血清皮肤试验(ASST)。结果观察组的促甲状腺素受体抗体(TRAb)、抗甲状腺过氧化物酶抗体(TPOAb)和甲状腺球蛋白抗体(TGAb)等甲状腺自身抗体指标及ASST的阳性率明显高于对照组,差异均有统计学意义(P<0.05);观察组患者的游离甲状腺素(FT4)、游离三碘甲状腺原氨酸(FT3)、总甲状腺激素(TT4)、总三碘甲状腺原氨酸(TT3)、超敏促甲状腺素(TSH)等指标明显高于对照组,差异均有统计学意义(P<0.05)。结论抗组胺耐药慢性荨麻疹患者甲状腺发病与甲状腺自身抗体密切相关,血清出现各种自身抗体表达及甲状腺激素水平异常,值得临床深入研究。%Objective To analyze the changes and significance of thyroid autoantibodies and thyroid hormone levels in patients with antihistamine-resistant chronic urticaria. Methods Forty patients with antihistamine-resistant chronic urticaria were selected as the study group, and 40 healthy persons were selected as the control group. The thyroid autoantibodies [thyrotropin receptor antibody (TRAb), thyroid peroxidase antibody (TPOAb), thyroglobulin antibody (TGAb)] in two groups were detected, and autologous serum skin test (ASST) was performed. Thyroid function indexes of the two groups were detected. Results TRAb, TPOAb, TGAb levels and the positive rate of ASST in the study group were significantly higher than those in the control group. The differences were of statistical significance (P<0.05). The free thyroxine (FT4), free triiodothyronine (FT3), the total thyroid hormone (TT4), three total triiodothyro-nine (TT3), high sensitive thyroid stimulating hormone

  6. Clinical Study on the Chronic Urticaria Treatment by Fasting and spell%禁食轮替疗法在慢性荨麻疹中的临床研究

    Institute of Scientific and Technical Information of China (English)

    黎昌强; 李竹; 张璐; 杨碧坤; 李俏丽; 余媛

    2014-01-01

    Objective:To investigate the nearlyand long-term effect of fasting and spell combined with drugs therapy on the chronic urticaria with food specific IgG positive.Methods:The selected cases positive allergen specific IgG antibodies of food of 60 cases of chronic urticaria, were randomly divided into experimental group 30 cases and control group of 30 cases, two groups were treated with chlorpheniramine 4mg 3 times a day, cetirizine 1 tablets 1 times a day. In the experimental group was treated simultaneously fasting and spell.The effects and adverse reactions of two groups were observed after 3 months of treatment, the recurrence were observed after 6 months. Results:After 3 months treatment,the cure rate of experimental group was 53.33%,it higher than 26.67%of control group,two groups have significant difference compared (P<0.05).After 6 months treatment,the recurrence rate of experimental group was 16.67%,it lower than 43.33%of control group, two groups have significant difference compared(P<0.05).The serum food specific IgG level of experimental group decreased significantly (P<0.05)before and after treatment. Conclusion:A fast rotation therapy can effectively reduce symptoms of patients caused by food allergen specific IgG with chronic urticaria and reducing the positive rate of intolerance food. This treatment was worth popularizing.%目的:探讨禁食轮替疗法联合药物治疗由食物不耐受引起的慢性荨麻疹的近、远期疗效。方法:选取慢性荨麻疹食物特异性IgG抗体阳性病例60例,随机分为实验组30例与对照组30例,两组均采用扑尔敏4mg每天3次,西替利嗪1片每晚1次。实验组除与对照组相同的治疗外,加用禁食、轮替的方法,3个月后观察疗法疗效及不良反应,6个月后观察复发情况。结果:3个月后实验组痊愈率53.33%,高于对照组26.67%,两组比较差异有显著性(P<0.05)。6个月后复发率实验组16.67%,对照组43.33%,两

  7. 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

  8. 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 

  9. 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.

  10. 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.

  11. Juvenile idiopathic arthritis

    Science.gov (United States)

    Juvenile rheumatoid arthritis (JRA); Juvenile chronic polyarthritis; Still disease; Juvenile spondyloarthritis ... The cause of juvenile idiopathic arthritis (JIA) is not known. It is thought to be an autoimmune illness . This means the body attacks ...

  12. Linaclotide-a novel secretagogue in the treatment of irritable bowel syndrome with constipation and chronic idiopathic constipation.

    Science.gov (United States)

    Sharma, Shivani; Sharma, Tina; Dhingra, Richa; Tomar, Prince; Singh, Sukhminder; Malhotra, Manav; Bhardwaj, T R

    2013-10-01

    Irritable bowel syndrome with constipation (IBS-C) and chronic idiopathic constipation (CIC) are highly prevalent gastrointestinal disorders. Traditional symptoms based therapies had somewhat limited success and efficacy in addressing the disorders. Recently, linaclotide emerged as novel peptide capable of improving abdominal symptoms in patients suffering from IBS-C and CIC. Guanylate cyclase C (GC-C) receptor a multi domain protein, found to be molecular target for linaclotide which acts by activating GC-C receptor on the apical surface of intestinal epithelial cells. Binding of linaclotide to GC-C receptor triggers the elevation of second messenger cGMP that elicits fluid secretion into intestinal cells which play a critical role in maintaining homeostasis through cystic fibrosis transmembrane conductance regulator (CFTR). Data from Phase II and III clinical trials demonstrated that linaclotide seems to produce a statistically significant increase in stool frequency, improved straining, decreased abdominal pain and discomfort. PMID:24001336

  13. 胸腺五肽联合抗组胺药治疗慢性荨麻疹的疗效观察%Effective observation on treating chronic urticaria with thymopoietin-5 plus antihistamines

    Institute of Scientific and Technical Information of China (English)

    邓景航; 李仰琪; 罗育武

    2015-01-01

    Objective:To investigate efficacy of thymopoietin-5 plus antihistamines on chronic urticaria.Methods:150 patients were divided into obs ervation group ( 95 c ases) a nd control group (55 cases).With antihistamines in both groups;the c ontrol group w as injected 2mg thymopoietin-5 e very 2 days while the obs ervation group w as injected 10mg thymopoietin-5 every da y.Results:The e fficacy in the observation group was 93.7%,significantly higher than thatin control group(x2=11.716,P0.05). The re currence rate of obs ervation group w as 17. 39%, significantly l ower (x2=8.454, P0.05)。观察组复发率为17.4%,显著低于对照组(x2=8.454,P<0.05)。结论:在抗组胺药的基础上,每日持续使用胸腺五肽治疗慢性荨麻疹可以获得更好的疗效,降低复发率,值得临床推广运用。

  14. 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.

  15. Pulmonary hyalinizing granuloma. Bilateral pulmonary nodules associated with chronic idiopathic thrombocytopenic purpura.

    Science.gov (United States)

    Satti, Mohamed B; Batouk, Abdelnasir A; Abdelaziz, Muntasir M; Ahmad, Mohamed F; Abdelaal, Mohamed A

    2005-09-01

    We report a case of a 30-year-old female who had been treated periodically with steroids for idiopathic thrombocytopenic purpura ITP over the last 10 years. Recently, during the course of investigation, she was found to have incidental asymptomatic multiple pulmonary nodules on chest CT. Following a needle biopsy to exclude malignancy, 2 nodules were excised and were histologically confirmed as pulmonary hyalinizing granuloma PHG. The remaining 2 nodules regressed on increasing her dose of steroids. The case is discussed with emphasis on the histological and radiological differential diagnosis, in addition to including ITP among the spectrum of immunologic conditions associated with PHG. PMID:16155671

  16. 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

  17. 697例慢性荨麻疹患者血清特异性IgE检测分析%DETECTION AND ANALYSIS OF SERUM SPECIFICITY IGE FOR 697 CHRONIC URTICARIA

    Institute of Scientific and Technical Information of China (English)

    杨增茹; 满永宏; 丁雨; 张金玉

    2011-01-01

    [Objective] To leam the types and distrubution of allergens of chronic urticaria in Nanyang and the surrounding area in order to help doctors with effective prevention, diagnosis and treatment. It will help identify the cause of the disease and guide the patients to change the living environment and diet, so as to avoid contacting with allergens and reducing and preventing the repeated bout [Methods] QD (ELLSA method) vitro allergy testing system was used for detecting serum specificity Ige of 14 inhaled allergens and 11 food allergens of 697 chronic urticaria, and qualitative and semi-quantitative test were used for them. [Results] The three most common inhaled allergens were house dust, dustmites-mite and wormwood-ragweed-plantain; The positive rates were 21.09%, 19.66% and 10.47%, respectively. The three most common food allergens were soy-peanuts, protein-egg yolk and shrimp-crab; the positive rate were 12.48%, 10.76% and 9.04%, respectively. [Conclusion] Allergic reaction is an important cause of chronic urticaril. Understanding the common allergens in local area and adopting the proper ways to carry out the allergen testing is helpful to guiding the patients to improve the environment, sanitary condictions and living habits, avoide the repeated contact with allergens and reduce relapse rate or morbidity.%[目的]了解南阳及周边地区慢性荨麻疹过敏原的种类及分布情况,以更好的帮助临床医生对慢性荨麻疹患者进行有效的预防、诊断和治疗,并帮助患者明确发病原因,指导患者改变周围生活环境和饮食习惯,避免再次接触过敏原,减少和防止过敏反应的反复发作.[方法]采用QD(EUSA法)体外过敏原检测系统对697例慢性荨麻疹患者14种吸入性过敏原和11种食入性过敏原的血清特异性IgE抗体进行定性和半定量检测.[结果]引起慢性过敏性荨麻疹最常见的3组吸入性过敏原分别是家尘;尘螨-粉螨;艾蒿-豚草-

  18. 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.

  19. 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。

  20. 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.

  1. 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.

  2. 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

  3. 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.

  4. 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.

  5. 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.

  6. 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. PMID:27134503

  7. 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.

  8. 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.

  9. 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

  10. Delayed pressure urticaria treated with the selective serotonin reuptake inhibitor escitalopram.

    Science.gov (United States)

    Eskeland, S; Tanum, L; Halvorsen, J A

    2016-07-01

    There is increasing evidence of platelet activation and systemic inflammation in chronic spontaneous urticaria and delayed pressure urticaria (DPU). Inflammation may be central to understanding the high comorbidity of depression and anxiety in patients with chronic urticaria (CU). We report a case of DPU and depression in a patient, which responded favourably to treatment with the selective serotonin reuptake inhibitor (SSRI) escitalopram. Sustained administration of SSRIs is associated with downregulation of serotonin transporters/receptors and depletion of platelet stored serotonin, which may reduce the ability of platelets to aggregate after thrombotic triggers. SSRIs are easier to manage and have significantly less disturbing adverse effects and cardiotoxicity than the tricyclic antidepressants (TCAs). SSRIs may represent an alternative to the traditional use of TCAs in treatment of CU. PMID:27037523

  11. 禁食、轮替疗法配合药物治疗食物不耐受的慢性荨麻疹的疗效观察%ClinicaI observations on the chronic urticaria with food specific IgG positive treatment by fasting and spell.

    Institute of Scientific and Technical Information of China (English)

    杨啸宇; 邱雄; 金泽龙; 汪平; 牟双梦; 杨闯; 陆小琴; 陈德宇

    2012-01-01

    Objective To observe the effects of fasting and spell combined with antihistamines therapy on the chronic urticaria with food specific IgG positive. Methods The cases 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 group A, group C was 30 cases of chronic urticaria with food specific IgG positive which were treated by mizolastine and ketotifen, simultaneously fasting and spell. The effects of three groups should be observed after 2 and 6 months treatment. The data analyzed by SPSS 17. 0 software. Results After two months treatment, the effective rate of the group A and C were no significant difference, but two of them were significant different from group B. After 6 months treatment, the effective rates of group A and C were no significant difference. , while the effective rates and the cure rates of group A and C were higher than group B. Conclusion The result show that the fasting and spell combined with antihistamines therapy was better for the chronic urticaria with food specific IgG positive. This treatment was worth popularizing.%目的 旨在采用禁食、轮替疗法联合药物对食物特异性IgG阳性的慢性荨麻疹患者进行治疗,观察其疗效.方法 慢性荨麻疹患者分为A、B、C 3组,A组为食物耐受组30例,采用咪唑斯叮、酮替芬治疗;B组为食物不耐受组30例,同样采用咪唑斯叮、酮替芬治疗;C组也为食物不耐受组30例,采用咪唑斯叮、酮替芬治疗同时,配合禁食轮替疗法.治疗2、6个月后观察其疗效,结果应用SPSS17.0统计软件包作统计学分析.结果 治疗2个月后A组与C组的有效率相差不大,差异无统计学意义,不过均优于B组;治疗6个月后,A组与C组的有效率差异无统计学意义,但均优于B组.痊愈

  12. 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.

  13. COMPARATIVE EFFICACY OF CHRONIC HEART FAILURE TREATMENT WITH PERINDOPRIL OR CARVEDILOL IN PATIENTS WITH ALCOHOLIC OR IDIOPATHIC DILATED CARDIOMYOPATHY

    Directory of Open Access Journals (Sweden)

    I. V. Zhirov

    2015-09-01

    Full Text Available Aim. To study the clinical and hemodynamic efficacy of monotherapy with ACE inhibitor perindopril or beta-blocker carvedilol in patients with chronic heart failure (CHF due to dilated cardiomyopathy (DCMP of various etiology.Material and methods. Patients (n=69 with DCMP of different etiology were included into the open randomized study. Idiopathic DCMP (IDCMP was diagnosed in 26 patients and alcoholic cardiomyopathy (ACMP - in 43 patients. Patients of IDCMP and ACMP groups were randomized for treatment with perindopril (groups 1 and 3, respectively or carvedilol (groups 2 and 4, respectively. Follow-up was 6 months. End-diastolic and end-systolic left ventricular volume, stroke volume index, ejection fraction (EF and exercise capacity were determined at baseline and in 2 and 6 months of treatment. Safety of the treatments was also assessed.Results. Group 1: the average CHF class (NYHA decreased by 20.7% (p<0.01, EF increased by 18.2% (p<0.05. Group 2: the average CHF class decreased by 29.6% (p<0.01, EF increased by 18.2% (p<0.05. Group 3: the average CHF class decreased by 14.3% (p<0.01, EF increased by 19.6% (p<0.05. Group 4: the average CHF class decreased by 41.4% (p<0.001, EF increased by 32.8% (p<0.001.Conclusion. Monotherapy with carvedilol in patients with ACMP was more effective than this with perindopril. Long-term monotherapy with perindopril or carvedilol in patients with DCMP was well tolerated and safety.

  14. 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.

  15. COMPARATIVE EFFICACY OF CHRONIC HEART FAILURE TREATMENT WITH PERINDOPRIL OR CARVEDILOL IN PATIENTS WITH ALCOHOLIC OR IDIOPATHIC DILATED CARDIOMYOPATHY

    Directory of Open Access Journals (Sweden)

    I. V. Zhirov

    2013-01-01

    Full Text Available Aim. To study the clinical and hemodynamic efficacy of monotherapy with ACE inhibitor perindopril or beta-blocker carvedilol in patients with chronic heart failure (CHF due to dilated cardiomyopathy (DCMP of various etiology.Material and methods. Patients (n=69 with DCMP of different etiology were included into the open randomized study. Idiopathic DCMP (IDCMP was diagnosed in 26 patients and alcoholic cardiomyopathy (ACMP - in 43 patients. Patients of IDCMP and ACMP groups were randomized for treatment with perindopril (groups 1 and 3, respectively or carvedilol (groups 2 and 4, respectively. Follow-up was 6 months. End-diastolic and end-systolic left ventricular volume, stroke volume index, ejection fraction (EF and exercise capacity were determined at baseline and in 2 and 6 months of treatment. Safety of the treatments was also assessed.Results. Group 1: the average CHF class (NYHA decreased by 20.7% (p<0.01, EF increased by 18.2% (p<0.05. Group 2: the average CHF class decreased by 29.6% (p<0.01, EF increased by 18.2% (p<0.05. Group 3: the average CHF class decreased by 14.3% (p<0.01, EF increased by 19.6% (p<0.05. Group 4: the average CHF class decreased by 41.4% (p<0.001, EF increased by 32.8% (p<0.001.Conclusion. Monotherapy with carvedilol in patients with ACMP was more effective than this with perindopril. Long-term monotherapy with perindopril or carvedilol in patients with DCMP was well tolerated and safety.

  16. NB-UVB联合抗组胺药治疗慢性自发性荨麻疹Meta分析%Efficacy of NB-UVB combined with antihistamines on chronic spontaneous urticaria:a Meta-analysis

    Institute of Scientific and Technical Information of China (English)

    熊潇; 石春蕊; 王亚婷; 吴瑾

    2015-01-01

    Objective:To assess the efficacy of NB-UVB combined with antihistamines in the treatment of the patients with chronic spontaneous urticaria ( CSU) . Methods:The database ( PubMed, the Cochrane Li-brary, SCI, EMbase, WangFa, CNKI and CBM ) was searched to retrieve randomized controlled trials ( RCTs) of NB-UVB combined with antihistamines in the treatment of CSU from the time of the data establish-ment to October, 2014. According to the inclusion and exclusion criteria, the literatures were screened, ex-tracted data and evaluated by two reviewers independently. The Meta-analysis was performed through RevMan 5.3 software. Results:Four RCTs involving 341 patients were included. The results of Meta-analysis showed that the effective rate of NB-UVB combined with antihistamines was higher than that of antihistamines alone with a significant difference. Conclusion:NB-UVB combined with antihistamines is more effective than anti-histamines monotherapy. However, well-designed RCTs with more samples are needed to verify the efficacy.%目的::评价 NB-UVB联合抗组胺药治疗慢性自发性荨麻疹的疗效。方法:计算机检索PubMed、Cochrane图书馆、Web of Science、EMbase、万方、CNKI和CBM,查找NB-UVB联合抗组胺药治疗慢性自发性荨麻疹的随机对照试验( RCT),检索时限从建库至2014年10月。由2名研究者按照纳入与排除标准独立进行文献筛选、资料提取和质量评价后,采用RevMan 5.3软件进行Meta分析。结果:纳入4个RCT,共341例患者。 Meta分析结果显示,NB-UVB联合抗组胺药治疗慢性自发性荨麻疹有效率显著高于单纯使用抗组胺药,差异有统计学意义。结论:与单用抗组胺药相比,NB-UVB联合抗组胺药具有更好的疗效,但目前纳入文献数量较少,需要进一步大样本、高质量的RCT进行验证。

  17. 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

  18. How not to miss autoinflammatory diseases masquerading as urticaria

    DEFF Research Database (Denmark)

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

    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 urtica......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 urticarial vasculitis and autoinflammatory disorders. The latter include cryopyrin-associated periodic syndrome and Schnitzler's syndrome, both rare and disabling conditions mediated by increased interleukin-1 secretion. Apart from the urticarial rash, patients are suffering from a variety of systemic...... 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...

  19. Idiopathic histaminergic angioedema without wheals: a case series of 31 patients.

    Science.gov (United States)

    Faisant, C; Boccon-Gibod, I; Mansard, C; Dumestre Perard, C; Pralong, P; Chatain, C; Deroux, A; Bouillet, L

    2016-07-01

    Idiopathic histaminergic acquired angioedema (IH-AAE) is a common cause of recurrent angioedema without wheals. It is a mast cell-mediated disease thought to belong to the same clinical entity as chronic urticaria (CU). The objective of this study was to describe the clinical and epidemiological characteristics of IH-AAE patients. From 2014 to 2015, 534 patients were seen at our national reference centre for angioedema and/or urticaria. Among them, we identified 31 patients with idiopathic histaminergic acquired angioedema without wheals (IH-AAE). Thirty-one patients (15 men and 16 women) with a mean age of 50 years met the criteria for IH-AAE. The average delay in diagnosis was 6·3 years. A history of allergy was found in 12 patients (38·7%), nine suffering from allergic rhinitis. The mean duration of attacks was 28·1 h. The AE attack was located in the upper respiratory tract in 54·8% of cases (17 patients). A lingual location was found in 29% of patients. Men were more likely than women to have an upper airway involvement. No intubations or admissions to intensive care units were reported. The dosage of anti-histamines to control the symptoms was onefold the recommended dose in 51·6% of patients (16 patients), twofold in 32% (10 patients) and three-fourfold in 16·1% (five patients). IH-AAE is characterized by an important delay in diagnosis, a frequent involvement of the upper airway and a benign course during attacks. As in CU, a trial of up to fourfold dose of H1-anti-histamines may be necessary to control symptoms. PMID:26969870

  20. 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

  1. 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.

  2. 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....

  3. 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。

  4. 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.

  5. Urticaria pigmentosa en el adulto

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    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.

  6. 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

  7. 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

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    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

  8. 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.

  9. 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

  10. 雷公藤多苷联合抗组胺药治疗慢性荨麻疹临床疗效及生活质量的观察%Clinical Efficacy of Triptergium Wilfordii Combined with Antihistamines on Treating Chronic Urticaria

    Institute of Scientific and Technical Information of China (English)

    钱苗; 张少渊

    2011-01-01

    目的 临床观察雷公藤多苷联合不同的第二代抗组胺药治疗慢性荨麻疹的临床疗效及对患者生活质量的影响.方法 360例慢性荨麻疹患者,随机分为六组.治疗组为雷公藤多苷联合不同的抗组胺药(氯雷他定、西替利嗪、咪唑斯汀)各一组,以及仅使用不同抗组胺药(氯雷他定、西替利嗪、咪唑斯汀)各一组作为对照组的治疗方案.六组于治疗前后记录荨麻疹症状评分以及皮肤病生活质量评分表.结果 治疗4周后,雷公藤多苷和抗组胺药联合应用的治疗组的症状评分均低于仅使用抗组胺药物的对照组(P<0.001),有效率治疗组也高于对照组(P<0.05).在生活质量方面,治疗组的DLQI评分在用药2周与4周后均显著低于对照组(P<0.05,P<0.001)结论 使用雷公藤多苷联合抗组胺药(尤其是咪唑斯汀)能够更快的减轻患者症状,提高患者的生活质量.%Objective To investigate the clinical efficacy of Triptergium wilfordii combined with different antihistamines on treating chronic urticaria (CU), and to evaluate the effects on dermatology life quality index of patients. Methods 360 patients with CU were randomly divided into six groups. Patients in three treatment groups were taken Triptergium wilfordii and antihistamines daily for four weeks. And the patients in three control groups were only taken antihistamines daily for four weeks. The severity of chronic urticaria in patients was rated according to Urticaria Activity Score (UAS). Dermatology life quality index (DLQI) questionnaire scores were used and then statistical analysis was made. Results After four weeks, there were significant differences in the UAS and DLQI among these six groups. The UAS and DLQI scores were significantly improved in the treatment groups. Conclusion Triptergium wilfordii combined with antihistamines can not only decrease UAS scores, but also improve the DLQI of patients with chronic urticaria.

  11. Effect of intravenous immunoglobulin in Guilain-Barre syndrome, myasthenia gravis and chronic idiopathic demyelinative polyneuropathy, A survey in Imam Khomeini Hospital

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    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.

  12. 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

  13. New Etiology of Cholinergic Urticaria.

    Science.gov (United States)

    Tokura, Yoshiki

    2016-01-01

    Cholinergic urticaria (CholU) is characterized by pinpoint-sized, highly pruritic wheals occurring upon sweating. Both direct and indirect theories in the interaction of acetylcholine (ACh) with mast cells have been put forward in the sweating-associated histamine release from mast cells. In the mechanism of indirect involvement of ACh, patients are hypersensitive to sweat antigen(s) and develop wheals in response to sweat substances leaking from the syringeal ducts to the dermis, possibly by obstruction of the ducts. Some patients with CholU exhibit a positive reaction to intradermal injection of their own diluted sweat, representing 'sweat allergy (hypersensitivity)'. Regarding the direct interaction theory between ACh and mast cells, we found that CholU with anhidrosis and hypohidrosis lacks cholinergic receptor M3 (CHRM3) expression in eccrine sweat gland epithelial cells. The expression of CHRM3 is completely absent in the anhidrotic areas and lowly expressed in the hypohidrotic areas. In the hypohidrotic area, where CholU occurs, it is hypothesized that ACh released from nerves cannot be completely trapped by cholinergic receptors of eccrine glands and overflows to the adjacent mast cells, leading to wheals. PMID:27584968

  14. 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.

  15. 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. PMID:26820109

  16. 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.

  17. 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

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    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

  18. Urticaria in monozygotic and dizygotic twins

    DEFF Research Database (Denmark)

    Thomsen, Simon Francis; van der Sluis, Sophie; Kyvik, Kirsten Ohm;

    2012-01-01

    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...

  19. MRC chronic Dyspnea Scale: Relationships with cardiopulmonary exercise testing and 6-minute walk test in idiopathic pulmonary fibrosis patients: a prospective study

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    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.

  20. Cyclosporine Treatment in a Patient with Concurrent Autoimmune Urticaria and Autoimmune Hepatitis

    OpenAIRE

    Ju, Hye Young; Kim, Hei Sung; Kim, Hyung Ok; Park, Young Min

    2009-01-01

    Patients with autoimmune urticaria show a higher rate of seropositivity for other autoantibodies and often have a history of autoimmune conditions. They also tend to have more severe symptoms and to have a poor response to conventional antihistamine treatment. Autoimmune hepatitis is a chronic inflammatory disorder in which progressive liver injury is thought to be the result of a T-cell-mediated immunologic attack against liver cells in genetically predisposed individuals. While the associat...

  1. Urticaria/arthritis syndrome: report of four B51 positive patients.

    OpenAIRE

    Pasero, G; OLIVIERI, I.; Gemignani, G; Vitali, C

    1989-01-01

    The development of articular manifestations in the course of chronic urticaria or in urticarial vasculitis has been widely reported. It is not completely clear, however, whether common pathogenetic mechanisms are involved in all patients with these clinical features. Four consecutive patients with simultaneous urticarial and articular manifestations, but without any evidence of an immune complex mediated disease, are described. The HLA-B51 antigen was positive in all these patients, suggestin...

  2. Physical activity recommendations for children with specific chronic health conditions: Juvenile idiopathic arthritis, hemophilia, asthma and cystic fibrosis

    OpenAIRE

    Philpott, J; Houghton, K.; Luke, A

    2010-01-01

    As a group, children with a chronic disease or disability are less active than their healthy peers. There are many reasons for suboptimal physical activity, including biological, psychological and social factors. Furthermore, the lack of specific guidelines for ‘safe’ physical activity participation poses a barrier to increasing activity. Physical activity provides significant general health benefits and may improve disease outcomes. Each child with a chronic illness should be evaluated by an...

  3. 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

  4. 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.

  5. Dieulafoy Lesion in the Ascending Colon Presenting with Gastrointestinal Bleeding and Severe Anemia Complicated by a Coexisting Severe Resistant Chronic Idiopathic Thrombocytopenic Purpura

    Directory of Open Access Journals (Sweden)

    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.

  6. Translocation t(3;12(q26;q21 In Jak2V617F Point Mutation Negative Chronic Idiopathic Myelofibrosis: A Case Report

    Directory of Open Access Journals (Sweden)

    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.

  7. 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

  8. 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.

  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. PMID:7082028

  10. 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.

  11. Inducible urticaria: Case series and literature review.

    Science.gov (United States)

    Amaya, Daniel; Sánchez, Andrés; Sánchez, Jorge

    2016-01-01

    Inducible urticaria is a heterogeneous group of skin disorders characterized by the appearance of wheals, pruritus and/or angioedema, sometimes accompanied by systemic symptoms caused by innocuous stimuli (cold, heat, pressure, etc.). This group of disorders compromises people's quality of life and most of the literature in this regard comes from case reports and case series since its epidemiology has been poorly studied and some cases are very rare. The aim of this review is to show an up-to-date overview of the available literature for various types of inducible urticarias, always beginning with an illustrative case and then describing their pathophysiological mechanisms, clinical manifestations, and treatment. PMID:27622434

  12. Cinnarizine is a useful and well-tolerated drug in the treatment of acquired cold urticaria (ACU).

    Science.gov (United States)

    Tosoni, Cinzia; Lodi-Rizzini, Fabio; Bettoni, Lorenzo; Toniati, Paola; Zane, Cristina; Capezzera, Rossana; Venturini, Marina; Calzavara-Pinton, Piergiacomo; Bettoni, Lucia

    2003-01-01

    Old generation H1-type antihistamines are the standard therapeutic option for acquired cold urticaria (ACU), but adverse effects are common. New antihistamines are well tolerated but efficacy is often poor. The present study aims to evaluate efficacy and safety of cinnarizine in the treatment of ACU patients intolerant to old antihistamines and resistant to new drugs. We studied 14 patients (4 males and 10 females). Mean duration of the disease was 48.9 (range 7-102) months. Cold cube test was positive in 78.6 % of patients. Cold urticaria was idiopathic in 10 (71.4 %) patients. Cryoglobulins were detected in the serum of 4 cases (28.6 %). Cinnarizine (25 mg t.i.d.) was administered for 3 months, and then it was gently tapered off and stopped within 2 months. A complete or good response was obtained in 8 (57.1 %) and 2 (14.3 %) patients, respectively. Only two patients were unresponsive (21.4 %). Tapering off or stopping cinnarizine was followed by the relapse of cold urticaria in 7 cases (50.0 %). These patients were amenable to a second treatment cycle. Six patients (42.9 %) had a persistent remission. A patient interrupted the therapy because of severe vertigo. Three patients reported mild and transitory adverse effects including epigastralgia, weight gain and drowsiness. In conclusion, cinnarizine at high doses may be considered as an effective and well-tolerated treatment for ACU. PMID:12609783

  13. Physical activity recommendations for children with specific chronic health conditions: Juvenile idiopathic arthritis, hemophilia, asthma and cystic fibrosis.

    Science.gov (United States)

    Philpott, J; Houghton, K; Luke, A

    2010-04-01

    As a group, children with a chronic disease or disability are less active than their healthy peers. There are many reasons for suboptimal physical activity, including biological, psychological and social factors. Furthermore, the lack of specific guidelines for 'safe' physical activity participation poses a barrier to increasing activity. Physical activity provides significant general health benefits and may improve disease outcomes. Each child with a chronic illness should be evaluated by an experienced physician for activity counselling and for identifing any contraindications to participation. The present statement reviews the benefits and risks of participation in sport and exercise for children with juvenile arthritis, hemophilia, asthma and cystic fibrosis. Guidelines for participation are included. PMID:21455465

  14. Idiopathic scoliosis

    Directory of Open Access Journals (Sweden)

    Jandrić Slavica

    2012-01-01

    Full Text Available 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 diagnostics of idiopathic scoliosis. The management of idiopathic scoliosis can be conservative or operative. The main forms of conservative management are: therapy exercises, electrical stimulation and spinal orthosis. The primary aim of scoliosis management is to stop curvature progression. The improvement of pulmonary function (vital capacity and treatment of pain are also of major importance. The guidelines for Conservative Management of Scoliosis. The International Society on Scoliosis Orthopaedic and Rehabilitation Treatment gave the guidelines for conservative management of scoliosis. Conservative management of scoliosis includes: a Lyonaise, Side-Shift, Dobosiewicz, Schroth and other kinesitherapy methods, b scoliosis intensive rehabilitation which appears to be effective with respect to many signs and symptoms of scoliosis and with respect to impeding curvature progression and c brace treatment, which has been found to be effective in preventing curvature progression and thus in altering the natural history of idiopathic scoliosis. Conclusion. The International Society has given the standards for kinesitherapy, intensive rehabilitation and spinal orthosis in clinical practice and clinical investigations. Surgical procedures can improve curves in the frontal plane, but have important limitations in maintaining fixation and achieving correction in other planes.

  15. Idiopathic scoliosis.

    OpenAIRE

    Jens Ivar Brox

    1989-01-01

    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...

  16. Hip joint structures assessment in juvenile idiopathic (chronic arthritis with ultrasound TOC \\o "1-5" \\h \\z examination

    Directory of Open Access Journals (Sweden)

    G. R. Movsisyan

    2004-01-01

    Full Text Available Sonographic (SG examination of hip joints was performed in 100 pts with juvenile chronic arthritis (JCA with different forms, activity and duration. SG signs of hip joint inflammation in JCA were identified. SG features in pts with different disease duration, form and activity were revealed. SG changes of clinically unchanged hip joints were noted which may be of important significance for early diagnosis of coxitis. More wide use of arthrosonography in pediatric rheumatology was proved.

  17. [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.

  18. 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

  19. [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. PMID:25133816

  20. Evaluation of the effects of and earliest response rate to anti-D treatment in children with chronic idiopathic thrombocytopenic purpura: a pilot study.

    Science.gov (United States)

    Yetgin, Sevgi; Aytaç, Selin; Olcay, Lale; Tunç, Bahattin; Ozbek, Namik; Aydinok, Yeşim

    2010-01-01

    In this pilot study, 30 (14 male, 16 female; median age: 8 years, range: 2-18) chronic non-splenectomized idiopathic thrombocytopenic purpura (ITP) patients with Rh+ blood group and their 49 attacks were evaluated after intravenous (i.v.) anti-D (WinRho SDF, Cangene Corporation, Winnipeg, MB, Canada) treatment at a dose of 50 microg/kg x 3 days (n = 21 cases; 35 attacks) or a single dose of 75 microg/kg (n = 9 cases; 14 attacks) to define the hemostatic dose of anti-D. Five of 30 patients (22/49 attacks) were resistant to steroid, intravenous immunoglobulin (IVIG) and vincristine treatment. Hemoglobin (Hb), white blood cells (WBC), platelets (plt) and reticulocytes (ret) were evaluated before and after treatment during the follow-up in sequences on the 1st, 7th, 14th and 21st days after anti-D treatment if the patients had no symptom. All patients, even the resistant ones, experienced an increase in plt count to provide protection from bleeding (> or = 20 x 10(9)/L in patients with symptoms, > or = 10 x 10(9)/L in patients without symptoms). The plt responses of one resistant and five non-resistant patients treated with a single 75 microg/kg dose of i.v. anti-D in 8 attacks were monitored at the 2nd, 4th, 8th, 24th and 48th hours of the treatment. A protective plt level was attained within 2 hours in 6 attacks of five non-resistant cases and in 24 hours in the remaining 2 attacks of one resistant case. This pilot study suggests that anti-D treatment in ITP patients is effective and can increase plt to a level adequate enough to protect from hemorrhage within 2 hours, when given in a 75 microg/kg dose. A few adverse events (i.e. chills, hemolysis and hemoglobinuria) resolved without intervention. PMID:20560246

  1. 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. PMID:27110120

  2. Efficacy and Safety of BCG Polysaccharide and Nucleic Acid Injection Combined With Antihistamines in the Treatment of Chronic Urticaria:A Systematic Review%卡介菌多糖核酸注射液联合抗组胺药治疗慢性荨麻疹有效性和安全性的系统评价

    Institute of Scientific and Technical Information of China (English)

    黄梦雅; 温路; 周汛

    2015-01-01

    Objective To systematically evaluate the efficacy and safety of BCG - PSN combined with antihistamines in the treatment of chronic urticaria. Methods We made a retrieval in PubMed,Cochrane Library,EMBase,CNKI,Wanfang,ⅤIP for literatures about the efficacy and safety of BCG - PSN combined with antihistamines in the treatment of chronic urticaria from January 1979( or from the establishment of some databases)to October 2014. The RevMan 5. 1 statistical software was employed to conduct systematic review. Results We included 8 pieces of literature and 853 patients. The meta - analysis showed the following results:the two groups were significantly different in effective rate〔OR(95% CI) = 3. 49(2. 42,5. 04),P <0. 01〕;the two groups were significantly different in recurrence rate〔OR(95% CI) = 0. 22(0. 12,0. 41),P < 0. 01〕;the two groups were not significantly different in the rate of adverse reaction〔OR(95% CI) = 0. 85(0. 50,1. 43),P = 0. 53〕. Conclusion Compared with the treatment with pure antihistamines,BCG - PSN combined with antihistamines has high effective rate and low recurrence rate,causes no severe adverse reactions and has favorable efficacy and safety.%目的:系统评价卡介菌多糖核酸注射液联合抗组胺药治疗慢性荨麻疹的有效性和安全性。方法计算机检索 PubMed、Cochrane 图书馆对照试验资料库、EMBase、中国期刊全文数据库(CNKI)、万方数据库、维普信息资源系统(ⅤIP)中关于卡介菌多糖核酸注射液联合抗组胺药治疗慢性荨麻疹有效性和安全性的文献,检索时间为1979年1月(1979年未建立的数据库以建库日为起始时间)—2014年10月。采用 RevMan 5.1统计软件对纳入文献进行系统评价。结果共纳入文献8篇,纳入患者总数为853例。Meta 分析结果显示,两组有效率比较,差异有统计学意义〔OR(95% CI)=3.49(2.42,5.04),P <0.01〕;复发率比较

  3. 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.

  4. 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

  5. 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.

  6. 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.

  7. Inhibition and Role of let-7d in Idiopathic Pulmonary Fibrosis

    OpenAIRE

    Kusum V Pandit; Corcoran, David; Yousef, Hanadie; Yarlagadda, Manohar; Tzouvelekis, Argyris; Gibson, Kevin F.; Konishi, Kazuhisa; Yousem, Samuel A.; Singh, Mandal; Handley, Daniel; Richards, Thomas; Selman, Moises; Watkins, Simon C.; Pardo, Annie; Ben-Yehudah, Ahmi

    2010-01-01

    Rationale: Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive, and usually lethal fibrotic lung disease characterized by profound changes in epithelial cell phenotype and fibroblast proliferation.

  8. Melatonin improves health status and sleep in children with idiopathic chronic sleep-onset insomnia: A randomized placebo-controlled trial.

    NARCIS (Netherlands)

    M.G. Smits; H.F. van Stel; K. van der Heijden; A.M. Meijer; A,.M.L. Coenen; G.A. Kerkhof

    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

  9. Idiopathic sclerosing orbital inflammation

    NARCIS (Netherlands)

    J.D. Hsuan; D. Selva; A.A. McNab; T.J. Sullivan; P. Saeed; B.A. O'Donnell

    2006-01-01

    Objective: To perform a multicenter review of the clinical features and treatment of 31 patients with idiopathic sclerosing orbital inflammation. Methods: We included all patients with histologically confirmed idiopathic sclerosing orbital inflammation from 5 regional orbital centers. We reviewed th

  10. Unusual Presentation of Acute Annular Urticaria: A Case Report

    OpenAIRE

    Gilles Guerrier; Jean-Marc Daronat; Roger Deltour

    2011-01-01

    Acute urticarial lesions may display central clearing with ecchymotic or haemorrhagic hue, often misdiagnosed as erythema multiforme, serum-sickness-like reactions, or urticarial vasculitis. We report a case of acute annular urticaria with unusual presentation occurring in a 20-month-old child to emphasize the distinctive morphologic manifestations in a single disease. Clinicians who care for children should be able to differentiate acute urticaria from its clinical mimics. A directed history...

  11. Chlorhexidine urticaria: A rare occurrence with a common mouthwash

    OpenAIRE

    Sharma Anamika; Chopra Harneet

    2009-01-01

    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.

  12. Perforated hydatid cyst into peritoneum presented with urticaria

    OpenAIRE

    Turgut Piskin; Cengiz Ara; Abuzer Dirican; Dincer Ozgor; Bulent Unal; Sezai Yılmaz

    2010-01-01

    Hydatid cyst of liver is generally asymptomatic unlessleading to complications. Spontaneously or trauma inducedperforation of cyst into peritoneum is one of thatcomplications. Rupture into the abdominal cavity maycause mild to fatal complications like abdominal pain, urticaria,anaphylaxis and sudden death. We present, herein,a case with abdominal pain and urticaria due to spontaneouslyhydatid cyst rupture into peritoneum. A 32 year-oldwoman admitted to the emergency room with abdominalpain an...

  13. Idiopathic portal hypertension

    International Nuclear Information System (INIS)

    To describe the radiologic findings of idiopathic portal hypertension and to find the points of differentiation between idiopathic portal hypertension and liver cirrhosis. Four portograms in five patients who for four years had suffered from pathologically confirmed idiopathic portal hypertension were retrospectively analyzed and compared with a portogram obtained from a control subject with liver cirrhosis. Portographic finding s of idiopathic portal hypertension were paucity of medium-sized portal branches, irregular and obtuse-angled division of peripheral branches, abrupt interruption and an avascular area beneath the liver margin. A portogram of idiopathic portal hypertension may be useful in differentiation this and liver cirrhosis

  14. The European Medicines Agency review of eltrombopag (Revolade) for the treatment of adult chronic immune (idiopathic) thrombocytopenic purpura: summary of the scientific assessment of the Committee for Medicinal Products for Human Use.

    Science.gov (United States)

    Nieto, Maria; Calvo, Gonzalo; Hudson, Ian; Feldschreiber, Peter; Brown, David; Lee, Ching Cheng; Lay, Geoffrey; Valeri, Anna; Abadie, Eric; Thomas, Angela; Pignatti, Francesco

    2011-09-01

    On 11(th) March 2010, the European Commission issued a marketing authorization valid throughout the European Union for Revolade for the treatment of adult chronic immune (idiopathic) thrombocytopenic purpura. Revolade is an orphan medicinal product indicated for splenectomized patients with immune (idiopathic) thrombocytopenic purpura who are refractory to other treatments (e.g. corticosteroids, immunoglobulins) and as second-line treatment for non-splenectomized patients where surgery is contraindicated. The active substance of Revolade is eltrombopag (ATC code B02BX05). Eltrombopag increases platelet production through activation of the thrombopoietin receptor. The recommended oral dose is 50 mg once daily to achieve and maintain a platelet count of the 50×10(9)/L or more necessary to reduce or prevent the risk of bleeding. The benefit of Revolade is a durable response in maintaining platelet levels. The most common side effects include headache, nausea, hepatobiliary toxicity, diarrhea, fatigue, paresthesia, constipation, rash, pruritus, cataract, arthralgia and myalgia. The decision to grant the marketing authorization was based on the favorable recommendation of the Committee for Medicinal Products for Human Use of the European Medicines Agency. The objective of this paper is to describe the data submitted to the European Medicines Agency and to summarize the scientific review of the application. The detailed scientific assessment report and product information, including the summary of product characteristics, are available on the European Medicines Agency website (www.ema.europa.eu). PMID:21712542

  15. Mineral Oil Aspiration Related Juvenile Idiopathic Arthritis.

    Science.gov (United States)

    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. PMID:26171269

  16. 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.

  17. Mineral Oil Aspiration Related Juvenile Idiopathic Arthritis

    Directory of Open Access Journals (Sweden)

    Andrew D. Nelson

    2015-01-01

    Full Text Available 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.

  18. Cough in idiopathic pulmonary fibrosis.

    Science.gov (United States)

    van Manen, Mirjam J G; Birring, Surinder S; Vancheri, Carlo; Cottin, Vincent; Renzoni, Elisabetta A; Russell, Anne-Marie; Wijsenbeek, Marlies S

    2016-09-01

    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. PMID:27581827

  19. 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.

  20. Idiopathic Intracranial Hypertension (Pseudotumor Cerebri)

    Science.gov (United States)

    ... Asked Questions Español Condiciones Chinese Conditions Idiopathic Intracranial Hypertension (Pseudotumor Cerebri) En Español Read in Chinese What is idiopathic intracranial hypertension? Idiopathic intracranial hypertension (IIH) is a disorder that ...

  1. 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.

  2. 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.

  3. Unusual Presentation of Acute Annular Urticaria: A Case Report

    Directory of Open Access Journals (Sweden)

    Gilles Guerrier

    2011-01-01

    Full Text Available Acute urticarial lesions may display central clearing with ecchymotic or haemorrhagic hue, often misdiagnosed as erythema multiforme, serum-sickness-like reactions, or urticarial vasculitis. We report a case of acute annular urticaria with unusual presentation occurring in a 20-month-old child to emphasize the distinctive morphologic manifestations in a single disease. Clinicians who care for children should be able to differentiate acute urticaria from its clinical mimics. A directed history and physical examination can reliably orientate necessary diagnostic testing and allow for appropriate treatment.

  4. Levels of plasma D-dimer, activated coagulation factor Ⅶ and Ⅻ in patients with chronic urticaria%慢性荨麻疹患者血浆D二聚体、活化凝血因子Ⅶ及活化凝血因子Ⅻ水平的研究

    Institute of Scientific and Technical Information of China (English)

    王朵勤; 唐慧; 沈燕芸; 徐金华

    2015-01-01

    目的 探讨血浆D二聚体、活化凝血因子Ⅶ(FⅦa)及活化凝血因子Ⅻ(FⅫa)在慢性荨麻疹(CU)患者中的表达及其与CU发病的关系.方法 对50例CU患者及50例健康对照用干式免疫散射色谱法检测血浆D二聚体水平,用酶联免疫吸附法检测FⅦa及FⅫa的水平,并结合患者病情严重程度情况进行分析.对43例CU患者自体血浆皮肤试验(APST)及41例CU患者作自体血清皮肤试验(ASST)结果与其血浆D二聚体水平进行比较.结果 CU患者血浆中D二聚体及FⅦa的水平均明显高于健康对照组(P<0.05),前者升高水平与病情严重程度呈正相关(P<0.05);CU患者FⅫa水平与健康对照组比较,差异无统计学意义(P>0.05).APST(+)患者的D二聚体水平明显高于APST(-)患者(P<0.05),而ASST(+)患者D二聚体水平与ASST(-)患者比较,差异无统计学意义(P>0.05).结论 凝血机制与CU相关,外源性凝血途径起着作用,针对凝血机制的研究对于CU的病情评估和临床治疗具有一定的意义.%Objective To measure the levels of plasma D-dimer,activated coagulation factor Ⅶ (FⅦa) and activated clotting factor Ⅻ (FⅫa) in patients with chronic urticaria (CU),and to investigate their relationship with the occurrence of CU.Methods Venous blood samples were collected from 50 patients with CU and 50 healthy human controls.Dry-column immune scattering chromatography was performed to detect the plasma level of D-dimer,and enzyme-linked immunosorbent assay (ELISA) to measure the levels of FⅦa and FⅫa.In addition,autologous plasma skin test (APST) was conducted in 43 patients with CU,and autologous serum skin test (ASST) in 41 patients with CU.A correlation analysis was carried out between the above three parameters and disease severity as well as between the results of APST and ASST and plasma level of D-dimer.Results The levels of plasma D-dimer and F Ⅶa were significantly higher in patients with CU than in healthy

  5. 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

  6. 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

  7. A conservative assessment of the major genetic causes of idiopathic chronic pancreatitis: data from a comprehensive analysis of PRSS1, SPINK1, CTRC and CFTR genes in 253 young French patients.

    Directory of Open Access Journals (Sweden)

    Emmanuelle Masson

    Full Text Available Idiopathic chronic pancreatitis (ICP has traditionally been defined as chronic pancreatitis in the absence of any obvious precipitating factors (e.g. alcohol abuse and family history of the disease. Studies over the past 15 years have revealed that ICP has a highly complex genetic architecture involving multiple gene loci. Here, we have attempted to provide a conservative assessment of the major genetic causes of ICP in a sample of 253 young French ICP patients. For the first time, conventional types of mutation (comprising coding sequence variants and variants at intron/exon boundaries and gross genomic rearrangements were screened for in all four major pancreatitis genes, PRSS1, SPINK1, CTRC and CFTR. For the purposes of the study, synonymous, intronic and 5'- or 3'-untranslated region variants were excluded from the analysis except where there was persuasive evidence of functional consequences. The remaining sequence variants/genotypes were classified into causative, contributory or neutral categories by consideration of (i their allele frequencies in patient and normal control populations, (ii their presumed or experimentally confirmed functional effects, (iii the relative importance of their associated genes in the pathogenesis of chronic pancreatitis and (iv gene-gene interactions wherever applicable. Adoption of this strategy allowed us to assess the pathogenic relevance of specific variants/genotypes to their respective carriers to an unprecedented degree. The genetic cause of ICP could be assigned in 23.7% of individuals in the study group. A strong genetic susceptibility factor was also present in an additional 24.5% of cases. Taken together, up to 48.2% of the studied ICP patients were found to display evidence of a genetic basis for their pancreatitis. Whereas these particular proportions may not be extrapolable to all ICP patients, the approach employed should serve as a useful framework for acquiring a better understanding of the

  8. Analysis of the T-Lymphocytes and Their Subpopu-lations of the Peripheral Blood in Patients with Urticaria

    Institute of Scientific and Technical Information of China (English)

    王冬云; 彭振辉; 谭升顺; 楚瑞琦; 刘平

    2003-01-01

    Objective: To study the function of cellular immunity of patients with urticaria.Methods:T-lymphocytes subpopulations of the peripheraal blood in 60 patients with urticaria and 40 henlthy controls were examined by flow cylonuetry. Results: The number of CD3+ and CD4+ cells in the urticaria group were significantly lower than those in the control group ( P<0. 01 ), especially in patients with acute urticaria. Conclusion: There was immunologic dysfunction of T lymphocyte in the patients with urticaria, and not only humoral immunity takes part but also cellular immunity plays a certain role in the pathogenesis of urticaria.

  9. Herpesvirus-Associated Acute Urticaria: An Age Matched Case-Control Study

    OpenAIRE

    Arianna Mareri; Adler, Stuart P.; Giovanni Nigro

    2013-01-01

    BACKGROUND: Acute and recurrent acute urticaria are often associated with multiple factors including infections and recent data suggest a role for herpesviruses. OBJECTIVE: To test the null hypothesis, that is, there is no association of herpesvirus infections with urticaria. METHODS: Thirty-seven patients between one month and 15 years of age were age matched to 37 controls who were healthy or had mild acute respiratory infections but without urticaria. Patients and controls were followed fo...

  10. Cardiac manifestations of idiopathic pulmonary fibrosis

    OpenAIRE

    Agrawal, Abhinav; Verma, Isha; Shah, Varun; Agarwal, Abhishek; Sikachi, Rutuja R

    2016-01-01

    Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive, parenchymal disease of the lung with an estimated prevalence of 14–43 per 100,000. Patient usually presents with coughing and exertional dyspnea, which can lead to acute respiratory failure. IPF has been associated with various co-morbidities such as lung cancer, emphysema, obstructive sleep apnea (OSA), GERD and multiple cardiovascular consequences. The cardiovascular manifestations of IPF include pulmonary hypertension, heart fa...

  11. 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

  12. 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.

  13. Idiopathic Pulmonary Fibrosis

    Science.gov (United States)

    ... Explore Idiopathic Pulmonary Fibrosis What Is... How the Lungs Work Other Names Causes Signs & Symptoms Diagnosis Treatments Living With Clinical Trials Links Related Topics How the Lungs Work Lung Transplant Pulmonary Hypertension Pulmonary Rehabilitation Respiratory Failure ...

  14. Idiopathic Gingival Hyperplasia

    OpenAIRE

    Cekmez, Ferhat; Pirgon, Ozgur; Tanju, Ilhan Asya

    2009-01-01

    Gingival hyperplasia is a rare condition but it is important for cosmetic and mechanic reasons and because of its potential as an indicator of systemic disease. Gingival fibromatosis may exist as an isolated abnormality or as part of a syndrome. In this article a case that was diagnosed clinically and histologically as idiopathic gingival fibromatosis is presented. Patient with gingival hyperplasia should be examined to exclude other reasons to determine the idiopathic gingival fibromatosis o...

  15. Atherosclerosis in Juvenile Idiopathic Arthritis

    Directory of Open Access Journals (Sweden)

    Ewa Jednacz

    2012-01-01

    Full Text Available Atherosclerosis is a chronic inflammatory disease of the arteries. Clinical consequences of the atherosclerotic process occur in the adult population, however atherosclerotic process begins in childhood. The classic risk factors for atherosclerosis include obesity, dyslipidaemia, age, gender or family history. In recent years, attention has been drawn to the similarity between atherosclerotic inflammatory processes and inflammatory changes in the course of systemic connective tissue disease, in particular systemic lupus etythematosus (SLE or rheumatoid arthritis (RA. There is also observed the similarity of the pathogenetic background of development of atherosclerosis and juvenile idiopathic arthritis (JIA. Elevated levels of pro-inflammatory cytokines are observed in the course of juvenile idiopathic arthritis. Also homocysteine concentrations, which may play a significant role in the development of atherosclerotic lesions, are observed higher in patients with JIA. Some studies revealed higher carotid intima-media thickness (IMT index values in children with JIA. In view of the fact that atherosclerotic process begins as early as in childhood, the introduction of appropriate preventive measures in children is a matter of utmost importance.

  16. 祛风清热胃苓汤联合氯雷他定递减疗法治疗慢性荨麻疹临床研究%Clinical Observation on Qufeng Qingre Weiling Decoction Combined with the Decreasing ;Amount of Loratadine in Treatment of Chronic Urticaria

    Institute of Scientific and Technical Information of China (English)

    冯爽; 陈宏; 唐莉

    2015-01-01

    目的:观察祛风清热胃苓汤联合口服氯雷他定递减疗法治疗慢性荨麻疹(CU)的临床疗效。方法将108例CU患者随机分为治疗组和对照组各54例,治疗组予祛风清热胃苓汤口服,同时服用氯雷他定10 mg,每日1次,并根据症状控制情况逐渐减量,对照组仅予氯雷他定递减疗法。2组均以2周为1个疗程,连续观察4个疗程。治疗8周后根据患者症状积分下降综合指数评价2组患者近期临床疗效,并于治疗4、6、8周时进行服用抗组胺药物评分。对痊愈患者停药后1、3、6个月进行随访,对比2组痊愈患者远期疗效。结果8周后治疗组治愈27例,近期疗效有效率为96.15%,对照组分别为13例和65.38%,差异有统计学意义(P<0.05)。治疗组服用抗组胺药物评分为(0.553±0.239)分,对照组为(0.721±0.245)分。治疗组远期临床疗效显著优于对照组。结论祛风清热胃苓汤联合口服氯雷他定递减疗法治疗CU的近期及远期临床疗效均优于对照组。%Objective To observe the clinical efficacy of Qufeng Qingre Weiling Decoction combined with the decreasing amount of loratadine in treatment of chronic urticaria (CU). Methods Totally 108 CU patients were randomly divided into treatment group and control group, 54 cases in each group. The treatment group was given Qufeng Qingre Weiling Decoction combined with the decreasing amount of loratadine (10 mg, 1 time per day) according to symptom controlling situation, and control group with the decreasing amount of loratadine only. Both groups were treated for 4 treatment courses (2 weeks as a treatment course). Symptom score reduce index was used to calculate the effective rate after 8 weeks of treatment. And the taking antihistamine medicine score was recorded 4, 6, 8 weeks of treatment. The follow-up visits were made to observe long-term efficacy of the cured patients 1 month, 3 months and 6 months after discontinuing the medication. Results Totally 27

  17. Bone marrow stroma in idiopathic myelofibrosis and other haematological diseases. An immunohistochemical study

    DEFF Research Database (Denmark)

    Lisse, I; Hasselbalch, H; Junker, P

    1991-01-01

    Bone marrow stroma was investigated immunohistochemically in 31 patients with haematological diseases, mainly idiopathic myelofibrosis (n = 8) and related chronic myeloproliferative disorders (n = 14). The bone marrow from patients with idiopathic myelofibrosis and some CML patients showed marked...... and capillarization, with the development of continuous sheets of basement membrane material beneath endothelial cells....

  18. Contact urticaria from protein hydrolysates in hair conditioners.

    Science.gov (United States)

    Niinimäki, A; Niinimäki, M; Mäkinen-Kiljunen, S; Hannuksela, M

    1998-11-01

    Protein hydrolysates (PHs) are added to hair-care products (to "repair" broken hair), soaps, bath gels, creams, etc. From one to 22 PHs used in hair-care products (collagen, keratin, elastin, milk, wheat, almond, and silk) were tested in three patient groups: A) 11 hairdressers with hand dermatitis B) 2160 consecutive adults with suspected allergic respiratory disease subjected to routine skin prick tests C) 28 adults with atopic dermatitis. In group A, all the 22 PHs were tested with scratch and patch tests. In groups B and C, one to three PHs were tested with prick tests. Positive scratch/prick test reactions were seen in 12 patients from three PHs altogether. All were women with atopic dermatitis, and all reacted to at least hydroxypropyl trimonium hydrolyzed collagen (Crotein Q). In three patients, prick and open tests with a hair conditioner containing Crotein Q were performed with positive results. One patient reported contact urticaria on her hands, and two reported acute urticaria on their head, face, and upper body from a hair conditioner containing Crotein Q. In seven of the eight studied sera, specific IgE to Crotein Q was detected. In conclusion, PHs of hair cosmetics can cause contact urticaria, especially in patients with atopic dermatitis.

  19. Atypical idiopathic inflammatory demyelinating lesions

    DEFF Research Database (Denmark)

    Wallner-Blazek, Mirja; Rovira, Alex; Fillipp, Massimo;

    2013-01-01

    Atypical lesions of a presumably idiopathic inflammatory demyelinating origin present quite variably and may pose diagnostic problems. The subsequent clinical course is also uncertain. We, therefore, wanted to clarify if atypical idiopathic inflammatory demyelinating lesions (AIIDLs) can be class...

  20. Definition, aims, and implementation of GA(2) LEN Urticaria Centers of Reference and Excellence

    DEFF Research Database (Denmark)

    Maurer, M; Metz, M; Bindslev-Jensen, C;

    2016-01-01

    and education, and to promote the awareness of urticaria by advocacy activities. To become a certified GA²LEN UCARE, urticaria centers have to apply and fulfill 32 requirements, defined by specific deliverables that are assessed during an audit visit. DISCUSSION AND CONCLUSION: The GA²LEN UCARE program...

  1. 9 CFR 311.22 - Hogs affected with urticaria, tinea tonsurans, demodex follicurlorum, or erythema.

    Science.gov (United States)

    2010-01-01

    ... tonsurans, demodex follicurlorum, or erythema. 311.22 Section 311.22 Animals and Animal Products FOOD SAFETY... 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,...

  2. Urticaria and Prodromal Symptoms Including Erythema Marginatum in Danish Patients with Hereditary Angioedema

    DEFF Research Database (Denmark)

    Rasmussen, Eva R; Valente de Freitas, Priscila; Bygum, Anette

    2015-01-01

    Erythema marginatum is a characteristic skin rash seen in patients with hereditary angioedema (HAE); however, it can be confused with urticaria, leading to delay in correct diagnosis. The aim of this study was to clarify how often erythema marginatum is misinterpreted as urticaria, potentially...

  3. Optimal management of idiopathic scoliosis in adolescence

    Directory of Open Access Journals (Sweden)

    Kotwicki T

    2013-07-01

    the need for surgical treatment. Surgery is the treatment of choice for severe idiopathic scoliosis which is rapidly progressive, with early onset, late diagnosis, and neglected or failed conservative treatment. The psychologic impact of idiopathic scoliosis, a chronic disease occurring in the psychologically fragile period of adolescence, is important because of its body distorting character and the onerous treatment required, either conservative or surgical. Optimal management of idiopathic scoliosis requires cooperation within a professional team which includes the entire therapeutic spectrum, extending from simple watchful observation of nonprogressive mild deformities through to early surgery for rapidly deteriorating curvature. Probably most demanding is adequate management with regard to the individual course of the disease in a given patient, while avoiding overtreatment or undertreatment. Keywords: management, idiopathic scoliosis, adolescence

  4. The clinical effect of clomipramine in chronic idiopathic pain disorder revisited using the Spielberger State Anxiety Symptom Scale (SSASS) as outcome scale

    DEFF Research Database (Denmark)

    Bech, Per; Gormsen, Lise; Loldrup, Dorte;

    2009-01-01

    only the negatively phrased items was used to measure the pure anxiolytic effect. The analgesic effect was measured by the Visual Analogue Scale (VAS) for bodily pain. The General Health Questionnaire (GHQ-12) was used to identify minor affective states. RESULTS: In total 171 patients with chronic non......-malignant pain were included (87 patients received placebo and 84 clomipramine). On the SSASS, clomipramine's (mean dose 125 mg daily) advantage over placebo in the planned 6-weeks' treatment period for all patients (intention-to-treat analysis) showed an effect size of 0.37. For completers only, the effect size...... was 0.45. In total 76 patients were GHQ-12 positive, and the effect size in favour of clomipramine was 0.50 (intention-to-treat approach) and 0.66 for completers. In general, the effect on the Bodily Pain VAS, i.e. the analgesic outcome, was low. Thus, even in completers who were GHQ-12 positive...

  5. Chronic pruritic skin disorders and sleep%睡眠不足在慢性瘙痒性皮肤病中的表现及处理

    Institute of Scientific and Technical Information of China (English)

    黄鸿达; 邓列华

    2012-01-01

    慢性瘙痒性皮肤病与睡眠不足有一定的联系.已有文献报导睡眠不足对患者的行为、生理及心理健康有不良的影响,降低了患者的生活质量.该文论述了慢性瘙痒性皮肤病引起睡眠不足的病因,对睡眠不足的常规治疗方案进行了概括,对如何治疗受睡眠不足困扰的皮肤病患者给予建议.正确的治疗不仅能改善皮肤病症状且能提高患者的整体生活质量.%Chronic pruritic skin disorder are variably associated with sleep deprivation. Sleep deprivation has been shown to have detrimental effects on behavioural, physiological and psychological health. This review focuses on the etiology of sleep disoder associated with pruritic skin conditions and also the commonly-seen chronic pruritic skin diseases such as atopic dermatitis, psoriasis, infestations and chronic idiopathic urticaria. Suggestions and advice on the management of sleep deprivation in patients with skin conditions are also included. Appropriate treatment will not only improve symptoms but also patient's quality of life.

  6. Juvenile idiopathic arthritis

    NARCIS (Netherlands)

    Prakken, Berent; Albani, Salvatore; Martini, Alberto

    2011-01-01

    Juvenile idiopathic arthritis is a heterogeneous group of diseases characterised by arthritis of unknown origin with onset before age of 16 years. Pivotal studies in the past 5 years have led to substantial progress in various areas, ranging from disease classification to new treatments. Gene expres

  7. High-dose acetylcysteine in idiopathic pulmonary fibrosis.

    NARCIS (Netherlands)

    Demedts, M.; Behr, J.; Buhl, R.; Costabel, U.; Dekhuijzen, P.N.R.; Jansen, H.M.L.; MacNee, W.; Thomeer, M.; Wallaert, B.; Laurent, F.; Nicholson, A.G.; Verbeken, E.K.; Verschakelen, J.; Flower, C.D.; Capron, F.; Petruzzelli, S.; Vuyst, P. De; Bosch, J.M. van den; Rodriguez-Becerra, E.; Corvasce, G.; Lankhorst, I.L.M.; Sardina, M.; Montanari, M.

    2005-01-01

    BACKGROUND: Idiopathic pulmonary fibrosis is a chronic progressive disorder with a poor prognosis. METHODS: We conducted a double-blind, randomized, placebo-controlled multicenter study that assessed the effectiveness over one year of a high oral dose of acetylcysteine (600 mg three times daily) add

  8. Anti-neutrophil cytoplasmic antibodies in idiopathic inflammatory disorders

    NARCIS (Netherlands)

    Mulder, Alide Heleen Leontine

    1994-01-01

    This thesis studies the prevalence of anti-neutrophil cytoplasmic antibodies (ANCA) in idiopathic inflammatory disorders in which GS-ANA were described during the 60s: rheumatoid arthritis, autoimmune liver diseases, inflammatory bowel disease, and juvenile chronic arthritis. In all of these disorde

  9. Isotretinoin induced rash, urticaria, and angioedema: a case report

    Directory of Open Access Journals (Sweden)

    Zonunsanga

    2015-10-01

    Full Text Available Isotretinoin is a vitamin A analogue, which is readily isomerized to tretinoin. It causes normalization of abnormal keratinisation. It also reduces sebum secretion. It also has anti-inflammatory as well as antibacterial properties. It has some adverse effects like teratogenecity, hypertriglyceridemia, pancreatitis, dryness of skin, cheilitis, altered liver functions etc. A 25 years old unmarried lady presented with acne vulgaris, who did not showed improvements with conventional (antibiotics therapy was given isotretinoin. She developed maculopapular rash, urticaria and angioedema Isotretinoin induced urticarial rashes and angioedema is rarely reported as far as our knowledge is concerned.

  10. Eosinofilia reacional, leucemia eosinofílica crônica e síndrome hipereosinofílica idiopática Reactive eosinophilia, chronic eosinophilic leukemia and idiopathic hypereosinophilic syndrome

    Directory of Open Access Journals (Sweden)

    Maria de Lourdes Lopes Ferrari Chauffaille

    2010-01-01

    conditions described as eosinophilia. Now these conditions are better understood due to the evolution of cellular and molecular biology. This knowledge has helped to characterize distinct disorders involving myeloid and lymphoid lineages. Hence, eosinophilia is categorized as reactive, clonal or idiopathic. With the introduction of anti-tyrosine kinase (imatinib mesylate therapy, which is effective for the FIP1L1/PDGFRa rearrangement, there is a possibility to control or cure chronic eosinophilic leukemia. For this reason, precise and fast diagnosis is necessary for ideal therapeutic decisions before organic lesions that are irreversible, such as heart injury, become established. The aim of this manuscript is to review eosinophilia and offer an update on diagnostic and therapeutic investigations.

  11. Genetics Home Reference: juvenile idiopathic arthritis

    Science.gov (United States)

    ... Home Health Conditions juvenile idiopathic arthritis juvenile idiopathic arthritis Enable Javascript to view the expand/collapse boxes. ... All Open All Close All Description Juvenile idiopathic arthritis refers to a group of conditions involving joint ...

  12. Urticaria Vasculitis: Estudio retrospectivo de 20 casos y protocolo diagn??stico-terap??utico

    OpenAIRE

    Soriano Hern??ndez, Isabel; Orgaz Molina, Jacinto; Arias Santiago, Salvador; El-Ahmed, Husein; Ortego Centeno, Norberto; Callejas, Jos?? L.; Fern??ndez Pugnaire, M. Antonia; Naranjo Sintes, Ram??n Jos??

    2011-01-01

    La urticaria vasculitis es una enfermedad cr??nica que se caracteriza por episodios urticariales o de angioedema que puede asociarse a niveles bajos de complemento. Hemos realizado un estudio descriptivo retrospectivo que incluye a 20 pacientes con urticaria vasculitis diagnosticados en los ??ltimos 5 a??os donde analizamos los s??ntomas m??s frecuentes y los tratamientos que se han empleado. A continuaci??n se ha dise??ado un protocolo diagn??stico-terap??utico de Urticaria Vascu...

  13. Juvenile idiopathic arthritis: a clinical overview

    Energy Technology Data Exchange (ETDEWEB)

    Davidson, J

    2000-02-01

    The chronic arthritides in childhood remain a poorly understood group of conditions. Their classification has been a source of much confusion over the years with differences in terminology between Europe and North America. A significant step forward in paediatric rheumatology has been the recent development of an internationally agreed classification system which uses the overall term juvenile idiopathic arthritis (JIA). The various subtypes of JIA and their clinical features are described, together with an overview of their differential diagnosis, complications and outcomes. An outline of current management strategies is given and potential future developments highlighted.

  14. Update on diagnosis and treatment of idiopathic pulmonary fibrosis

    Science.gov (United States)

    Baddini-Martinez, José; Baldi, Bruno Guedes; da Costa, Cláudia Henrique; Jezler, Sérgio; Lima, Mariana Silva; Rufino, Rogério

    2015-01-01

    Idiopathic pulmonary fibrosis is a type of chronic fibrosing interstitial pneumonia, of unknown etiology, which is associated with a progressive decrease in pulmonary function and with high mortality rates. Interest in and knowledge of this disorder have grown substantially in recent years. In this review article, we broadly discuss distinct aspects related to the diagnosis and treatment of idiopathic pulmonary fibrosis. We list the current diagnostic criteria and describe the therapeutic approaches currently available, symptomatic treatments, the action of new drugs that are effective in slowing the decline in pulmonary function, and indications for lung transplantation. PMID:26578138

  15. Idiopathic chronic eosinophilic pneumonia. A clinical and follow-up study of 62 cases. The Groupe d'Etudes et de Recherche sur les Maladies "Orphelines" Pulmonaires (GERM"O"P).

    Science.gov (United States)

    Marchand, E; Reynaud-Gaubert, M; Lauque, D; Durieu, J; Tonnel, A B; Cordier, J F

    1998-09-01

    Idiopathic chronic eosinophilic pneumonia (CEP) is a rare disorder of unknown cause with nonspecific respiratory and systemic symptoms but rather characteristic peripheral alveolar infiltrates on imaging, developing mainly in women and in atopic subjects. The disorder is highly responsive to oral corticosteroid therapy, but relapses are frequent on reducing or stopping treatment. The long-term course of the disease and data regarding outcome, particularly the need for prolonged oral corticosteroid therapy and the development of severe asthma, are somewhat contradictory. A multicentric retrospective study was conducted in an attempt to describe better the initial features and, above all, the later course of CEP in a large homogeneous series of 62 stringently selected patients of whom 46 were followed for more than 1 year. The prevalence of smokers was low (6.5%) and about half of our patients (51.6%) had a previous, and often prolonged, history of asthma. The clinical and roentgenographic features were in keeping with previous studies, but we found that computed tomography could disclose ground glass opacities not detected by X-ray, and that migratory infiltrates before treatment were more frequent (25.5%) than reported previously. The bronchoalveolar lavage cellular count always showed a striking eosinophilic pattern, thus allowing distinction between CEP and cryptogenic organizing pneumonia, both syndromes sharing many common clinical and imaging features. About two-thirds of the patients (68%) showed a ventilatory defect in pulmonary function tests, with about one-half of these presenting with an obstructive pattern, sometimes without previous asthma. Along with the submucosal eosinophilic infiltration noted in 2 patients without ventilatory defect, this is strong evidence to confirm that CEP is not only an alveolointerstitial but also an airway disease. The dramatic response to oral corticosteroid therapy was observed in all treated patients. Although only 1

  16. Acute Idiopathic Scrotal Edema

    Directory of Open Access Journals (Sweden)

    Micheál Breen

    2013-01-01

    Full Text Available We report a case of acute idiopathic scrotal edema (AISE in a 4-year-old boy who presented with acute scrotal pain and erythema. The clinical features, ultrasound appearance, and natural history of this rare diagnosis are reviewed. In this report, we highlight the importance of good ultrasound technique in differentiating the etiology of the acute scrotum and demonstrate the color Doppler “Fountain Sign” that is highly suggestive of AISE.

  17. Idiopathic Brachial Neuritis

    OpenAIRE

    Gonzalez-Alegre, Pedro; Recober, Ana; Kelkar, Praful

    2002-01-01

    Idiopathic brachial neuritis is a well defined clinical condition that most commonly affects young adults, seen usually by primary care physicians, neurologists or orthopaedic surgeons. Its onset is characterized by acute, aching shoulder pain lasting a few days to weeks, followed by progressive shoulder girdle and upper extremity weakness and atrophy, with a slow but progressive recovery of motor function over 6 to 18 months. Its early recognition can help avoid unnecessary and potentially h...

  18. 荨麻疹外周血细胞因子表达模式研究进展%Cytokine expression patterns in peripheral blood of patients with urticaria

    Institute of Scientific and Technical Information of China (English)

    陈奇权; 郝飞

    2016-01-01

    Urticaria has various subtypes,and their mechanisms are different from each other.Cytokine levels in peripheral blood fully reflect the degree of inflammation and types of effector cells implicated in the pathogenesis of urticaria.High expressions of T helper type 2 (Th2) cytokines and numerous pro-inflammatory cytokines suggest that acute urticaria is an allergic disease and an inflammatory disease respectively.The expression levels of cytokines in peripheral blood of patients with chronic urticaria hint that Th1/Th2 imbalance,activation of Th17,Tc17 and Th9 cells,massive release of pro-inflammatory factors and chemokines,and noninflammatory and non-immunological systems are all involved in the occurrence and development of chronic urticaria.It has been gradually revealed that cytokine expression patterns differ among chronic urticaria patients with different response to autologous serum skin test.In addition,expressions of some cytokines are also abnormal in patients with inducible urticaria,such as cold urticaria,delayed pressure urticaria,etc.%荨麻疹的类型多样,发病机制也各不相同.细胞因子在外周血中的水平充分反应疾病的炎症水平及发病机制所牵涉的效应细胞.在急性荨麻疹中,Th2系列因子的高表达证实了急性荨麻疹的过敏性,大量促炎症因子的高表达反映出急性荨麻疹的炎症性.在慢性荨麻疹中,透过外周血细胞因子的表达水平可以发现,不仅Th1/Th2失衡、还有Th17、Tc17和Th9的活化、促炎症因子和趋化因子的广泛激活和非炎症非免疫系统等均参与了慢性荨麻疹的发生发展过程.自体血清皮肤试验不同反应性的慢性荨麻疹的细胞因子表达模式差异也逐渐被证实.除此之外,可诱导性荨麻疹,如寒冷性荨麻疹和延迟压力性荨麻疹等在部分细胞因子表达上也存在差异.

  19. Idiopathic granulomatous mastitis

    International Nuclear Information System (INIS)

    Objective was to discuss the clinical and radiological features and treatment approaches in 14 patients diagnosed with idiopathic granulomatous mastitis (GM). We retrospectively evaluated the clinical features, radiological findings and treatment approaches in 14 patients with idiopathic GM in the General Surgery Department, Gulhane School of Medicine, Ankara, Turkey between April 2000 and June 2006. The mean age of the patients was 34.5 years (range 27-41 years). The complaints at admission were a mass in the breast in 7 (50%) patients, an abscess and a mass in 6 (42.8%) and a skin fisculain one (7.2%). Granulomatous mastitis was unilateral in all subjects (on the right in 5 patients and on the left in 9). All of the patients underwent ultrasonographic evaluation. Mammography was performed in 8 and magnetic resonance imaging in 5 patients. Seven patients (50%) were suspected to have breast carcinoma according radiological findings. We performed the large excision in 11, incisional biopsy plus abscess drainage in one, and incisional biopsy plus abscess drainage plus medical treatment (prednisolone, methotrexate) in 2 patients. Due to the development of abscess after 9 months, drainage and large excision were performed in one patient who received medical treatment. Idiopathic GM is a disease that generally affects young women of reproductive age and may be mistaken for breast carcinoma in clinical and radiological evaluations. The gold standard for the diagnosis is histopathologic evaluation. (author)

  20. 凉血解毒饮2号治疗慢性荨麻疹56例临床观察%Clinical observations of 56 cases of urticaria Treated with Liang Xue Jie Du Yin No.2

    Institute of Scientific and Technical Information of China (English)

    刘海杰; 史新明; 冯军; 梅淑清; 彭东洲

    2012-01-01

    Objective To investigate the clinical efficacy and treatment mechanism of Liang Xue Jie Du Yin No.2 (Cooling and Detoxifying Herb) in the treatment of chronic urticaria- Methods One hundred and twelve patients with chronic urticaria were enrolled in this study, 56 of which were treated with Liang Xue Jie Du Yin No.2 (the study group), and 56 were treated with loratadine (the control group). Results The symptoms of urticaria were significantly alleviated in the study group, compared with the control group (P<0.05). Conclusion Liang Xue Jie Du Yin No.2 is effective and safe for treating chronic urticaria, which is worthy of extension in clinical practice.%目的 探讨凉血解毒饮2号治疗慢性荨麻疹的临床疗效与治疗机制.方法 本研究共112例慢性荨麻疹患者,其中56例作为治疗组采用凉血解毒饮2号治疗,56例作为对照组口服氯雷他定片,两组进行临床对照观察.结果 与对照组相比,治疗组经凉血解毒饮2号治疗后荨麻疹症状有明显减轻,差异有统计学意义(P<0.05).结论 凉血解毒饮2号治疗慢性荨麻疹有效、安全,适于推广应用.

  1. Idiopathic pleuroparenchymal fibroelastosis: description of a novel clinicopathologic entity.

    Science.gov (United States)

    Frankel, Stephen K; Cool, Carlyne D; Lynch, David A; Brown, Kevin K

    2004-12-01

    Between 1996 and 2001, we identified five cases of a unique idiopathic pleuroparenchymal lung disease characterized by a clinical presentation suggestive of a chronic idiopathic interstitial pneumonia, marked pleural and parenchymal radiographic involvement with an upper lobe predominance, and surgical lung biopsy findings that did not fit with any of the currently defined interstitial pneumonias. The pathologic findings included the following: (1) intense fibrosis of the visceral pleura; (2) prominent, homogenous, subpleural fibroelastosis; (3) sparing of the parenchyma distant from the pleura; (4) mild, patchy lymphoplasmacytic infiltrates; and (5) small numbers of fibroblastic foci present at the leading edge of the fibrosis. In this report, we characterize the clinical, radiographic, physiologic, and pathologic findings of this entity, which we term idiopathic pleuroparenchymal fibroelastosis. PMID:15596706

  2. Moving Flash-fire Cupping Along the Channels―A New Method for Treating Urticaria

    Institute of Scientific and Technical Information of China (English)

    王巍

    2004-01-01

    @@ Urticaria is a skin disease, which is commonly encountered in children as well as in adults. It is a localized or systemic transient mucocutaneous edematous reaction due to allergic pathologic changes.

  3. Acute urticaria and angioedema caused by horse-chestnut (aesculus hippocastanum) ingestion: a case report

    OpenAIRE

    Akinci, Emine; OĞUZTÜRK, Oğuzhan; Coşkun, Figen

    2012-01-01

    Acute urticaria and angioedema, which can develop due to various causes, are common life threatening condition seen in emergency departments (EDs). The literature includes reports of angioedema cases developing after contacting various plants and seeds. We present the case of a 47-year-old male patient who developed acute urticaria and angioedema after eating horse-chestnut (aesculus hippocastanum). The patient presented to the ED with redness and irritation spread around the body and swellin...

  4. Atypical acute urticaria in children and its relationship with urticarial vasculitis

    OpenAIRE

    ARSLAN, Zafer; ÖZMEN, Serap; SÜRMELİ, Sara; ARDA, Nilüfer

    2011-01-01

    In childhood, urticarial lesions are sometimes associated with purpura. This form might be identified as atypical, and may also be related to urticarial vasculitis (UV). The aim of this study was to assess the clinicopathologic characteristics of UV in children with atypical urticaria. Materials and methods: Fifteen children with atypical urticaria were evaluated with medical history, physical examination, and laboratory and skin punch biopsy findings. Results: Infections were detected as...

  5. Delayed onset urticaria in depressive patients with bupropion prescription: a nationwide population-based study.

    Directory of Open Access Journals (Sweden)

    Li-Yu Hu

    Full Text Available BACKGROUND: Bupropion, which is widely used in patients with depressive disorder, may cause allergic reactions. However, the real prevalence of these side effects may be overlooked and underreported due to the delayed onset phenomenon. OBJECTIVE: This study aimed to estimate the real incidence of bupropion-induced urticaria and clarify the delayed onset phenomenon. METHODS: We conducted a nationwide cohort study between 2000 and 2009 using Taiwan's National Health Insurance Dataset. Among 65,988 patients with depressive disorders, we identified new users of bupropion with depressive disorders (bupropion cohort, n = 2,839 and matched them at a ratio of 1:4 regarding age and sex (non-bupropion matched cohort, n = 11,356. The risk of urticaria was compared between the two cohorts. RESULTS: The risk of urticaria occurrence was higher in bupropion users than in matched controls within 4 weeks of starting the medication (risk ratio 1.81; 95% confidence interval 1.28-2.54; p = 0.001. The occurrence of urticaria in the bupropion cohort were more frequent on Days 15-28 than Day 1-14 (p = 0.002. Cox proportional hazards model showed that a history of urticaria was an independent risk factor for developing bupropion-induced urticaria. CONCLUSIONS: Of the antidepressants, bupropion may pose a higher risk of drug-induced urticaria, and this condition might be ignored due to the delayed onset phenomenon. Depressive patients with a history of urticaria are at higher risk of the adverse drug reaction. This study emphasizes the need for increased clinical awareness of this adverse outcome to bupropion use.

  6. Idiopathic fistula-in-ano

    Institute of Scientific and Technical Information of China (English)

    Sherief Shawki; Steven D Wexner

    2011-01-01

    Fistula-in-ano is the most common form of perineal sep- sis. Typically, a fistula includes an internal opening, a track, and an external opening. The external opening might acutely appear following infection and/or an abs-cess, or more insiduously in a chronic manner. Mana-gement includes control of infection, assessment of the fistulous track in relation to the anal sphincter muscle, and finally, definitive treatment of the fistula. Fistulo-tomy was the most commonly used mode of manage-ment, but concerns about post-fistulotomy incontinence prompted the use of sphincter preserving techniques such as advancement flaps, fibrin glue, collagen fistula plug, ligation of the intersphincteric fistula track, and stem cells. Many descriptive and comparative studies have evaluated these different techniques with variable outcomes. The lack of consistent results, level I eviden-ce, or long-term follow-up, as well as the heterogeneity of fistula pathology has prevented a definitive treatment algorithm. This article will review the most commonly available modalities and techniques for managing idio-pathic fistula-in-ano.

  7. [Urticaria pigmentosa: two different clinical presentations in pediatric patients].

    Science.gov (United States)

    Spada, Julieta; Lequio, Mariana; Pyke, María de los Ángeles; Hernández, Marisa; Chouela, Edgardo

    2011-08-01

    Urticaria pigmentosa (UP) is the most frequent clinical feature of cutaneous mastocytosis. It usually begins in a bimodal way: a peak of incidence from birth to the age of 3 and the other one between 2(nd) and 6(th) decades of life. Darier's sign is constant over the affected skin without affecting the surrounding skin. When UP starts early, it has a good prognosis disappearing into adolescence, while late onset is often associated with persistent or systemic involvement. This article reports two cases of UP, one with the classic description of the disease and the other with an unusual clinical presentation, prompting the pediatrician to incorporate both forms as different manifestations of the same entity.

  8. Premature subclinical atherosclerosis in children and young adults with juvenile idiopathic arthritis. A review considering preventive measures

    DEFF Research Database (Denmark)

    Bohr, Anna-Helene; Fuhlbrigge, Robert C; Pedersen, Freddy Karup;

    2016-01-01

    Many studies show that Juvenile Idiopathic Arthritis (JIA) is associated with early subclinical signs of atherosclerosis. Chronic inflammation per se may be an important driver but other known risk factors, such as dyslipidemia, hypertension, insulin insensitivity, a physically inactive lifestyle...

  9. [Idiopathic progressive subglottic stenosis].

    Science.gov (United States)

    Sittel, C

    2014-07-01

    Idiopathic subglottic stenosis is causing a narrowing of the central airway at the laryngotracheal junction. Etiology is remaining unclear at large. There is a marked preponderance for women in the fertile age, an association to estrogene or progesterone metabolism remains doubtful. Suggested treatment varies from repeated endoscopic interventions to primary open resection. Therapy selection in this heterogeneous condition should be based on the individual patient situation as well as surgeon's expertise. This complex entity is prone to complications and should preferably be managed in a referral center.

  10. Idiopathic intracranial hypertension

    DEFF Research Database (Denmark)

    Yri, Hanne M; Jensen, Rigmor H

    2015-01-01

    AIMS: The aims of this article are to characterize the headache in idiopathic intracranial hypertension (IIH) and to field-test the ICHD diagnostic criteria for headache attributed to IIH. MATERIALS AND METHODS: We included 44 patients with new-onset IIH. Thirty-four patients with suspected but u...... tinnitus may suggest intracranial hypertension. Based on data from a well-defined IIH cohort, we propose a revision of the ICDH-3 beta diagnostic criteria with improved clinical applicability and increased sensitivity and specificity....

  11. A retrospective study of 72 cases diagnosed with idiopathic trigeminal neuralgia in indian populace

    OpenAIRE

    Yadav, Sunil; Mittal, Hitesh-Chander; Sachdeva, Akash; Verma, Ajay; Dhupar, Vikas; Dhupar, Anita

    2015-01-01

    Context: Trigeminal neuralgia is as a chronic, debilitating condition, which can have a major impact on quality of life. There are few reports of trigeminal neuralgia in oriental populations. Objectives: To evaluate the retrospective data of the patients diagnosed with idiopathic trigeminal neuralgia and to understanding the disorder in the Indian populace. Methods: The retrospective data of 72 patients with typical idiopathic trigeminal neuralgia regarding age of onset, gender, site of invol...

  12. 老年特发性便秘患者直肠肛门动力学变化及心理评价%CHANGES IN ANORECTAL DYNAMICS AND PSYCHOLOGICAL EVALUATION IN ELDERLY PATIENTS WITH CHRONIC IDIOPATHIC CONSTIPATION

    Institute of Scientific and Technical Information of China (English)

    高利利; 吴本俨; 邵勇; 李园

    2001-01-01

    To investigate what anorectal dynamic abnormality and psychological factors exits in elderly patients with chronic idiopathic constipation (CIC), study was performed in 59 elderly patients with CIC and 36 elderly healthy subjects(EHS).Anorectal pressure was measured with Medtronic PcPolygraf,which was a water perfused catheter system.All subjests completed a self-rated inventory assessing psychological distress including depression(SDS) and anxiety(SAS). Maximal squeezing pressure and the changes in anal pressure during defecation in elderly patients(EP) with CIC were lower than those in EHS(P<0.05).The rectal lowest volume of sensory threshold(RLSTV),the rectal threshold volume for desire to defecate and the rectal maximal volume of tolerance were higher in EP than those in EHS(P<0.05). There were 28(47.5%) of EP who had increasing anal pressure when defecation was stimulated.The scores of SDS and SAS were higher in EP than those in EHS(P<0.05). It suggested that elderly patients with CIC may be associated with lower sensitivity,higher tolerance and discoordination of annorectum during defecation.Both depression and anxiety were associated with abnormal dynamics in EP with CIC.%探讨老年慢性特发性便秘(CIC)患者直肠肛门运动功能变化及其与心理因素的关系。采用瑞典Medtronic公司生产的8通道水灌注式消化道压力检测系统、Zung抑郁自评量表(SDS)及焦虑自评量表(SAS)对59例患者及36例老年对照者进行直肠肛门压力测定及心理状况分析。结果发现,老年CIC患者最大缩榨压、模拟排便时肛管压力变化低于老年对照组(P<0.05),直肠初始感觉阈值、排便阈值和最大耐受容量均高于老年对照组(P<0.05),并有28例(47.5%)CIC患者模拟排便时出现肛管压力异常升高。老年CIC患者SDS、SAS标准总分均明显高于老年对照组(P<0.05)。说明老年CIC患者与直肠低敏感、高耐受及排便

  13. Adolescent Idiopathic Scoliosis

    Science.gov (United States)

    Choudhry, Muhammad Naghman; Ahmad, Zafar; Verma, Rajat

    2016-01-01

    Background: Scoliosis refers to deviation of spine greater than 10 degrees in the coronal plane. Idiopathic Scoliosis is the most common spinal deformity that develops in otherwise healthy children. The sub types of scoliosis are based on the age of the child at presentation. Adolescent idiopathic scoliosis (AIS) by definition occurs in children over the age of 10 years until skeletal maturity. Objective: The objective of this review is to outline the features of AIS to allow the physician to recognise this condition and commence early treatment, thereby optimizing patient outcome. Method: A thorough literature search was performed using available databases, including Pubmed and Embase, to cover important research published covering AIS. Conclusion: AIS results in higher incidence of back pain and discontent with body image. Curves greater than 50 degrees in thoracic region and greater than 30 degrees in lumbar region progress at a rate of 0.5 to 1 degree per year into adulthood. Curves greater than 60 degrees can lead to pulmonary functional deficit. Therefore once the disease is recognized, effective treatment should be instituted to address the deformity and prevention of its long-term sequelae. PMID:27347243

  14. 血清IL-15、IL-21、IgE水平与荨麻疹的关系%Relationship between serum levels of interleukin-15,interleukin-21,IgE and the pathogenesis of urticaria

    Institute of Scientific and Technical Information of China (English)

    朱慧兰; 郭庆; 李润祥; 林路洋; 李振洁; 梁碧华; 龚业青; 张锡宝

    2009-01-01

    目的探讨患者血清IL-15、IL-21、IgE与荨麻疹发病机制的关系.方法用ELISA法检测急性荨麻疹(AU)、慢性荨麻疹(CU)患者及健康献血者的血清IL-15、IL-21、IgE含量,分析其与病情、病程的关系.结果AU患者血清IL-15、IL-21水平[(1.59±0.73)、(38.30±24.59)pg/mL]均低于健康对照组[(4.98±4.46)、(64.94±25.37)pg/mL],而IgE高于对照组[(91.28±41.00),(58.68±18.29)IU/mL](P<0.01).CU患者血清IL-15、IL-21水平[(2.35±0.87)、(47.67±29.57)pg/mL]均低于对照组,而血清IgE[(76.65+38.49)IU/mL]高于对照组(P<0.01,P<0.05,P<0.05).AU、CU患者之间血清IL-15、IL-21、IgE水平组间差异无统计学意义(P>0.05).AU患者IL-15与IL-21呈正相关性(P<0.05)、与病程呈负相关性(P<0.05);CU患者IgE与IL-21、IL-15均呈负相关性(P<0.01),IL-21与症状评分呈负相关性(P<0.05).结论血清IL-21、IL-15水平下降后对IgE分泌抑制下降可能与荨麻疹发病机制有关.%Objective To study the relationship of serum levels of interleukin(IL)-15,IL-21 and IgE to the pathogenesis of urticaria.MethodsSerum levels of IL-15,IL-21 and IgE were detected with ELISA in 30 patients with chronic urticaria.30 patients with acute urticria and 30 sex-and age-matched normal human controls.Moreover,symptom scores and clinical course of patients were assessed.Results The serum levels of IL-15 and IL-21 were 1.59±0.73 pg/mL and 38.30±24.59 pg/mL respectively in patients with acute urticaria.2.35±0.87pg/mL and 47.67±29.57pg/mL respectively in those with chronic urticaria,4.98±4.46pg/mL and 64.94±25.37pg/mL respectively in the normal controls;the differenee was significant between these patients and controls.A significant increase was noted in the level of IgE in patients with acute urticaria and those with chronic urticaria compared with the controls(91.28±41.00 IU/mL vs 58.68±18.29IU/mL.76.65±38.49IU/mL vs 58.68±18.29IU/mL,P<0.01,0.05respectively).No significant difierence

  15. Differential Diagnosis in Idiopathic Granulomatous Mastitis and Tuberculous Mastitis

    OpenAIRE

    Seo, Hee Ri Na; Na, Kuk Young; Yim, Hyun Ee; Kim, Tae Hee; Kang, Doo Kyoung; Oh, Ki Keun; Kang, Seok Yun; An, Young-Sil; Chun, Mison; Kim, Woojae; Park, Rae Woong; Jung, Yong Sik; Kim, Ku Sang

    2012-01-01

    Purpose Idiopathic granulomatous mastitis (IGM) is a rare chronic inflammatory disease of unknown etiology. The diagnosis of IGM requires that other granulomatous lesions in the breast be excluded. Tuberculous mastitis (TM) is also an uncommon disease that is often difficult to differentiate from IGM. The purpose of this study is to develop a new algorithm for the differential diagnosis and treatment of IGM and TM. Methods Medical records of 68 patients (58 with IGM and 10 with TM) between Ju...

  16. Clinical case: Differential diagnosis of idiopathic pulmonary fibrosis

    OpenAIRE

    Cordeiro, Carlos Robalo; Alfaro, Tiago M.; Freitas, Sara

    2013-01-01

    Background The diagnosis of idiopathic pulmonary fibrosis can be quite challenging, even after careful clinical evaluation, imaging and pathological tests. This case report intends to demonstrate and discuss these difficulties, especially those concerning the differential diagnosis with chronic hypersensitivity pneumonitis. Case presentation A 58-year-old white male presented with shortness of breath, dry cough, fatigue and weight loss for two months. He was a former smoker and had regular ex...

  17. Guía Argentina de urticaria y angioedema

    Directory of Open Access Journals (Sweden)

    Jorge Máspero

    2014-08-01

    Full Text Available Se actualiza el diagnóstico de la urticaria crónica (UC y los conceptos, definiciones y sugerencias basados en la evidencia para su tratamiento. La urticaria ocurre en al menos 20% de la población en algún momento de la vida. Su etiología difiere en la forma aguda (menos de 6 semanas, y en la crónica. No es posible pronosticar si las formas agudas evolucionarán a UC, ya que todas son agudas al comienzo. La UC ocurre como espontánea (UCE o inducible (UCI. El diagnóstico es sencillo, pero incluye un minucioso estudio para descartar diagnósticos diferenciales; para UCI son útiles las pruebas de provocación en la caracterización y manejo. Los estudios complementarios se deben limitar y orientar según sospecha clínica. El tratamiento se divide en tres enfoques: evitación, eliminación o tratamiento del estímulo desencadenante o de la causa, y tratamiento farmacológico. Recientemente éste se modificó, con empleo de antihistamínicos de segunda generación como primera línea y aumento de dosis de antihistamínicos H1 no sedantes, hasta 4 veces, como segunda línea. Los antihistamínicos son fundamentales para tratar la UC; sin embargo, un 40% de los pacientes no logra un buen control pese al aumento de dosis y requiere otro medicamento adicional. La evidencia más reciente considera que un grupo de fármacos puede utilizarse como tercera línea en estos casos, para mejorar la calidad de vida y limitar la toxicidad por el uso frecuente o crónico de esteroides sistémicos. Se recomiendan para esta tercera línea solo 3 fármacos: omalizumab, ciclosporina A o antileucotrienos.

  18. Idiopathic Normal Pressure Hydrocephalus

    Directory of Open Access Journals (Sweden)

    Basant R. Nassar BS

    2016-04-01

    Full Text Available Idiopathic normal pressure hydrocephalus (iNPH is a potentially reversible neurodegenerative disease commonly characterized by a triad of dementia, gait, and urinary disturbance. Advancements in diagnosis and treatment have aided in properly identifying and improving symptoms in patients. However, a large proportion of iNPH patients remain either undiagnosed or misdiagnosed. Using PubMed search engine of keywords “normal pressure hydrocephalus,” “diagnosis,” “shunt treatment,” “biomarkers,” “gait disturbances,” “cognitive function,” “neuropsychology,” “imaging,” and “pathogenesis,” articles were obtained for this review. The majority of the articles were retrieved from the past 10 years. The purpose of this review article is to aid general practitioners in further understanding current findings on the pathogenesis, diagnosis, and treatment of iNPH.

  19. Idiopathic Bilateral Bloody Tearing

    Directory of Open Access Journals (Sweden)

    Emrullah Beyazyıldız

    2015-01-01

    Full Text Available Bloody tear is a rare and distinct clinic phenomenon. We report a case presenting with the complaint of recurrent episodes of bilateral bloody tearing. A 16-year-old girl presented to our clinic with complaint of bloody tearing in both eyes for 3 months. Bloody tearing was not associated with her menses. A blood-stained discharge from the punctum was not observed during the compression of both nasolacrimal ducts. Nasolacrimal passage was not obstructed. Imaging studies such as dacryocystography and gradient-echo magnetic resonance imaging (MRI of nasolacrimal canal were normal. Intranasal endoscopic evaluation was normal. We collected samples from bloody tears two times and pathological examination was performed. Pathological analysis showed lots of squamous cells and no endometrial cells; dysplastic cells were found. Further evaluations for underlying causes were unremarkable. No abnormalities were found in ophthalmologic, radiologic, and pathologic investigations. This condition is likely a rare abnormality and the least recognized aetiology for the idiopathic phenomenon.

  20. ADHD in idiopathic epilepsy

    Directory of Open Access Journals (Sweden)

    Marcos H. C. Duran

    2014-01-01

    Full Text Available Our aim was to clarify the correlation of attention deficit hyperactivity disorder (ADHD with epilepsy and behavior problems. This was a cross-sectional study. Sixty children with idiopathic epilepsy were interviewed using the MTA-SNAP IV Teacher and Parent Rating Scale, Vineland Adaptive Behavior Scales and Conners’ Rating Scales. We used the chi-square test to analyze the correlation of epilepsy variables in patients with and without ADHD with a significance level of 0.05. Eight patients had ADHD symptoms (13%, seven had the inattentive ADHD subtype and only three had behavioral problems. When epileptic patients with and without ADHD symptoms were compared we found no significant difference in regard to epilepsy variables. All patients were controlled and 43% were either without AED or undergoing withdrawal. Our study revealed a low comorbidity of ADHD symptoms and epilepsy due to low interference of seizures and drug treatment on the comorbid condition.

  1. Idiopathic thrombocytopenic purpura

    Directory of Open Access Journals (Sweden)

    L Kayal

    2014-01-01

    Full Text Available Idiopathic thrombocytopenic purpura (ITP is defined as a hematologic disorder, characterized by isolated thrombocytopenia without a clinically apparent cause. The major causes of accelerated platelet consumption include immune thrombocytopenia, decreased bone marrow production, and increased splenic sequestration. The clinical presentation may be acute with severe bleeding, or insidious with slow development with mild or no symptoms. The initial laboratory tests useful at the first visit to predict future diagnosis were erythrocyte count, leukocyte count, anti-glycoprotein IIb/IIIa antibodies, reticulated platelets, plasma thrombopoietin level. Treatment should be restricted to those patients with moderate or severe thrombocytopenia who are bleeding or at risk of bleeding. We present a case report on ITP with clinical presentation, diagnosis and management.

  2. Enhancement of mite antigen-induced histamine release by deuterium oxide from leucocytes of chronic urticarial patients

    Energy Technology Data Exchange (ETDEWEB)

    Numata, T.; Yamamoto, S.; Yamura, T.

    1981-09-01

    The mite antigen-induced histamine release from leucocytes of chronic urticarial patients was enhanced in the presence of deuterium oxide, which stabilizes microtubules. This enhancing effect of deuterium oxide on the histamine release from leucocytes may provide a useful means for the detection of allergens in vitro in chronic urticaria.

  3. Idiopathic pulmonary fibrosis: treatment update.

    LENUS (Irish Health Repository)

    O'Connell, Oisin J

    2011-11-01

    Idiopathic pulmonary fibrosis (IPF) is the most common of the idiopathic interstitial pneumonias. Despite multiple recent clinical trials, there is no strong evidence supporting a survival advantage for any agent in the management of patients with IPF. The limited effectiveness of current treatment regimes has led to a search for novel therapies including antifibrotic strategies. This article reviews the evidence supporting the treatments currently used in the management of IPF.

  4. Managing juvenile idiopathic arthritis-associated uveitis.

    Science.gov (United States)

    Hawkins, Madeleine J; Dick, Andrew D; Lee, Richard J W; Ramanan, Athimalaipet V; Carreño, Ester; Guly, Catherine M; Ross, Adam H

    2016-01-01

    Bilateral chronic anterior uveitis is an extra-articular feature of juvenile idiopathic arthritis. Although figures vary, uveitis occurs in approximately 11%-13% of patients with this disease and is most commonly associated with the female gender, oligoarthritis, and presence of antinuclear antibodies. The disease has an insidious onset and is often asymptomatic. Managing patients with juvenile idiopathic arthritis-associated uveitis remains challenging as the disease may prove to be refractory to traditional treatment regimens. Stepwise immunomodulatory therapy is indicated, with new biologic drugs being used last in cases of refractory uveitis. Small scale studies and practice have provided the evidence to undertake randomized control trials to evaluate the efficacy, safety, and cost-effectiveness of anti-tumor necrosis factor-α therapies, such as infliximab and adalimumab. These have demonstrated promising results, with further data awaited from ongoing trials for adalimumab (as SYCAMORE and ADJUVITE trials). Lower grade evidence is supporting the use of newer biologics such as rituximab, daclizumab, tocilizumab, and abatacept in those cases refractory to anti-tumor necrosis factor-α therapy.

  5. Acute and subacute idiopathic interstitial pneumonias.

    Science.gov (United States)

    Taniguchi, Hiroyuki; Kondoh, Yasuhiro

    2016-07-01

    Idiopathic interstitial pneumonias (IIPs) may have an acute or subacute presentation, or acute exacerbation may occur in a previously subclinical or unrecognized chronic IIP. Acute or subacute IIPs include acute interstitial pneumonia (AIP), cryptogenic organizing pneumonia (COP), nonspecific interstitial pneumonia (NSIP), acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF) and AE-NSIP. Interstitial lung diseases (ILDs) including connective tissue disease (CTD) associated ILD, hypersensitivity pneumonitis, acute eosinophilic pneumonia, drug-induced lung disease and diffuse alveolar haemorrhage need to be differentiated from acute and subacute IIPs. Despite the severe lack of randomized controlled trials for the treatment of acute and subacute IIPs, the mainstream treatment remains corticosteroid therapy. Other potential therapies reported in the literature include corticosteroids and immunosuppression, antibiotics, anticoagulants, neutrophil elastase inhibitor, autoantibody-targeted treatment, antifibrotics and hemoperfusion therapy. With regard to mechanical ventilation, patients in recent studies with acute and subacute IIPs have shown better survival than those in previous studies. Therefore, a careful value-laden decision about the indications for endotracheal intubation should be made for each patient. Noninvasive ventilation may be beneficial to reduce ventilator associated pneumonia. PMID:27123874

  6. Systemic-onset juvenile idiopathic arthritis.

    Science.gov (United States)

    Cimaz, Rolando

    2016-09-01

    Systemic-onset juvenile idiopathic arthritis (SoJIA) is a systemic inflammatory disease which has up to now been classified as a category of juvenile idiopathic arthritis. However, in this context, systemic inflammation has been associated with dysregulation of the innate immune system, suggesting that it may rather be part of the spectrum of autoinflammatory disorders. The disease is in fact unique with regard to the other JIA categories, in terms of clinical manifestations, prognosis, and response to conventional immunosuppressant therapies. It is characterized clinically by fever, lymphadenopathy, arthritis, rash, and serositis. IL-1 and IL-6 play a major role in the pathogenesis of SoJIA, and treatment with IL-1 and IL-6 inhibitors has shown to be highly effective. However, complications of SoJIA, including macrophage activation syndrome, limitations in functional outcome by arthritis and long-term damage from chronic inflammation continue to be a major issue in patients' care. Recent advances on the pathogenesis and treatment have revolutionized the care and prognosis of this potentially life-threatening pediatric condition.

  7. Managing comorbidities in idiopathic pulmonary fibrosis

    Directory of Open Access Journals (Sweden)

    Fulton BG

    2015-09-01

    Full Text Available Blair G Fulton,1 Christopher J Ryerson1,2 1Department of Medicine, 2Centre for Heart Lung Innovation, University of British Columbia, Vancouver, BC, Canada Abstract: Major risk factors for idiopathic pulmonary fibrosis (IPF include older age and a history of smoking, which predispose to several pulmonary and extra-pulmonary diseases. IPF can be associated with additional comorbidities through other mechanisms as either a cause or a consequence of these diseases. We review the literature regarding the management of common pulmonary and extra-pulmonary comorbidities, including chronic obstructive pulmonary disease, lung cancer, pulmonary hypertension, venous thromboembolism, sleep-disordered breathing, gastroesophageal reflux disease, coronary artery disease, depression and anxiety, and deconditioning. Recent studies have provided some guidance on the management of these diseases in IPF; however, most treatment recommendations are extrapolated from studies of non-IPF patients. Additional studies are required to more accurately determine the clinical features of these comorbidities in patients with IPF and to evaluate conventional treatments and management strategies that are beneficial in non-IPF populations. Keywords: interstitial lung disease, management, idiopathic pulmonary fibrosis, comorbidities

  8. Occupational contact urticaria caused by food - a systematic clinical review.

    Science.gov (United States)

    Lukács, Judit; Schliemann, Sibylle; Elsner, Peter

    2016-10-01

    Food industry workers are at increased risk for occupational contact urticaria (CU). There are many foodstuffs that have been reported to cause occupational CU, including seafood, meat, vegetables, and fruits. The aim of this review is to summarize all reported occupational cases of CU in the food industry. This is a systematic review based on a MEDLINE search of articles in English and German and a manual search, between 1990 and 2014, to summarize the case reports and case series of occupational CU in the food industry. Many different foodstuffs have been implicated in CU. Occupational CU has been reported in many different occupations, mostly in individuals dealing with seafood, meat, vegetables, and fruits, such as chefs, cooks, bakers, butchers, slaughterhouse workers, and fish-factory workers. Foodstuffs that commonly induce occupational protein contact dermatitis include fish, seafood, meats, vegetables, and fruits. Food handlers may acquire CU resulting from occupational exposures. The prognosis varies widely. The diagnosis of immunological CU is based on the clinical history and on a positive prick test with the suspected substance and/or measurement of specific IgE. PMID:27425004

  9. Cardiac manifestations of idiopathic pulmonary fibrosis.

    Science.gov (United States)

    Agrawal, Abhinav; Verma, Isha; Shah, Varun; Agarwal, Abhishek; Sikachi, Rutuja R

    2016-05-01

    Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive, parenchymal disease of the lung with an estimated prevalence of 14-43 per 100,000. Patient usually presents with coughing and exertional dyspnea, which can lead to acute respiratory failure. IPF has been associated with various co-morbidities such as lung cancer, emphysema, obstructive sleep apnea (OSA), GERD and multiple cardiovascular consequences. The cardiovascular manifestations of IPF include pulmonary hypertension, heart failure, coronary artery disease, cardiac arrhythmias & cardiac manifestations of drugs used to treat IPF. This review will outline evidence of the association between IPF and cardiovascular conditions and attempt to provide insights into the underlying pathophysiology. We also discuss the impact of these cardiovascular diseases on patients with IPF including increased morbidity and mortality. PMID:27195188

  10. Idiopathic granulomatous mastitis: presentation, investigation and management.

    Science.gov (United States)

    Benson, John R; Dumitru, Dorin

    2016-06-01

    Idiopathic granulomatous mastitis (IGM) is a rare chronic inflammatory condition of the breast which although benign can mimic carcinoma. Establishing a diagnosis can be challenging and requires a high index of suspicion with exclusion of infective and autoimmune breast diseases. IGM is characterized histologically by noncaseating granulomas which are of a lobulo-centric pattern and often associated with microabscess formation. Management of confirmed cases remains controversial with proponents of initial surgical or medical therapies - each has its associated problems which can be worse than the original symptoms of IGM. However, many patients require more than one modality of treatment to completely resolve IGM lesions and careful judgment is necessary to ensure optimal type and sequencing of treatments. PMID:27067146

  11. Genetics Home Reference: idiopathic pulmonary fibrosis

    Science.gov (United States)

    ... idiopathic pulmonary fibrosis. N Engl J Med. 2007 Mar 29;356(13):1317-26. Citation on PubMed ... PJ, Garcia CK. Effect of telomere length on survival in patients with idiopathic pulmonary fibrosis: an observational ...

  12. Adult idiopathic scoliosis: the tethered spine.

    Science.gov (United States)

    Whyte Ferguson, Lucy

    2014-01-01

    This article reports on an observational and treatment study using three case histories to describe common patterns of muscle and fascial asymmetry in adults with idiopathic scoliosis (IS) who have significant scoliotic curvatures that were not surgically corrected and who have chronic pain. Rather than being located in the paraspinal muscles, the myofascial trigger points (TrPs) apparently responsible for the pain were located at some distance from the spine, yet referred pain to locations throughout the thoracolumbar spine. Asymmetries in these muscles appear to tether the spine in such a way that they contribute to scoliotic curvatures. Evaluation also showed that each of these individuals had major ligamentous laxity and this may also have contributed to development of scoliotic curvatures. Treatment focused on release of TrPs found to refer pain into the spine, release of related fascia, and correction of related joint dysfunction. Treatment resulted in substantial relief of longstanding chronic pain. Treatment thus validated the diagnostic hypothesis that myofascial and fascial asymmetries were to some extent responsible for pain in adults with significant scoliotic curvatures. Treatment of these patterns of TrPs and muscle and fascial asymmetries and related joint dysfunction was also effective in relieving pain in each of these individuals after they were injured in auto accidents. Treatment of myofascial TrPs and asymmetrical fascial tension along with treatment of accompanying joint dysfunction is proposed as an effective approach to treating both chronic and acute pain in adults with scoliosis that has not been surgically corrected.

  13. Oral ezatiostat HCl (Telintra®, TLK199 and Idiopathic Chronic Neutropenia (ICN: a case report of complete response of a patient with G-CSF resistant ICN following treatment with ezatiostat, a glutathione S-transferase P1-1 (GSTP1-1 inhibitor

    Directory of Open Access Journals (Sweden)

    Lyons Roger M

    2011-11-01

    Full Text Available Abstract Idiopathic chronic neutropenia (ICN describes a heterogeneous group of hematologic diseases characterized by low circulating neutrophil levels often associated with recurrent fevers, chronic mucosal inflammation, and severe systemic infections. The severity and risk of complications, including serious infections, are inversely proportional to the absolute neutrophil count (ANC, with the greatest problems occurring in patients with an ANC of less than 0.5 × 109/L. This case report describes a 64-year-old female with longstanding rheumatoid arthritis who subsequently developed ICN with frequent episodes of sepsis requiring hospitalization and prolonged courses of antibiotics over a 4-year period. She was treated with granulocyte colony stimulating factors (G-CSF but had a delayed, highly variable, and volatile response. She was enrolled in a clinical trial evaluating the oral investigational agent ezatiostat. Ezatiostat, a glutathione S-transferase P1-1 inhibitor, activates Jun kinase, promoting the growth and maturation of hematopoietic progenitor stem cells. She responded by the end of the first month of treatment with stabilization of her ANC (despite tapering and then stopping G-CSF, clearing of fever, and healing of areas of infection. This ANC response to ezatiostat treatment has now been sustained for over 8 months and continues. These results suggest potential roles for ezatiostat in the treatment of patients with ICN who are not responsive to G-CSF, as an oral therapy alternative, or as an adjunct to G-CSF, and further studies are warranted.

  14. 咪唑斯汀治疗荨麻疹并发过敏性鼻炎的疗效和安全性观察%Therapeutic effect and safety of mizolastine in the treatment of urticaria and allergic rhinitis

    Institute of Scientific and Technical Information of China (English)

    朱宇

    2012-01-01

    目的:观察咪唑斯汀(皿治林)治疗急慢性荨麻疹并发过敏性鼻炎的临床疗效及安全性.方法:选取我院2007年3月-2010年4月收治的120例急、慢性荨麻疹并发过敏性鼻炎患者,随机分为试验组(咪唑斯汀组)和对照组(西替利嗪组)各60例,比较两组患者的治疗效果及不良反应情况.结果:①试验组在用药1h内起效效果明显优于对照组.②试验组总有效率为88.3%,对照组总有效率为76.7%,两组患者总有效率比较差异有统计学意义.急性荨麻疹并发过敏性鼻炎患者中,试验组与对照组差异无统计学意义;慢性荨麻疹并发过敏性鼻炎患者中,试验组与对照组差异有统计学意义.③试验组患者出现轻微口干2例,对照组出现头痛1例,嗜睡3例,口干2例.两组患者不良反应比较差异有统计学意义(P<0.05).④试验组患者的满意度明显高于对照组.结论:咪唑斯汀(皿治林)治疗急慢性荨麻疹并发过敏性鼻炎的效果理想,且不良反应轻微,不嗜睡,临床用药安全性较高.%Objective: To observe the therapeutic effect and safety of mizolastine in the treatment of acute /chronic urticaria with allergic rhinitis. Method: One hundred and twenty cases of acute /chronic urticaria with allergic rhinitis were recruited in our hospital from March 2007 to April 2010, and randomly divided them into observation group (mizolastine treatment group) and control group (cetirizine group), each group consisted of 60 cases. The therapeutic effect and adverse reactions of these two groups were compared. Results: ①The therapeutic effect of the observation group within one hour of treatment was evi dently better than that of the control group. ②The total effective rate of the observation group was 88.3%, and the control group 76.7%. There was a significant difference between the total effective rates of the two groups. There was no a significant difference between the total effective rates of

  15. Male idiopathic oligoasthenoteratozoospermia

    Institute of Scientific and Technical Information of China (English)

    Giorgio Cavallini

    2006-01-01

    Idiopathic oligoasthenoteratozoospermia (iOAT) affects approximately 30% of all infertile men. This mini-review discussed recent data in this field. Age, non-inflammatory functional alterations in post-testicular organs, infective agents (Chlamydia trachomatis, herpes virus and adeno-associated viruses), alterations in gamete genome, mitochondrial alterations, environmental pollutants and "subtle" hormonal alterations are all considered possible causes of iOAT.Increase of reactive oxygen species in tubules and in seminal plasma and of apoptosis are reputed to affect sperm concentration, motility and morphology. iOAT is commonly diagnosed by exclusion, nevertheless spectral traces of the main testicular artery may be used as a diagnostic tool for iOAT. The following can be considered therapies for iOAT: 1) tamoxifen citrate (20 mg/d) + testosterone undecanoate (120 mg/d) (pregnancy rate per couple/month [prcm]:3.8%); 2) folic acid (66 mg/d) + zinc sulfate (5 mg/d); 3) L-carnitine (2 g/d) alone or in combination with acetyl-L-carnitine (1 g/d) (prcm: 2.3%); and 4) both carnitines + one 30 mg cinnoxicam suppository every 4 days (prcm: 8.5%).Alpha-blocking drugs improved sperm concentration but not morphology, motility or pregnancy rate. Tranilast (300 mg/d) increased sperm parameters and pregnancy rates in an initial uncontrolled study. Its efficacy on sperm concentration (but not on sperm motility, morphology or prcm) was confirmed in subsequent published reports. The efficacy of tamoxifen + testosterone undecanoate, tamoxifen alone, and recombinant follicle-stimulating hormone is still a matter for discussion.

  16. Syphilis mimicking idiopathic intracranial hypertension

    DEFF Research Database (Denmark)

    Yri, Hanne; Wegener, Marianne; Jensen, Rigmor

    2011-01-01

    Idiopathic intracranial hypertension (IIH) is a condition of yet unknown aetiology affecting predominantly obese females of childbearing age. IIH is a diagnosis of exclusion as raised cerebrospinal fluid pressure may occur secondary to numerous other medical conditions. An atypical phenotype...... or an atypical disease course should alert the physician to reevaluate a presumed IIH-diagnosis. The authors report a case of a 32-year-old non-obese male with intracranial hypertension, secondary to a syphilitic central nervous system infection, initially misdiagnosed as being idiopathic. Upon relevant...

  17. Successful treatment of idiopathic pulmonary capillaritis with intravenous cyclophosphamide.

    LENUS (Irish Health Repository)

    Flanagan, Frances

    2013-03-01

    Idiopathic pulmonary hemosiderosis (IPH), a subtype of diffuse alveolar hemorrhage is a rare condition, first described by Virchow in 1864. Historically, it manifests in children in the first decade of life with the combination of hemoptysis, iron deficiency anemia, and alveolar infiltrates on chest radiograph. More recently, diffuse alveolar hemorrhage has been classified by the absence or presence of pulmonary capillaritis (PC), the latter carrying a potential for a poorer outcome. While systemic corticosteroids remain the first line treatment option, other immune modulators have been trailed including hydroxychloroquine, azathioprine, 6-mercaptopurine, and cyclophosphamide with varying results. Our case demonstrates for the first time, the successful use of intravenous cyclophosphamide in the management of chronic idiopathic PC.

  18. Cold urticaria patients exhibit normal skin levels of functional mast cells and histamine after tolerance induction

    DEFF Research Database (Denmark)

    Kring Tannert, Line; Stahl Skov, Per; Bjerremann Jensen, Louise;

    2012-01-01

    Cold urticaria is a skin condition characterized by rapid appearance of itchy wheals and occasionally angioedema in response to cold stimulation. Antihistamines do not sufficiently protect all patients from symptoms, even when used in higher than standard doses. In these patients, desensitization...

  19. Purine Bases in Blood Plasma of Patients with Chronic Pulmonary Diseases

    Directory of Open Access Journals (Sweden)

    Larissa E. Muravluyova

    2012-09-01

    Full Text Available The article is focused on the study of purine bases and intermediates of purine catabolism in plasma of patients with chronic obstructive bronchitis and idiopathic interstitial pneumonia. Decrease of adenine and hypoxantine in plasma of patients with idiopathic interstitial pneumonia was registered. Increase of guanine in plasma of patients with chronic obstructive pulmonary disease was established.

  20. Genetics in juvenile idiopathic arthritis

    NARCIS (Netherlands)

    Albers, Heleen Marion

    2015-01-01

    Juvenile idiopathic arthritis (JIA) is a non-common disease in children that can persist into adulthood. JIA is considered to be an auto-immune disease. Genetic factors play a role in the pathogenesis. In a new cohort of JIA patients from North-West European descent genetic candidate gene associatio

  1. Analysis of Parallel and Transverse Visual Cues on the Gait of Individuals with Idiopathic Parkinson's Disease

    Science.gov (United States)

    de Melo Roiz, Roberta; Azevedo Cacho, Enio Walker; Cliquet, Alberto, Jr.; Barasnevicius Quagliato, Elizabeth Maria Aparecida

    2011-01-01

    Idiopathic Parkinson's disease (IPD) has been defined as a chronic progressive neurological disorder with characteristics that generate changes in gait pattern. Several studies have reported that appropriate external influences, such as visual or auditory cues may improve the gait pattern of patients with IPD. Therefore, the objective of this…

  2. Diagnosis and classification of juvenile idiopathic arthritis.

    Science.gov (United States)

    Eisenstein, Eli M; Berkun, Yackov

    2014-01-01

    In recent years, it has become increasingly clear that the term Juvenile Idiopathic Arthritis (JIA) comprises not one disease but several. Moreover, recent studies strongly suggest that some of these clinico-pathophysiologic entities appear to cross current diagnostic categories. The ultimate goal of the JIA classification is to facilitate development of better, more specific therapy for different forms of disease though improved understanding of pathophysiology. The past two decades have witnessed significant advances in treatment and improved outcomes for many children with chronic arthritis. However, understanding of the basic biologic processes underlying these diseases remains far from complete. As a result, even the best biologic agents of today represent "halfway technologies". Because they do not treat fundamental biologic processes, they are inherently expensive, need to be given for a long time in order to ameliorate the adverse effects of chronic inflammation, and do not cure the disease. Pediatric rheumatology is now entering an era in which diagnostic categories may need to change to keep up with discovery. A more precise, biologically based classification is likely to contribute to development of more specific and improved treatments for the various forms of childhood arthritis. In this review, we discuss how genetic, gene expression, and immunologic findings have begun to influence how these diseases are understood and classified.

  3. Idiopathic Inflammatory Myopathies: Clinical Approach and Management.

    Science.gov (United States)

    Malik, Asma; Hayat, Ghazala; Kalia, Junaid S; Guzman, Miguel A

    2016-01-01

    Idiopathic inflammatory myopathies (IIM) are a group of chronic, autoimmune conditions affecting primarily the proximal muscles. The most common types are dermatomyositis (DM), polymyositis (PM), necrotizing autoimmune myopathy (NAM), and sporadic inclusion body myositis (sIBM). Patients typically present with sub-acute to chronic onset of proximal weakness manifested by difficulty with rising from a chair, climbing stairs, lifting objects, and combing hair. They are uniquely identified by their clinical presentation consisting of muscular and extramuscular manifestations. Laboratory investigations, including increased serum creatine kinase (CK) and myositis specific antibodies (MSA) may help in differentiating clinical phenotype and to confirm the diagnosis. However, muscle biopsy remains the gold standard for diagnosis. These disorders are potentially treatable with proper diagnosis and initiation of therapy. Goals of treatment are to eliminate inflammation, restore muscle performance, reduce morbidity, and improve quality of life. This review aims to provide a basic diagnostic approach to patients with suspected IIM, summarize current therapeutic strategies, and provide an insight into future prospective therapies. PMID:27242652

  4. A cohort description and analysis of the effect of gabapentin on idiopathic cough

    OpenAIRE

    Van de Kerkhove, Charlotte; Goeminne, Pieter C; van Bleyenbergh, Pascal; Dupont, Lieven J.

    2012-01-01

    Background Chronic idiopathic cough (known as cough hypersensitivity syndrome) is defined by cough in the absence of an identifiable cause. Gabapentin has been suggested as a treatment but evidence is scarce. The aim of our study was to describe the clinical features of patients with unexplained chronic cough and to investigate the effect of gabapentin (600 mg twice a day for a minimal duration of 4 weeks) in reducing cough symptoms. Methods A patient cohort analysis was performed. Patients w...

  5. Adult idiopathic scoliosis: the tethered spine.

    Science.gov (United States)

    Whyte Ferguson, Lucy

    2014-01-01

    This article reports on an observational and treatment study using three case histories to describe common patterns of muscle and fascial asymmetry in adults with idiopathic scoliosis (IS) who have significant scoliotic curvatures that were not surgically corrected and who have chronic pain. Rather than being located in the paraspinal muscles, the myofascial trigger points (TrPs) apparently responsible for the pain were located at some distance from the spine, yet referred pain to locations throughout the thoracolumbar spine. Asymmetries in these muscles appear to tether the spine in such a way that they contribute to scoliotic curvatures. Evaluation also showed that each of these individuals had major ligamentous laxity and this may also have contributed to development of scoliotic curvatures. Treatment focused on release of TrPs found to refer pain into the spine, release of related fascia, and correction of related joint dysfunction. Treatment resulted in substantial relief of longstanding chronic pain. Treatment thus validated the diagnostic hypothesis that myofascial and fascial asymmetries were to some extent responsible for pain in adults with significant scoliotic curvatures. Treatment of these patterns of TrPs and muscle and fascial asymmetries and related joint dysfunction was also effective in relieving pain in each of these individuals after they were injured in auto accidents. Treatment of myofascial TrPs and asymmetrical fascial tension along with treatment of accompanying joint dysfunction is proposed as an effective approach to treating both chronic and acute pain in adults with scoliosis that has not been surgically corrected. PMID:24411157

  6. [Juvenil idiopathic arthritis. Part 1: diagnosis, pathogenesis and clinical manifestations].

    Science.gov (United States)

    Espada, Graciela

    2009-10-01

    Juvenile idiopathic arthritis is not a single disease and constitutes an heterogeneous group of illnesses or inflammatory disorders. This new nomenclature encompasses different disease categories, each of which has different presentation, clinical signs, symptoms, and outcome. The cause of the disease is still unknown but both environmental and genetic factors seem to be related to its pathogenesis. Is the most common chronic rheumatic disease in children and an important cause of short-term and long-term disability. In this article, clinical manifestation, new classification and approach to diagnosis are reviewed.

  7. Sympathovagal balance analysis in idiopathic postural orthostatic tachycardia syndrome.

    Science.gov (United States)

    Russo, Vincenzo; De Crescenzo, Ilaria; Ammendola, Ernesto; Santangelo, Lucio; Calabrò, Raffaele

    2007-08-01

    The idiopathic postural tachycardia syndrome (POTS) is a complex disorder characterized by chronic orthostatic symptoms and an increase in heart rate within 10 minutes of standing on upright posture, without significant orthostatic hypotension. We describe a case of a 36 year-old patient with POTS, diagnosed by head-up tilt testing. Power spectral analysis of heart rate variability (HRV), performed during the tilt test, revealed the ratio of low and high frequency powers (LF/HF) that increased with the onset of orthostatic intolerance. The increase in LF/HF power ratio may represent sympathetic beta-receptors hyperactivity. Atenolol alleviated his clinical symptoms.

  8. The changing treatment landscape in idiopathic pulmonary fibrosis

    Directory of Open Access Journals (Sweden)

    Ulrich Costabel

    2015-03-01

    Full Text Available Idiopathic pulmonary fibrosis (IPF is a chronic, progressive and irreversible fibrotic disease of the lung that has greatly frustrated clinicians for a long time. The prognosis of IPF (median survival 2–5 years following diagnosis is poorer than that of some cancers and for many years no significant advances were made in its management. However, between 2011 and 2014 a number of pivotal developments were made that have improved the outlook for patients with IPF. Herein, we review this rapidly changing landscape, discussing key events whilst still acknowledging that IPF remains a challenging disease to diagnose and manage.

  9. Effect of Auricular Acupuncture with Low Power Laser on Four Chronic Allergic Dermatoses and Serum IgE Level

    Institute of Scientific and Technical Information of China (English)

    You-hong Hou; Fang Xu; Shao-xi Wu

    2005-01-01

    @@ The objective of the study was to investigate the effectiveness of low power laser irradiating auricular points on four chronic allergic dermatoses including eczema, urticaria, facial cosmetic dermatitis, and atopic dermatitis, and on the changes of serum IgE level.

  10. Resistin in idiopathic inflammatory myopathies

    OpenAIRE

    Filkova, Maria; Hulejova, Hana; Kuncova, Klara; Plestilova, Lenka; Andres Cerezo, Lucie; Mann, Herman; Klein, Martin; Zamecnik, Josef; Gay, Steffen; Vencovsky, Jiri; Senolt, Ladislav

    2012-01-01

    Introduction The purpose of this study was to evaluate and compare the serum levels and local expression of resistin in patients with idiopathic inflammatory myopathies to controls, and to determine the relationship between resistin levels, inflammation and disease activity. Methods Serum resistin levels were determined in 42 patients with inflammatory myopathies and 27 healthy controls. The association among resistin levels, inflammation, global disease activity and muscle strength was exami...

  11. Syphilis mimicking idiopathic intracranial hypertension

    DEFF Research Database (Denmark)

    Yri, Hanne; Wegener, Marianne; Jensen, Rigmor

    2011-01-01

    Idiopathic intracranial hypertension (IIH) is a condition of yet unknown aetiology affecting predominantly obese females of childbearing age. IIH is a diagnosis of exclusion as raised cerebrospinal fluid pressure may occur secondary to numerous other medical conditions. An atypical phenotype or a...... antibiotic treatment, signs and symptoms of elevated intracranial pressure resolved completely. Syphilis is a rare, but very important, differential diagnosis that in this case was clinically indistinguishable from IIH....

  12. Idiopathic epilepsy and school achievement.

    OpenAIRE

    Sturniolo, M G; Galletti, F

    1994-01-01

    Forty one children (20 boys, 21 girls) aged 6-10.8 years (mean age 8.6 years) who were affected with idiopathic epilepsy underwent neuropsychological (Wechsler Intelligence Scale for Children, Bender test) and behavioural assessment (Personality Inventory for Children; this was also used in a matched control group). Further information was obtained by teachers' reports. School underachievement occurred in 25 children (61%). Statistical analysis showed no influence of sex, social background, a...

  13. [Chronic inflammatory demyelinating polyradiculoneuropathy].

    Science.gov (United States)

    Franques, J; Azulay, J-P; Pouget, J; Attarian, S

    2010-06-01

    Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is a demyelinating chronic neuropathy of immune origin whose diagnosis is based upon clinical, biological and electrophysiological data; previously critical to the diagnosis the nerve biopsy is now restricted to the rare situations where accurate diagnosis cannot be reached using these data alone. CIDP are mainly idiopathic, but a few associated diseases must be sought for as they require specific attention. Such associated diseases must particularly be discussed when the manifestations are severe or resistant to immunomodulating or immunosuppressive agents. Indeed, idiopathic CIDP are usually responsive to these treatments. The effectiveness of these treatments is limited by the importance of the secondary axonal loss. The dependence or the resistance may sometimes justify the association of several immunomodulating treatments. A single randomized controlled trial support the use of cytotoxic drugs and none with rituximab.

  14. Gastaut type idiopathic occipital epilepsy

    Directory of Open Access Journals (Sweden)

    I. V. Volkov

    2015-01-01

    Full Text Available Idiopathic occipital epilepsy is a rare epileptic syndrome. Its incidence in a Novosibirsk cohort of patients with idiopathic focal epilepsy is 0.9%. Objective: to present a clinical description of new cases of Gastaut syndrome, the types of its course, and treatment options in these patients. Patients and methods. The study covers 17 cases of Gastaut type idiopathic occipital epilepsy in 13 women and 4 men aged 11–53 years. Results. Among 17 cases we present 4 family cases with the disease. Three generations in 2 families were observed to have epilepsy, including Gastaut syndrome concurrent with childhood absence epilepsy. The adolescent onset of the disease was seen in most cases. Its main symptoms were focal visual seizures (100%, focal sensory seizures (58.9%, cephalalgia (47.1%, speech disorders (41.2%, and secondarily generalized convulsive seizures (35.3%. According to the frequency of seizures, the investigators identified 5 types of the course: single focal seizures, rare focal seizures with or without convulsions, frequent focal seizures with or without convulsions. The identity of the course of epilepsy was found in familial cases. 76.5% of the patients had a good quality of life: 41.2% of them were untreated while 35.3% were treated; no seizures were noted. 

  15. Therapeutic Effect Observations on Treatment of Urticaria with Acupuncture plus Garlic-partitioned Moxibustion

    Institute of Scientific and Technical Information of China (English)

    GENG Ping; TIAN Yu-hua; LIN Zhao-juan; WANG Gui-fen; WANG Si-you

    2004-01-01

    Forty-six patients with intractable urticaria were treated by acupuncture plus garlic-partitioned moxibustion. The results were compared with those of simple acupuncture in a control group of 30patients. The total effective rate were 91.3%, in the observation group and 73.3%, in the control group. It is showed that acupuncture plus garlic-partitioned moxibustion has a better effect on intractable urticaria than simple acupuncture.%针刺配合隔蒜灸治疗顽固性荨麻疹46例,并与单纯针刺治疗30例对照观察,结果观察组总有效率91.3%;对照组总有效率73.3%.说明针刺配合隔蒜灸较单纯针刺治疗顽固性荨麻疹效果更好.

  16. Acupuncture plus Point-injection for 32 Cases of Obstinate Urticaria

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    In order to observe the therapeutic effects of acupuncture plus point-injection for obstinate urticaria, 64cases of obstinate urticaria were randomly divided into the following two groups. 32 cases in the treatment group were treated with acupuncture at the points of Quchi (LI11), Xuehai (SP10), Zusanli (ST 36), Sanyinjiao (SP6) and Fengchi (GB20) plus point-injection at the points of Zusanli (ST36) and Quchi (LI11). 32 cases in the control group were treated with antihistamines (such as Acrivastine, Cinnarizine or Ranitidine). The results showed that the therapeutic effect in the treatment group was obviously better than that in the control group (P<0.05), with a much lower relapse rate in the former than that in the latter (P<0.01).

  17. Contact urticaria to the MCU-2A/P gas mask.

    Science.gov (United States)

    Elmer, K B; George, R M

    1999-05-01

    A case of contact urticaria to the silicone rubber in the MCU-2A/P gas mask is presented. Contact urticaria is a type I hypersensitivity reaction mediated by immunoglobulin E that usually manifests as localized erythema, edema, pruritus, and urticarial plaques. It can also cause systemic reactions, including anaphylaxis. Allergic reactions to silicone rubber have been increasingly reported and are of importance in medical and military personnel. The implication of such a diagnosis in an active duty military member is significant because the individual cannot be worldwide-qualified. The correct diagnosis of allergic skin reactions to personal protective gear is critical to maintaining a strong fighting force and protecting military personnel from potentially life-threatening allergic reactions.

  18. Correlationship between HLA-DRB1 Alleles and Chonic Urticaria in Guangxi%HLA-DRB1基因与慢性荨麻疹的相关性

    Institute of Scientific and Technical Information of China (English)

    吴易; 蒙金秋; 曹存巍; 何钠; 李菊裳; 梁伶

    2011-01-01

    目的 探讨慢性荨麻疹与HLA-DRB1等位基因的相关性.方法 采用聚合酶链反应-序列特异性引物方法,检测慢性荨麻疹(CU)患者组144例(汉族64例,壮族80例)和正常对照组199例(汉族95例,壮族104例)的HLA-DRB1等位基因频率,使用SPSS 13.0统计软件分析.结果 在检测的16个位点中,DRB1* 12和*1401等位基因频率在汉族患者组与汉族对照组间差异有统计学意义(Pc <0.001,RR=6.715;Pc<0.001,RR=28.776);DRB1*1401等位基因频率在壮族患者组与壮族对照组间差异有统计学意义(Pc=0.002,RR=4.526).DRB1*12等位基因频率在汉族患者组与壮族患者组间比较,差异有统计学意义(Pc<0.001).结论 DRB1* 12和*1401等位基因可能与汉族CU有相关性;DRB1 * 1401等位基因可能与壮族CU有相关性;DRB1基因多态性在汉、壮族间分布有差异.%Objective To investigate the genetic susceptibility of chronic urticaria. The corretationship between HLA-DRBl alleles and chronic urticaria was evaluated. Methods PCR amplification with sequence-specific primers was used to detect HLA-DRBl alleles in 144 chronic urticaria patients (64 cases of Han and 80 cases of Zhuang) ,the results were compared to those of 199 normal controls (95 cases of Han and 104 cases of Zhuang). Results The diffences of frequency of DRB1 * 12, * 1401 alleles in the patient group and the control group in Han were statistically significant ( Pc < 0: 001 ,RR= 6. 715 ; Pc < 0. 001, RR = 28. 776). The difference of the frequency of DRBl * 1401 allele in the patient group and the control group was statistically significant in Zhuang (Pc =0. 002 ,RR =4. 526) . The difference of the frequency of DRB1 * 12 allele in Han and Zhuang patients was statistically significant ( Pc < 0. 001). Conclusion DRB1 * 12, * 1401 alleles may be associated with chronic urticaria in Han people. DRBl * 1401 allele may be associated with chronic urticaria in Zhuang people. There are discrepancy in the

  19. Acute urticaria caused by the injection of goat-derived hyaluronidase

    OpenAIRE

    Kim, Joo-Hee; Choi, Gil-Soon; Ye, Young-Min; Nahm, Dong-Ho; Park, Hae-Sim

    2009-01-01

    Hyaluronidase is a goat testicular protein that hydrolyzes hyaluronic acid, a structural component of the intercellular matrix. It is commonly used as a spreading factor to improve the diffusion of drugs, including local anesthetics and chemotherapeutics. We experienced a 55-yr-old female with generalized urticaria that developed within 1 hr after the epidural injection of hyaluronidase. She had a history of allergic rhinitis, and had suffered from post-herpetic neuralgia and a herniated disc...

  20. Sense of alexithymia in patients with anxiety disorders comorbid with recurrent urticaria

    Directory of Open Access Journals (Sweden)

    Ogłodek EA

    2016-04-01

    Full Text Available Ewa A Ogłodek,1 Anna M Szota,1 Marek J Just,2 Aleksander Araszkiewicz,1 Adam R Szromek3 1Department of Psychiatry, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Toruń, 2Department of General and Endocrine Surgery, Municipal Hospital, Piekary Śląskie, 3Department of Organization and Management, Silesian University of Technology, Gliwice, Poland Aim: Alexithymia is associated with limited cognitive processing of emotions by an individual suffering from recurrent urticaria and alexithymia and makes them focus on somatic manifestations of emotional arousal and on poorly controlled compulsive reactions to negative stimulation. Alexithymia is considered to be a personality trait, which, along with other factors, predisposes individuals toward developing somatic diseases. The aim of the study was to assess the measurement of alexithymic features in patients with recurrent urticaria and to assess the types of concurrent anxiety disorders and overall anxiety level.Methods: In order to diagnose clinical anxiety symptoms in patients, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition and the Hamilton Anxiety Rating Scale were applied. Alexithymic features were measured by means of a shortened version of the Toronto Alexithymia Scale, characterized by high discrimination power, internal coherence, and reliability.Results: According to the Toronto Alexithymia Scale results, the greatest contributing factor was “inability to differentiate between feelings and bodily sensations”. This was observed in both males and females. Most frequently, the patients were found to suffer from generalized anxiety disorder and social phobia.Conclusion: Alexithymia may result from the difficulty associated with expressing emotions caused by anxiety disorders. Undergoing treatment for anxiety disorders may contribute to reduced exacerbation of urticaria. Keywords: alexithymia, anxiety, recurrent urticaria

  1. Urticaria after methyl aminolevulinate photodynamic therapy in a patient with nevoid basal cell carcinoma syndrome.

    Science.gov (United States)

    Wolfe, Christopher M; Green, W Harris; Hatfield, H Keith; Cognetta, Armand B

    2012-11-01

    Methyl aminolevulinate photodynamic therapy (MAL-PDT) is utilized in several countries for the treatment of basal cell carcinoma, but allergic sensitization has been reported by the manufacturer. To the best of our knowledge, we report the first case of urticaria following MAL-PDT in a patient with nevoid basal cell carcinoma syndrome. Prophylactic use of antihistamines may allow continued use of MAL-PDT in this setting.

  2. The air quality health index and emergency department visits for urticaria in Windsor, Canada.

    Science.gov (United States)

    Kousha, Termeh; Valacchi, Giuseppe

    2015-01-01

    Ambient air pollution exposure has been associated with several health conditions, limited not only to respiratory and cardiovascular systems but also to cutaneous tissues. However, few epidemiological studies examined pollution exposure on skin problems. Basically, the common mechanism by which pollution may affect skin physiology is by induction of oxidative stress and inflammation. Urticaria is among the skin pathologies that have been associated with pollution. Based on the combined effects of three ambient air pollutants, ozone (O₃), nitrogen dioxide (NO₂), and fine particulate matter (PM) with a median aerodynamic diameter of less than 2.5 μm (PM(2.5)), on mortality, the Air Quality Health Index (AQHI) in Canada was developed. The aim of this study was to examine the associations of short-term changes in AQHI with emergency department (ED) visits for urticaria in Windsor-area hospitals in Canada. Diagnosed ED visits were retrieved from the National Ambulatory Care Reporting System (NACRS). A time-stratified case-crossover design was applied to 2905 ED visits (males = 1215; females = 1690) for urticaria from April 2004 through December 2010. Odds ratios (OR) and their corresponding 95% confidence intervals (95%CI) for ED visits associated with increase by one unit of risk index were calculated employing conditional logistic regression. Positive and significant results were observed between AQHI levels and OR for ED visits for urticaria in Windsor for lags 2 and 3 days. A distributed lag nonlinear model technique was applied to daily counts of ED visits for lags 0 to 10 and significant results were obtained from lag 2 to lag 5 and for lag 9. These findings demonstrated associations between ambient air pollution and urticarial confirming that air pollution affects skin conditions.

  3. Idiopathic inflammatory myopathies and the lung

    Directory of Open Access Journals (Sweden)

    Jean-Christophe Lega

    2015-06-01

    Full Text Available Idiopathic inflammatory myositis (IIM is a group of rare connective tissue diseases (CTDs characterised by muscular and extramuscular signs, in which lung involvement is a challenging issue. Interstitial lung disease (ILD is the hallmark of pulmonary involvement in IIM, and causes morbidity and mortality, resulting in an estimated excess mortality of 50% in some series. Except for inclusion body myositis, these extrapulmonary disorders are associated with the general and visceral involvement frequently found in other CTDs including fever, Raynaud's phenomenon, arthralgia, nonspecific cutaneous modifications and ILD, for which the prevalence is estimated to be up to 65%. Substantial heterogeneity exists within the spectrum of IIMs, and each condition is associated with various frequencies and subtypes of pulmonary involvement. This heterogeneity is partly related to the presence of various autoantibodies encompassing anti-synthetase, anti-MDA5 and anti-PM/Scl. ILD is present in all subsets of IIM including juvenile myositis, but is more frequent in dermatomyositis and overlap myositis. IIM can also be associated with other presentations of respiratory involvement, namely pulmonary arterial hypertension, pleural disease, infections, drug-induced toxicity, malignancy and respiratory muscle weakness. Here, we critically review the current knowledge about adult and juvenile myositis-associated lung disease with a detailed description of therapeutics for chronic and rapidly progressive ILD.

  4. [Optic neuritis in juvenile idiopathic arthritis patient].

    Science.gov (United States)

    Lourenço, Daniela M R; Buscatti, Izabel M; Lourenço, Benito; Monti, Fernanda C; Paz, José Albino; Silva, Clovis A

    2014-01-01

    Optic neuritis (ON) was rarely reported in juvenile idiopathic arthritis (JIA) patients, particularly in those under anti-tumor necrosis factor alpha blockage. However, to our knowledge, the prevalence of ON in JIA population has not been studied. Therefore, 5,793 patients were followed up at our University Hospital and 630 (11%) had JIA. One patient (0.15%) had ON and was reported herein. A 6-year-old male was diagnosed with extended oligoarticular JIA, and received naproxen and methotrexate subsequently replaced by leflunomide. At 11 years old, he was diagnosed with aseptic meningitis, followed by a partial motor seizure with secondary generalization. Brain magnetic resonance imaging (MRI) and electroencephalogram showed diffuse disorganization of the brain electric activity and leflunomide was suspended. Seven days later, the patient presented acute ocular pain, loss of acuity for color, blurred vision, photophobia, redness and short progressive visual loss in the right eye. A fundoscopic exam detected unilateral papilledema without retinal exudates. Orbital MRI suggested right ON. The anti-aquaporin 4 (anti-AQP4) antibody was negative. Pulse therapy with methylprednisolone was administered for five days, and subsequently with prednisone, he had clinical and laboratory improvement. In conclusion, a low prevalence of ON was observed in our JIA population. The absence of anti-AQP4 antibody and the normal brain MRI do not exclude the possibility of demyelinating disease associated with chronic arthritis. Therefore, rigorous follow up is required.

  5. Weekly injection of histaglobulin produces long-term remission in chronic urticaria: A prospective clinical study

    Directory of Open Access Journals (Sweden)

    Gurumoorthy Rajesh

    2016-01-01

    Conclusions: Histaglobulin was found to be effective in producing long-term remission and it reduced the antihistamine requirement as well. Thus, it can serve as an effective alternative to existing treatment modalities.

  6. Report - Recurrent hip arthritis diagnosed as juvenile idiopathic arthritis: A case report.

    Science.gov (United States)

    Chang, Tung-Ming; Yang, Kuender D; Yong, Su-Boon

    2016-05-01

    Juvenile idiopathic arthritis is the most common rheumatic disease in childhood. It is a chronic inflammatory disease associated with arthritis of unknown etiology that begins before the age of 16 and persists for longer than 6 weeks. In this report, the case of a child who suffered recurrent alternative hip arthritis with bilateral hip arthritis is examined, in which he was finally diagnosed as suffering from Juvenile idiopathic arthritis. A 14-year-old boy of Taiwanese origin presented with a normal birth and developmental history. At the age of 10, right-side hip joint pain was experienced, which later migrated to the left side. On further inspection, synovium hypertrophy, cartilage erosion and hip turbid fluid accumulation were found and aseptic arthritis was presumed to be the primary cause. However, after re-examining both his clinical history and presentation, Juvenile idiopathic arthritis was the final diagnosis. Any child presenting with repeat joint swelling are at risk of Juvenile idiopathic arthritis. This is still to be the case if symptoms recede or heal and no initial diagnosis is made. Therefore, a better understanding of the risk of recurrent arthritis is needed. It cannot be emphasized strongly enough that Juvenile idiopathic arthritis should be suspected at all times when a child suffers from recurrent aseptic arthritis of the hip joint.

  7. Ultrastructural differences between diabetic and idiopathic gastroparesis

    NARCIS (Netherlands)

    Faussone-Pellegrini, Maria Simonetta; Grover, Madhusudan; Pasricha, Pankaj J.; Bernard, Cheryl E.; Lurken, Matthew S.; Smyrk, Thomas C.; Parkman, Henry P.; Abell, Thomas L.; Snape, William J.; Hasler, William L.; Uenalp-Arida, Aynur; Nguyen, Linda; Koch, Kenneth L.; Calles, Jorges; Lee, Linda; Tonascia, James; Hamilton, Frank A.; Farrugia, Gianrico

    2012-01-01

    The ultrastructural changes in diabetic and idiopathic gastroparesis are not well studied and it is not known whether there are different defects in the two disorders. As part of the Gastroparesis Clinical Research Consortium, full thickness gastric body biopsies from 20 diabetic and 20 idiopathic g

  8. Practical management of Idiopathic Pulmonary Fibrosis.

    Science.gov (United States)

    Kishaba, Tomoo

    2015-01-01

    Idiopathic Pulmonary Fibrosis (IPF) is relentless progressive interstitial lung disease (ILD) of unknown etiology. Main pathogenesis is aberrant recovery of epithelial injury and collagen deposition. Majority of IPF patients have been elderly men with smokers. However, there are important differential diagnosis such as fibrotic non-specific interstitial pneumonia (NSIP), Connective Tissue Disease (CTD) associated ILD, chronic hypersensitivity pneumonia (CHP). Clinical point of view, non-productive cough and progressive exertional dyspnea are main symptoms. In addition, scalene muscle hypertrophy, fine crackles and finger clubbing are key findings. Serum marker such as lactate deydrogenase (LDH), Krebs von den Lungeng-6 (KL-6) are sensitive for ILD detection and activity. Pulmonary function test and 6 minute walk test (6MWT) are quite meaningful physiological examination. Serial change of forced vital capacity 6MWT distance predict mortality of IPF. International IPF guideline published recently and highlighted on the importance of high resolution computed tomography (HRCT) findings. Key findings of IPF are honeycombing, traction bronchiectasis and subpleural reticular opacity. IPF is chronic progressive disease. Therefore, tracing disease behavior is crucial and unifying clinical, physiological, imaging information over time provide useful information for physicians.In management, many candidate agent failed to have positive result. Pirfenidone which is anti-fibrotic agent showed to slow the decline of vital capacity and prevent of acute exacerbation. Molecular agent such as nintedanib is promising agent for prevention of progression of IPF. In this review, we review the clinical information of IPF and IPF guideline. Lastly, we show the clinical algorithm of this devastated disease. PMID:26278687

  9. Initial management of adults with idiopathic (immune) thrombocytopenic purpura.

    Science.gov (United States)

    George, J N

    2002-03-01

    Since idiopathic (immune) thrombocytopenic purpura (ITP) in adults is usually a chronic condition with few spontaneous remissions, the goal of treatment is not cure, but to maintain a hemostatically safe platelet level. The indication for treatment should be based not merely on platelet counts, but also clinical indices of bleeding. Although most patients show good initial response to prednisone, the side effects of steroids limit this treatment. Currently, long-term management usually involves splenectomy. Since splenectomy has surgical risks and may also predispose the patient to sepsis, a clinical trial using anti-D (WinRho-SDR) has been performed to determine whether this treatment can safely delay or avoid the need for surgery. The use of WinRho may also reveal the occurrence of spontaneous remissions, a previously unrecognized subgroup of adults with chronic ITP. PMID:11913992

  10. Idiopathic Adulthood Ductopenia: ‘It Is Out There’

    Science.gov (United States)

    Bilal, Mohammad; Kazemi, Ali; Babich, Michael

    2016-01-01

    Idiopathic adulthood ductopenia (IAD) is a chronic cholestatic entity of unknown origin characterized by loss of inter-lobular bile ducts that was first described two decades ago. Although the diagnostic criteria have been described in detail, IAD continues to be a rare diagnosis. Our thorough literature search revealed less than a hundred cases of IAD reported. Here we present a 34-year-old female with no significant past history who was evaluated for persistent elevation of serum alkaline phosphate levels. Serology was negative for all viral hepatitides, and a chronic liver disease workup was unremarkable. Magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography did not reveal any abnormalities in the biliary tree. Finally, a liver biopsy demonstrated ductopenia involving greater than 50% of the portal triads, making a diagnosis of IAD. Since the disease can progress rapidly, close follow-up is warranted, so liver transplantation can be pursued if deemed necessary. PMID:27403109

  11. Treatment of uveitis associated with juvenile idiopathic arthritis.

    Science.gov (United States)

    Bou, Rosa; Iglesias, Estíbaliz; Antón, Jordi

    2014-08-01

    Chronic anterior uveitis affects 10-30 % of patients with juvenile idiopathic arthritis (JIA) and is still a cause of blindness in childhood. In most patients it is asymptomatic, bilateral, and recurrent, so careful screening and early diagnosis are important to obtain the best long-term prognosis. The treatment of chronic uveitis associated with JIA is challenging. Initial treatment is based on topical steroids and mydriatic drops. Methotrexate is the most common first-line immunomodulatory drug used. For refractory patients, biologicals, mainly the anti-tumor-necrosis-factor (TNF) drugs adalimumab and infliximab, have been revealed to be effective and have changed the outcome for these patients. Collaboration between pediatric rheumatologists and ophthalmologists is important for the successful diagnosis and treatment of patients with uveitis associated with JIA. PMID:24938442

  12. Imaging of juvenile idiopathic arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, Karl [Birmingham Children' s Hospital, Radiology Department, Birmingham (United Kingdom)

    2006-08-15

    Over the past decade there have been considerable changes in the classification and imaging of juvenile idiopathic arthritis (JIA). Radiology now has a considerable role in the management of JIA, the differential diagnosis, monitoring disease progression and detecting complications. The different imaging modalities available, their role and limitations are discussed in this article and the various disease features that the radiologist should be aware of are described. An approach to the imaging of the child with joint disease and in the monitoring of disease complications are also discussed. (orig.)

  13. [Chronic inflammatory bowel diseases in cats].

    Science.gov (United States)

    Ghermai, A K

    1989-01-01

    The aetiology of chronic idiopathic intestinal inflammation is unknown. It is characterized by a diffuse infiltration with inflammatory cells into the intestinal mucosa and sometimes submucosa. Cats with chronic intermittent vomiting and diarrhoea, later on accompanied by anorexia and weight loss, are presented. Definitive diagnosis can be obtained by intestinal biopsy only. An immune pathogenesis is suspected, which is supported by the fact, that chronic inflammatory bowel disease responds to steroid therapy.

  14. IL-23及其相关细胞因子在慢性特发性血小板减少性紫癜中的表达与作用探讨%Expression and Significance of Interleukin-23 and Its Related Cytokines in Chronic Idiopathic Thrombocytopenic Purpura

    Institute of Scientific and Technical Information of China (English)

    黄颖; 李永志; 魏彩霞; 黎承平; 李维佳; 杨弘

    2011-01-01

    The aim of this study was to investigate the expression and immunologic regulation function of interleukin23 and its related cytokines in chronic idiopathic thrombocytopenic purpura(ITP) patients. Levels of cytokines in peripheral blood mononuclear cells(PBMNC) were detected by reverse-transcription real-time polymerase chain reaction in 30 patients with chronic ITP and 15 healthy volunteers. The quantity of IL-23, IL-12, IL-17 in serum was detected by enzyme-linked immunosorbent assay(ELISA). The results showed that low detectable mRNA levels of IL-23p19 ,IL-12p35,IL-27 and IL-12p40 were found in all patients and healthy persons. Trace of IL-17 mRNA were expressed in PBMNC of part of patients and normal controls. Levels of IL-12p35, IL-27, IL-17 mRNA between healthy persons and chronic ITP patients were not statistically different. Compared with normal controls, patients showed the lower expression levels of IL23p19 and IL-12p40 mRNA (p <0.01 ). The IL-12 levels of chronic ITP patients were significantly higher than that of normal controls (p<0.01). The IL-23 and IL-17 levels of chronic ITP patients were same to that of normal controls. It is concluded that the imbalance of T cell subsets in ITP patients mainly associated with IL-12, but not with IL-23 and IL-17.%本研究旨在探讨IL-23及其它的IL-12家族成员在慢性特发性血小板减少性萦癜(ITP)的表达及其免疫调节功能.运用反转录实时PCR方法检测30例慢性ITP患者和15例正常对照者外周血单个核细胞(PBMNC)中IL-23p19、IL-12p35、IL-12p40、IL-27、IL-17 mRNA的表达水平,用ELISA方法检测血浆IL-23、IL-12、IL-17含量并分析其在慢性ITP中的表达规律及与T亚群的关系.结果表明,慢性ITP患者及正常人PBMNC均低水平表达IL-23p19、IL-12p35、IL-27、IL-12p40 mRNA;部分患者及正常人PBMNC微量表达IL-17 mRNA.IL-12p35、IL-27、1L-17mRNA的表达水平与正常对照相比无显著差异,IL-23p19、IL-12p40 mRNA的表达水

  15. Qualitative Dermatoglyphics In Idiopathic Epilepsy

    Directory of Open Access Journals (Sweden)

    Ranganath Priya

    2004-01-01

    Full Text Available Genetic aetiology has been proposed for both idiopathic epilepsy and dermatoglyphics. Hence, the present study has been undertaken to find out the existence of any correlation between dermatoglyphics and idiopathic epilepsy. Material consisted of 100 patients (58 males and 42 females and 100 controls (52 males and 48 females. Patient′s age ranged from 5 to 40 years and controls were between 18 and 25 years. Dermatoglyphics were obtained by painting method. Qualitative parameters observed were percentage frequency of fingerprint patterns (loops, whorls and arches,, patterns in hypothenar area/ interdigital are and flexion creases (Simian crease, sydney line. On comparison with controls, in males, with hands combined, loops (52.24% and arches (7.93% were increased and whorls (39.83% were decreased (p<0.05. In females, with hands combined, arches (13.1% and whorls (36.43% were increased and loops (50.48% were decreased (p< 0.03. Significant differences have not been observed for the patterns in hypothenar area /interdigital area and flexion creases. These dermatoglyphics features could be used as additional markers to evaluate patients of epilepsy.

  16. Idiopathic epilepsy and school achievement.

    Science.gov (United States)

    Sturniolo, M G; Galletti, F

    1994-05-01

    Forty one children (20 boys, 21 girls) aged 6-10.8 years (mean age 8.6 years) who were affected with idiopathic epilepsy underwent neuropsychological (Wechsler Intelligence Scale for Children, Bender test) and behavioural assessment (Personality Inventory for Children; this was also used in a matched control group). Further information was obtained by teachers' reports. School underachievement occurred in 25 children (61%). Statistical analysis showed no influence of sex, social background, age of onset, seizure type, duration of illness, features seen on electroencephalography, and treatment. School failure was due to poor performance in almost all academic fields, and was associated with higher visuomotor impairment; children showing good school performance had a higher mean IQ and less visuomotor impairment. The behaviour of children with epilepsy who had a good academic performance did not differ from that of their healthy peers. Emotional maladjustment (social skill impairment, depression, poor motivation, and low self esteem) was associated with poor school performance. Such problems, that may complicate the course of idiopathic epilepsy and require an appropriate educational programme, should be carefully considered by the clinician. PMID:8017966

  17. Posterior asymmetry and idiopathic scoliosis

    CERN Document Server

    Rousie, D L; Berthoz, A

    2009-01-01

    Study design Are there neuro-anatomical abnormalities associated with idiopathic scoliosis (IS)? Posterior Basicranium (PBA) reflects cerebellum growth and contains vestibular organs, two structures suspected to be involved in scoliosis. Objective The aim of this study was to compare posterior basicranium asymmetry (PBA) in Idiopathic scoliosis (IS) and normal subjects. Method: To measure the shape of PBA in 3D, we defined an intra-cranial frame of reference based on CNS and guided by embryology of the neural tube. Measurements concerned three directions of space referred to a specific intra cranial referential. Data acquisition was performed with T2 MRI (G.E. Excite 1.5T, mode Fiesta). We explored a scoliosis group of 76 women and 20 men with a mean age of 17, 2 and a control group of 26 women and 16 men, with a mean age of 27, 7. Results: IS revealed a significant asymmetry of PBA (Pr>|t|<.0001) in 3 directions of space compared to the control group. This asymmetry was more pronounced in antero-posterior...

  18. Idiopathic subglottic stenosis: a familial predisposition.

    Science.gov (United States)

    Dumoulin, Elaine; Stather, David R; Gelfand, Gary; Maranda, Bruno; Maceachern, Paul; Tremblay, Alain

    2013-03-01

    Idiopathic subglottic stenosis is a narrowing of the trachea at the level of the cricoid cartilage of unknown etiology. It is a rare condition for which the real incidence has never been established owing to the difficulty of making the diagnosis. Although there is a female preponderance, no familial cases have been reported in the literature. We describe two pairs of sisters as well as a mother and daughter presenting with idiopathic subglottic stenosis. All known causes of tracheal stenosis were excluded, including prolonged intubation, surgery, autoimmune and inflammatory disorders, infection and gastroesophageal reflux disease. These are the first cases reported in the literature that suggest a genetic predisposition for idiopathic subglottic stenosis.

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

    OpenAIRE

    Thomsen SF; De, S.; FL

    2015-01-01

    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 dis...

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

    OpenAIRE

    Francis Thomsen, Simon

    2015-01-01

    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...