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Vol. 43. Issue 3.
Pages 249-253 (May - June 2015)
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Vol. 43. Issue 3.
Pages 249-253 (May - June 2015)
Original Article
DOI: 10.1016/j.aller.2014.02.007
Hashimoto's disease is a frequent comorbidity and an exacerbating factor of chronic spontaneous urticaria
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A. Sugiyamaa,
Corresponding author
, H. Nishiea, S. Takeuchib, M. Yoshinaric, M. Furueb
a Department of Dermatology, National Fukuoka Hospital, National Hospital Organization, 4-39-1, Yakatabaru, Minami-ku, Fukuoka 811-1394, Japan
b Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Fukuoka 812-8582, Japan
c Yoshinari Medical Clinic, 2-3-10, Ookusu, Minami-ku, Fukuoka 815-0082, Japan
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Tables (4)
Table 1. Reported positive rates of thyroid autoantibodies among CSU patients.
Table 2. Severity of CSU symptoms.
Table 3. Diagnosis criteria of autologous serum skin test from “The practical side of allergy test and immunotherapy” compiled under the supervision of Dr. Kazuo Akiyama at National Hospital Organization Sagamihara National Hospital.
Table 4. Results of examinations and changes in urticaria symptoms.
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Abstract
Background

The precise pathogenesis of chronic spontaneous urticaria (CSU) remains unknown. However, an important association between CSU and autoimmune disorders such as Hashimoto's disease (HD) has been reported.

We investigated the frequency of HD as a comorbidity of CSU and the prevalence rate of autoreactivity among CSU patients with HD.

Patients and methods

The presence of thyroid autoantibodies and the levels of thyroid hormones were examined in 40 CSU patients who showed urticaria symptoms for >4 weeks. Patients who were diagnosed with HD, including subclinical ones, and were in need of treatment received thyroid therapy, and the changes in their urticarial symptoms were observed. An autologous serum skin test (ASST) was also performed to examine the relation of CSU with autoreactivity.

Results

Eleven of the 40 CSU patients were diagnosed with HD, and 4 of the 5 patients who received and completed thyroid therapy showed considerable remission of urticarial symptoms during and after treatment. In addition, the rate of positive ASST results tended to be higher in CSU patients with HD (5 of 7) than in those without HD (2 of 6).

Conclusions

The comorbidity rate of HD in CSU patients was high, and such patients tended to have a positive ASST. Thyroid therapy in CSU patients with HD can lead to a considerable remission of urticarial symptoms, which may suggest that HD is possibly involved in the aetiology of CSU, or is at least a potential exacerbating factor for CSU.

Keywords:
Autoimmune urticaria
Autoreactivity
Chronic spontaneous urticaria
Hashimoto's disease
Thyroid autoantibodies
Thyroid hormone

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