Plasmapheresis for severe, unremitting, chronic urticaria.
Histamine-releasing autoantibodies have been identified in chronic idiopathic urticaria. 8 patients with severe disease and histamine-releasing activity in their sera underwent plasmapheresis. Symptoms were abolished for 2 months in 1 patient and for 3 weeks in another, 2 showed almost complete resolution of symptoms, 2 had temporary relief, and the other 2 showed little change. Further investigation in 4 of the patients showed significantly reduced skin-test responses to fresh post-exchange autologous sera after plasmapheresis compared with stored pre-exchange sera, but the response to intradermal histamine remained unchanged. Blood cellular histamine increased as in-vitro serum histamine-releasing activity fell after plasmapheresis. These results favour a pathogenetic role for histamine-releasing autoantibodies in patients with chronic urticaria.
Grattan
C E
CE
St John's Institute of Dermatology, UMDS, London, UK.
Francis
D M
DM
Slater
N G
NG
Barlow
R J
RJ
Greaves
M W
MW
D000328:Adult; D001323:Autoantibodies / Q000378:metabolism; D005260:Female; D006632:Histamine / Q000097:blood; D006636:Histamine Release; D006801:Humans; D008297:Male; D008875:Middle Aged; D010956:Plasmapheresis; D014581:Urticaria / Q000378:metabolism / Q000628:therapy*
D001323:Autoantibodies; D006632:Histamine