Etiologic aspects of chronic urticaria.
BACKGROUND
Urticaria is a common disease that is always a challenge to the dermatologist due to its evasive etiology.


METHODS
One hundred and seven chronic urticaria patients were studied. Routine laboratory investigations were performed and Helicobacter pylori (H. pylori) immunoglobulin G (IgG) antibody determinations, autoimmune reactivity, infections, allergies, and hyperreactivities were investigated.


RESULTS
Pathologic findings were seen in 92 patients. Concomitant diseases suggesting autoimmune reactivity were detected in nine patients and, in 16 patients, infections including maxillary sinusitis, streptococcal tonsillitis, and tooth infection were found. Elevated total IgE level was detected in 37 out of 75 patients and positive skin prick test results in 47 out of 91 patients. Fifty-five patients had a history of recent dyspeptic symptoms. A diagnosis of adult celiac disease was made in two patients and, additionally, IgA antigliadin antibodies were seen in four patients. H. pylori IgG antibodies were found in 40 out of 107 patients. Active gastritis was verified by esophagogastroduodenoscopy in 30 out of 32 patients with positive Helicobacter staining in 24 samples. An elevated IgE level was detected in 64% of H. pylori-positive and in 39% of H. pylori-negative patients.


CONCLUSIONS
In this study, several findings suggesting aberrant immunologic activation were detected in chronic urticaria patients. Inflammation in the gastrointestinal tract, e.g. caused by H. pylori infection, may have an important role in the etiology of chronic urticaria.
Department of Dermatology, Medical Microbiology, and Pathology, University of Turku, Finland.
M
M
Liutu
K
K
Kalimo
J
J
Uksila
H
H
Kalimo
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D005260:Female; D005756:Gastritis / Q000150:complications / Q000382:microbiology; D005767:Gastrointestinal Diseases / Q000150:complications / Q000382:microbiology; D016481:Helicobacter Infections / Q000150:complications; D016480:Helicobacter pylori; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D007073:Immunoglobulin E / Q000097:blood; D008297:Male; D008875:Middle Aged; D012882:Skin Tests; D014581:Urticaria / Q000209:etiology* / Q000382:microbiology
D007070:Immunoglobulin A; D007073:Immunoglobulin E