Chronic idiopathic urticaria: a family study.
BACKGROUND
Genetic factors play a pivotal role in the pathogenesis of many autoimmune disorders. Recent studies demonstrated that chronic idiopathic urticaria (CIU) is an autoimmune disease at least in a subset of patients, but familial studies have not yet been conducted.


OBJECTIVE
To investigate the familial pattern of CIU.


METHODS
One thousand three hundred eight adults with CIU (aged >12 years; male/female 388/920) seen during the last 10 years were thoroughly interviewed to ascertain the presence of CIU among first-degree relatives. Positive histories were confirmed by medical recordings. Proportions were compared with those expected in the general population on the basis of a 0.1% prevalence of the disease.


RESULTS
Fifty-six of 1,308 (4%) patients had a familial history of CIU affecting at least one first-degree relative. This number exceeded by approximately eight times the expected one (P < 0.001). Twenty-two of 23 (96%) patients with a positive familial history were positive on autologous serum skin test (P < 0.01 by comparison with previous studies).


CONCLUSIONS
The observation that CIU is much more frequent among first-degree relatives of affected individuals than in the general population suggests the existence of a genetic background for the disease and provides a clinical support to the reported association between CIU and human leukocyte antigen DR4. Ninety-six percent of patients with a positive familial history were positive on autologous serum skin test, a condition that has been associated with the presence of circulating histamine releasing factors, including anti-Fc epsilonRI or anti-immunoglobulin E antibodies.
Asero
Riccardo
R
Ambulatorio di Allergologia, Ospedale Caduti Bollatesi, Bollate (MI), Italy. r.asero@libero.it
D000293:Adolescent; D000328:Adult; D002908:Chronic Disease; D005192:Family Health; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D008297:Male; D014581:Urticaria / Q000175:diagnosis / Q000235:genetics*