Role of Helicobacter pylori Infection in the treatment and outcome of chronic urticaria.
BACKGROUND
Chronic urticaria is thought to have numerous causative factors including a large variety of infectious conditions, food intake, and drugs. The impact of Helicobacter pylori infection has been studied with ambiguous results. The aim of this study was to investigate the course of chronic urticaria in H. pylori-positive patients undergoing eradication compared to H. pylori-negative urticaria patients.


METHODS
We included 74 urticaria patients with positive H. pylori breath test and 74 age- and sex-matched H. pylori-negative controls. All urticaria patients underwent an extensive diagnostic work-up to search for trigger foci. H. pylori-infected patients were submitted to eradication therapy. Mean follow-up time was 58 months.


RESULTS
Neither the prevalence of H. pylori nor the eradication therapy had an influence on the clinical course of chronic urticaria. In 81.1% of H. pylori-infected patients at least one additional infectious focus was found. Nevertheless, it could be shown that individuals that described any kind of symptom relief presented with higher serum IgE levels at diagnosis (198.1 vs 115.7 kU/L, p= .027) but this effect was independent of H. pylori infection.


CONCLUSIONS
In conclusion there is no evidence that eradication of H. pylori improves the outcome in patients with chronic urticaria. The high rate of spontaneous remission and the coexistence of multiple foci will always obscure the evaluation of any specific antimicrobial therapy.
Hellmig
S
S
Department of General Internal Medicine, University Hospital of Schelswig-Holstein, Campus Kiel, Kiel, Germany. shellmig@1med.uni-kiel.de
Troch
K
K
Ott
S J
SJ
Schwarz
T
T
Fölsch
U R
UR
D000328:Adult; D001944:Breath Tests; D016022:Case-Control Studies; D005260:Female; D016481:Helicobacter Infections / Q000150:complications*; D016480:Helicobacter pylori / Q000254:growth & development / Q000502:physiology*; D006801:Humans; D008297:Male; D014581:Urticaria / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology*