Pathogenesis and treatment of chronic urticaria.
Chronic urticaria has been considered a skin disease of unknown origin, but recent data suggest that about 40% to 45% of patients have an autoimmune disorder with circulating immunoglobulin G (IgG) antibody directed at the a subunit of the high-affinity IgE receptor. Recent data also implicate complement activation in the degranulation of cutaneous mast cells. Antibodies to thyroid antigens are present in 24% of patients, regardless of thyroid function. Antihistamines are first-line therapy, but they may not be sufficient if urticaria is severe and associated with frequent episodes of angioedema. Corticosteroids given on alternate days are efficacious and have few adverse effects if they are given in a slow, tapering course.
Kaplan
A P
AP
Medical University of South Carolina, Charleston, SC 29423, USA. Kaplana@musc.edu
Finn
A
A
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000906:Antibodies / Q000097:blood; D015153:Blotting, Western; D002908:Chronic Disease; D006633:Histamine Antagonists / Q000627:therapeutic use; D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology; D008407:Mast Cells / Q000378:metabolism; D017455:Receptors, IgE / Q000276:immunology; D012867:Skin / Q000378:metabolism; D013959:Thyroid Diseases / Q000276:immunology; D014581:Urticaria / Q000188:drug therapy* / Q000276:immunology* / Q000378:metabolism
D000305:Adrenal Cortex Hormones; D000906:Antibodies; D006633:Histamine Antagonists; D017455:Receptors, IgE; D007073:Immunoglobulin E