A retrospective review of clinical presentation, thyroid autoimmunity, laboratory characteristics, and therapies used in patients with chronic idiopathic urticaria.
BACKGROUND
Our knowledge of autoimmune characteristics of chronic idiopathic urticaria (CIU) is limited.


OBJECTIVE
To study the demographic, laboratory, and clinical patterns of a cohort of patients with CIU.


METHODS
We evaluated 236 patients with CIU seen in a recent 2-year span. For serum basophil activation testing (BAT-CD203), the samples were sent to the National Jewish Medical and Research Center for donor basophil CD203 expression assay (5% cell surface expression was considered a positive result).


RESULTS
Of the 236 patients with CIU, 77% were females with a mean age of 39 years. The mean age of males was 43 years. Of patients tested for BAT-CD203 (50 females and 8 males), 38% of females (n = 19) and 13% of males (n = 1) had positive test results. Of the 146 females and 42 males tested for thyroid autoimmunity (TA), 34% of females (n = 50) and 17% of males (n = 7) had underlying TA. Nine BAT-CD203-positive females (47%) had TA compared with 11 of 30 BAT-CD203-negative females (37%). No correlation was found between antinuclear antibodies and BAT-CD203. Cyclosporine or corticosteroids were used in 28% of the study population, with another 16% requiring a trial of additional third-line agents with or without prednisone/cyclosporine. There was no significant difference in the maximum number of medications used in subgroups based on the presence or absence of BAT-CD203 and TA.


CONCLUSIONS
The frequency of TA in patients with CIU was 30%, which is higher than that previously reported. The frequency of TA and BAT-CD203 positivity was higher in females. In this clinical cohort, there was no correlation between BAT-CD203 and TA.
Najib
Umer
U
Division of Allergy and Inflammation, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts 02445, USA.
Bajwa
Zahid H
ZH
Ostro
Martin G
MG
Sheikh
Javed
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000799:Angioedema / Q000150:complications; D000974:Antibodies, Antinuclear / Q000097:blood; D001323:Autoantibodies / Q000097:blood / Q000276:immunology; D015551:Autoimmunity / Q000276:immunology*; D015549:Basophil Degranulation Test; D002908:Chronic Disease; D015331:Cohort Studies; D016572:Cyclosporine / Q000627:therapeutic use; D005260:Female; D006633:Histamine Antagonists / Q000627:therapeutic use; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000627:therapeutic use; D017455:Receptors, IgE / Q000276:immunology; D012189:Retrospective Studies; D012882:Skin Tests; D013961:Thyroid Gland / Q000276:immunology*; D014581:Urticaria / Q000097:blood* / Q000188:drug therapy* / Q000276:immunology*; D055815:Young Adult
D000974:Antibodies, Antinuclear; D001323:Autoantibodies; C543355:FcepsilonRI alpha-chain, human; D006633:Histamine Antagonists; D017455:Receptors, IgE; C006606:anti-thyroglobulin; D007073:Immunoglobulin E; D016572:Cyclosporine; D011241:Prednisone