title: A retrospective review of clinical presentation, thyroid autoimmunity, laboratory characteristics, and therapies used in patients with chronic idiopathic urticaria.
abstract: 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.
authors.affiliation: Division of Allergy and Inflammation, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts 02445, USA.
authors.forename: Umer
authors.initials: U
authors.lastname: Najib
authors.forename: Zahid H
authors.initials: ZH
authors.lastname: Bajwa
authors.forename: Martin G
authors.initials: MG
authors.lastname: Ostro
authors.forename: Javed
authors.initials: J
authors.lastname: Sheikh
mesh_terms: 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
chemical_list: 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