title: Chronic urticaria in patients with autoimmune thyroiditis: significance of severity of thyroid gland inflammation.
abstract: BACKGROUND
  There is a clear association between autoimmune thyroiditis (AT) and chronic urticaria/angioedema (CUA). However, not all patients with AT demonstrate urticaria.
  
  
  OBJECTIVE
  The aim of the study was to investigate in which patients with AT did CUA become a problem. A sensitive inflammation marker, neopterine (NP) was used to confirm whether the severity of inflammation in the thyroid gland was responsible for urticaria or not.
  
  
  METHODS
  Neopterine levels were assessed in patients with AT with urticaria and without urticaria. Furthermore, levels were compared in relation to pre and post levothyroxine treatment. Twenty-seven patients with urticaria (Group 1) and 28 patients without urticaria (Group 2) were enrolled in the study. A course of levothyroxine treatment was given to all patients, and urine neopterine levels before and after the trial were obtained.
  
  
  RESULTS
  All patients completed the trial. Mean age in Group 1 and Group 2 was similar (35.70 ± 10.86 years and 38.36 ± 10.38 years, respectively) (P=0.358). Pre-treatment urine neopterine levels were significantly higher in Group 1 (P=0.012). Post-treatment levels decreased in each group, as expected. However, the decrease in the neopterine level was insignificant in the patients of Group 2 (P=0.282). In Group 1, a significant decrease in post-treatment neopterine levels (P=0.015) was associated with the remission of urticaria.
  
  
  CONCLUSIONS
  In patients with CUA and AT, pre-treatment elevated levels of NP, and its decrease with levothyroxine treatment along with symptomatic relief in urticaria, may be evidence of the relationship between the degree of inflammation in thyroid and presence of urticaria.
authors: Department of Internal Medicine, Division of Allergy, Ankara, Turkey.
authors: Mustafa
authors: M
authors: Gulec
authors: Ozgür
authors: O
authors: Kartal
authors: A Zafer
authors: AZ
authors: Caliskaner
authors: Mahmut
authors: M
authors: Yazici
authors: Halil
authors: H
authors: Yaman
authors: Sami
authors: S
authors: Ozturk
authors: Osman
authors: O
authors: Sener
mesh_terms: D000328:Adult; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007249:Inflammation / Q000150:complications / Q000188:drug therapy / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012720:Severity of Illness Index; D013961:Thyroid Gland / Q000473:pathology*; D013967:Thyroiditis, Autoimmune / Q000150:complications* / Q000188:drug therapy / Q000473:pathology*; D013974:Thyroxine / Q000627:therapeutic use; D014581:Urticaria / Q000150:complications* / Q000188:drug therapy / Q000473:pathology*; D055815:Young Adult
chemical_list: D013974:Thyroxine