title: Streptococcal tonsillitis as a cause of urticaria: tonsillitis and urticaria.
abstract: BACKGROUND
  The primary role of infections in chronic urticaria (CU) is controversial. We hypothesised that streptococcal tonsillitis (ST) could be a primary cause of CU or acute recurrent urticaria (ARU).
  
  
  METHODS
  Retrospective study of 14 outpatients observed between January 2000 and December 2009, with CU/ARU and clinical and/or laboratorial suspicion of an aetiopathogenic link with ST. Clinical history, objective examination and laboratorial study were looked for. Three groups were defined: spontaneous resolution of urticaria, resolution after tonsillectomy, and still symptomatic.
  
  
  RESULTS
  In these patients, a causal relationship between ST and urticaria is supported by: markers of streptococcal infection, the perception of a clinical relationship between tonsillitis and urticaria, the decrease of urticaria severity with early antibiotherapy to tonsillitis and urticaria resolution after tonsillectomy.
  
  
  CONCLUSIONS
  Our study encourages the investigation of tonsillitis in these otherwise idiopathic patients, especially until young adulthood and even in the absence of any symptoms.
authors: Immunoallergology Department, Coimbra University Hospital, Coimbra, Portugal. gicalado@sapo.pt
authors: G
authors: G
authors: Calado
authors: G
authors: G
authors: Loureiro
authors: D
authors: D
authors: Machado
authors: B
authors: B
authors: Tavares
authors: C
authors: C
authors: Ribeiro
authors: C
authors: C
authors: Pereira
authors: A S
authors: AS
authors: Luís
mesh_terms: D000293:Adolescent; D000328:Adult; D015551:Autoimmunity; D002648:Child; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D013290:Streptococcal Infections / Q000150:complications* / Q000601:surgery; D013291:Streptococcus / Q000276:immunology*; D014068:Tonsillectomy; D014069:Tonsillitis / Q000150:complications* / Q000601:surgery; D014581:Urticaria / Q000209:etiology* / Q000517:prevention & control; D055815:Young Adult