title: Hashimoto's disease is a frequent comorbidity and an exacerbating factor of chronic spontaneous urticaria.
abstract: BACKGROUND
  The precise pathogenesis of chronic spontaneous urticaria (CSU) remains unknown. However, an important association between CSU and autoimmune disorders such as Hashimoto's disease (HD) has been reported. We investigated the frequency of HD as a comorbidity of CSU and the prevalence rate of autoreactivity among CSU patients with HD.
  
  
  METHODS
  The presence of thyroid autoantibodies and the levels of thyroid hormones were examined in 40 CSU patients who showed urticaria symptoms for >4 weeks. Patients who were diagnosed with HD, including subclinical ones, and were in need of treatment received thyroid therapy, and the changes in their urticarial symptoms were observed. An autologous serum skin test (ASST) was also performed to examine the relation of CSU with autoreactivity.
  
  
  RESULTS
  Eleven of the 40 CSU patients were diagnosed with HD, and 4 of the 5 patients who received and completed thyroid therapy showed considerable remission of urticarial symptoms during and after treatment. In addition, the rate of positive ASST results tended to be higher in CSU patients with HD (5 of 7) than in those without HD (2 of 6).
  
  
  CONCLUSIONS
  The comorbidity rate of HD in CSU patients was high, and such patients tended to have a positive ASST. Thyroid therapy in CSU patients with HD can lead to a considerable remission of urticarial symptoms, which may suggest that HD is possibly involved in the aetiology of CSU, or is at least a potential exacerbating factor for CSU.
authors.affiliation: Department of Dermatology, National Fukuoka Hospital, National Hospital Organization, 4-39-1, Yakatabaru, Minami-ku, Fukuoka 811-1394, Japan. Electronic address: aki0407@dermatol.med.kyushu-u.ac.jp.
authors.forename: A
authors.initials: A
authors.lastname: Sugiyama
authors.affiliation: Department of Dermatology, National Fukuoka Hospital, National Hospital Organization, 4-39-1, Yakatabaru, Minami-ku, Fukuoka 811-1394, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Nishie
authors.affiliation: Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Fukuoka 812-8582, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Takeuchi
authors.affiliation: Yoshinari Medical Clinic, 2-3-10, Ookusu, Minami-ku, Fukuoka 815-0082, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Yoshinari
authors.affiliation: Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Fukuoka 812-8582, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Furue
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001323:Autoantibodies / Q000097:blood; D002908:Chronic Disease; D015897:Comorbidity; D018450:Disease Progression; D005260:Female; D050031:Hashimoto Disease / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D013961:Thyroid Gland / Q000276:immunology*; D013963:Thyroid Hormones / Q000378:metabolism; D014581:Urticaria / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D001323:Autoantibodies; D013963:Thyroid Hormones
keywords: Autoimmune urticaria; Autoreactivity; Chronic spontaneous urticaria; Hashimoto's disease; Thyroid autoantibodies; Thyroid hormone