title: Relationship between Helicobacter pylori and idiopathic chronic urticaria: effectiveness of Helicobacter pylori eradication.
abstract: BACKGROUND
  Chronic urticaria (CU) is defined as the presence of urticaria on most days of the week for a period of 6 weeks or longer. Some studies have reported an association between CU and Helicobacter pylori (H. pylori) infection.
  
  
  OBJECTIVE
  To determine the prevalence of H. pylori infection using the stool antigen test in patients with idiopathic CU and to investigate the infected patients with CU following eradication of H. pylori.
  
  
  METHODS
  One hundred patients with idiopathic CU and 100 healthy controls were referred to our clinic between May 2012 and June 2013 and were tested for H. pylori antigen. The patients infected with H. pylori received quadruple therapy for 2 weeks. To assess eradication efficacy, a repeated H. pylori stool antigen test was performed in each patient 6 weeks after the end of anti-H. pylori therapy. The effectiveness of eradication therapy on CU was assessed 3 months after treatment.
  
  
  RESULTS
  Thirty-six percent patients with idiopathic CU were infected with H. pylori while 23% of the controls were infected. Response to eradication therapy was evident in 33 (91.67%) patients in whom H. pylori was eradicated while 3 (8.33%) patients showed no response despite eradication of H. pylori. Clinical follow-up of 33 successfully treated patients 3 months later revealed complete remission of urticaria in 54.5%, partial remission in 18.2%, and no improvement in 27.3%.
  
  
  CONCLUSIONS
  The results of our study suggest that H. pylori infection should be included in diagnostic workup of patients with no response to habitual treatment for CU or symptomatic gastrointestinal patients. For the diagnosis of H. pylori infection, one should consider the costs and accessibility of the population to the HpSA(®) stool antigen test and Urea breath test (UBT).
authors.affiliation: Department of Dermatology, Imam Khomeini Hospital, Ardabil University of Medical Sciences, Ardabil, Iran.
authors.forename: Majid Rostami
authors.initials: MR
authors.lastname: Mogaddam
authors.affiliation: Department of Gastroenterology, Imam Khomeini Hospital, Ardabil University of Medical Sciences, Ardabil, Iran.
authors.forename: Abbas
authors.initials: A
authors.lastname: Yazdanbod
authors.affiliation: Department of Midwifery, Ardabil Branch, Islamic Azad University, Ardabil, Iran.
authors.forename: Nastaran Safavi
authors.initials: NS
authors.lastname: Ardabili
authors.affiliation: Department of Internal Medicine, Imam Khomeini Hospital, Ardabil University of Medical Sciences, Ardabil, Iran.
authors.forename: Nasrollah
authors.initials: N
authors.lastname: Maleki
authors.affiliation: Department of Dermatology, Imam Khomeini Hospital, Ardabil University of Medical Sciences, Ardabil, Iran.
authors.forename: Sonia
authors.initials: S
authors.lastname: Isazadeh
keywords: Helicobacter pylori; chronic urticaria; eradication
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