title: Chronic Idiopathic Urticaria: Systemic Complaints and Their Relationship with Disease and Immune Measures.
abstract: BACKGROUND
  Patients with chronic idiopathic urticaria (CIU)/chronic spontaneous urticaria sometimes report systemic complaints (SCs).
  
  
  OBJECTIVE
  We sought to determine the frequency and characteristics of SCs among patients with CIU, as well as the association of SCs with disease measures, basophil histamine release, and serum tryptase.
  
  
  METHODS
  Adult patients with CIU were recruited from a university allergy clinic. Patients completed a disease symptom survey and underwent blood sampling for subsequent basophil histamine release and serum tryptase measurement.
  
  
  RESULTS
  A total of 155 patients with CIU were surveyed, with 103 reporting SCs with concomitant hives as follows: joint pain or swelling (55.3%), headache/fatigue (47.6%), flushing (42.7%), wheezing (30.1%), gastrointestinal complaints (26.2%), and palpitations (9.7%). Patients with SCs (CIU-SC) were compared with those with no SCs (CIU-NSC). Both groups had similar demographic characteristics (average age in 40s, majority female and white) and basophil histamine release profiles. CIU-SC had significantly greater disease duration (51.5% CIU-SC vs 30.8% CIU-NSC had >4 years duration), emergency department visits (41.7% vs 23.1% had >1 visit in the last year), CIU-related work absences (65% vs 27.5% had >1 day), oral corticosteroid use (84.5% vs 59.6%), quality-of-life impairment (76.1 vs 59.2 SkinDex score), and serum tryptase levels (5.1 ng/mL vs 3.9 ng/mL).
  
  
  CONCLUSIONS
  Despite similar demographic characteristics and basophil profiles as patients with CIU-NSC, patients with CIU-SC have features of greater disease burden (work absences, emergency department visits, and corticosteroid use), quality-of-life impairment, and baseline serum tryptase levels.
authors.affiliation: Johns Hopkins University School of Medicine, Baltimore, Md.
authors.forename: Judy C
authors.initials: JC
authors.lastname: Doong
authors.affiliation: Division of Allergy and Clinical Immunology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Md.
authors.forename: Kris
authors.initials: K
authors.lastname: Chichester
authors.affiliation: Division of Allergy and Clinical Immunology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Md.
authors.forename: Eric T
authors.initials: ET
authors.lastname: Oliver
authors.affiliation: Division of Rheumatology, Allergy and Immunology, Department of Internal Medicine, Virginia Commonwealth University, Richmond, Va.
authors.forename: Lawrence B
authors.initials: LB
authors.lastname: Schwartz
authors.affiliation: Division of Allergy and Clinical Immunology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Md. Electronic address: ssaini@jhmi.edu.
authors.forename: Sarbjit S
authors.initials: SS
authors.lastname: Saini
mesh_terms: D000328:Adult; D018771:Arthralgia; D001491:Basophils / Q000276:immunology*; D002908:Chronic Disease; D005260:Female; D005483:Flushing; D006261:Headache; D006632:Histamine / Q000378:metabolism*; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D053802:Tryptases / Q000097:blood; D014581:Urticaria / Q000175:diagnosis* / Q000276:immunology / Q000503:physiopathology
chemical_list: D007073:Immunoglobulin E; D006632:Histamine; D053802:Tryptases
keywords: Chronic idiopathic urticaria; Chronic spontaneous urticaria; Histamine; Quality of life; Systemic complaints; Tryptase