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Kronik Ürtikerde Hastalık Süresini Etkileyen Faktörler: Tek-Merkez Deneyimi

Yıl 2022, Cilt: 44 Sayı: 1, 45 - 52, 14.01.2022

Mehmet Bankir Güzin Özden

https://doi.org/10.20515/otd.962823

Öz

Kronik ürtiker (KÜ), altı haftadan uzun süredir tekrarlayan kaşıntılı büller, anjiyoödem veya her ikisi ile karakterizedir. Kliniğimizde kronik ürtiker tanısı ile takip edilen hastaların klinik ve demografik özelliklerini, laboratuvar sonuçlarını ve hastalık süresini etkileyen faktörleri değerlendirdik. Çalışmaya Mart-Aralık 2020 tarihleri arasında polikliniğimize başvuran 101 hasta dahil edildi. Hastaların demografik özellikleri, komorbid hastalıkları, deri prik testi sonuçları, phadiatop, Total IgE, anti-TPO, vitamin B12, vitamin D, ferritin, tam kan sayımı, otolog serum deri testi(ASST), haftalık ürtiker aktivite skoru (UAS7) hastane kayıtlarından geriye dönük incelendi. Değişkenler arasındaki ilişkiler ve bunların hastalık süresine etkileri istatistiksel olarak araştırıldı. Anti-TPO pozitifliği olan kronik ürtikerli hastalarda hastalık süresinin daha uzun olduğu görüldü (p=0.019). Yapılan multıple regresyon analizinde UAS7 değerinin hastalık süresi üzerinde 2,989 kat etkisi olduğu tespit edilmiştir. Hastalık süresi ile UAS7 (r=0,277; p=0,005) arasında pozitif korelasyon saptandı. Anjiyoödem (p=0,005), dermatografizm (p=0,012) ve kadın cinsiyeti (p=0,031) olan hastalarda daha uzun hastalık süresi olduğu saptandı. Anti-TPO pozitifliği, eşlik eden anjiyoödem, dermatografizm ve daha yüksek UAS7 skorları, kronik ürtikerlerinin daha uzun süreceğini öngörmektedir.

Anahtar Kelimeler

Kronik ürtiker hastalık süresi anti-TPO Otolog serum deri tetsti (ASST) Ürtiker aktivite skoru (UAS7) dermatografizm

Destekleyen Kurum

Bu çalışma herhangi bir kurum yada kuruluş tarafından desteklenmemiştir.

Kaynakça

  • Reference1. Zuberbier T, Aberer W, Asero R, et al. The EAACI/GA(2)LEN/EDF/WAO guideline for the definition, classification, diagnosis and management of urticaria. Allergy. 2018;73(7):1393-414.
  • Reference2. Bracken SJ, Abraham S, MacLeod AS. Autoimmune Theories of Chronic Spontaneous Urticaria. Front Immunol. 2019;10:627.
  • Reference3. Sanchez-Borges M, Asero R, Ansotegui IJ , et al. Diagnosis and treatment of urticaria and angioedema: a worldwide perspective. World Allergy Organ J. 2012;5(11):125-47.
  • Reference4. Maurer M, Rosen K, Hsieh HJ, et al. Omalizumab for the treatment of chronic idiopathic or spontaneous urticaria. N Engl J Med. 2013;368(10):924-35.
  • Reference5. Cordeiro Moreira AS, Rosmaninho Lopes de Soares ESMI, Pereira Guilherme MA, et al. Use of omalizumab in the treatment of chronic urticaria. Eur Ann Allergy Clin Immunol. 2016;48(6):242-6.
  • Reference6. Holgate ST, Djukanovic R, Casale T, et al. Anti-immunoglobulin E treatment with omalizumab in allergic diseases: an update on anti-inflammatory activity and clinical efficacy. Clin Exp Allergy. 2005;35(4):408-16.
  • Reference7. Quaranta JH, Rohr AS, Rachelefsky GS, et al. The natural history and response to therapy of chronic urticaria and angioedema. Ann Allergy. 1989;62(5):421-4.
  • Reference8. Hiragun M, Hiragun T, Mihara S, et al. Prognosis of chronic spontaneous urticaria in 117 patients not controlled by a standard dose of antihistamine. Allergy. 2013;68(2):229-35.
  • Reference9. Kolkhir P, Church MK, Weller K, et al. Autoimmune chronic spontaneous urticaria: What we know and what we do not know. J Allergy Clin Immunol. 2017;139(6):1772-81 e1.
  • Reference10. Altrichter S, Peter HJ, Pisarevskaja D, et al. IgE mediated autoallergy against thyroid peroxidase--a novel pathomechanism of chronic spontaneous urticaria? PLoS One. 2011;6(4):e14794.
  • Reference11. Kolkhir P, Metz M, Altrichter S, et al. Comorbidity of chronic spontaneous urticaria and autoimmune thyroid diseases: A systematic review. Allergy. 2017;72(10):1440-60.
  • Reference12. Sugiyama A, Nishie H, Takeuchi S, et al. Hashimoto's disease is a frequent comorbidity and an exacerbating factor of chronic spontaneous urticaria. Allergol Immunopathol (Madr). 2015;43(3):249-53.
  • Reference13. Kim YS, Han K, Lee JH, et al. Increased Risk of Chronic Spontaneous Urticaria in Patients With Autoimmune Thyroid Diseases: A Nationwide, Population-based Study. Allergy Asthma Immunol Res. 2017;9(4):373-7.
  • Reference14. Pepys J. Skin tests for immediate, type I, allergic reactions. Proc R Soc Med. 1972;65(3):271-2.
  • Reference15. Konstantinou GN, Asero R, Maurer M, et al. EAACI/GA(2)LEN task force consensus report: the autologous serum skin test in urticaria. Allergy. 2009;64(9):1256-68.
  • Reference16. Zuberbier T, Aberer W, Asero R, et al. The EAACI/GA(2) LEN/EDF/WAO Guideline for the definition, classification, diagnosis, and management of urticaria: the 2013 revision and update. Allergy. 2014;69(7):868-87.
  • Reference17. Merrett J, Merrett TG. Phadiatop--a novel IgE antibody screening test. Clin Allergy. 1987;17(5):409-16.
  • Reference18. Sanchez-Borges M, Caballero-Fonseca F, Capriles-Hulett A, et al. Factors linked to disease severity and time to remission in patients with chronic spontaneous urticaria. J Eur Acad Dermatol Venereol. 2017;31(6):964-71.
  • Reference19. Marin-Cabanas I, Berbegal-de Gracia L, de Leon-Marrero F, et al. Management of Chronic Spontaneous Urticaria in Routine Clinical Practice Following the EAACI/GA(2)LEN/EDF/WAO Guidelines. Actas Dermosifiliogr. 2017;108(4):346-53.
  • Reference20. Kozel MM, Mekkes JR, Bossuyt PM, et al. Natural course of physical and chronic urticaria and angioedema in 220 patients. J Am Acad Dermatol. 2001;45(3):387-91.
  • Reference21. Confino-Cohen R, Chodick G, Shalev V, et al. Chronic urticaria and autoimmunity: associations found in a large population study. J Allergy Clin Immunol. 2012;129(5):1307-13.
  • Reference22. Pan XF, Gu JQ, Shan ZY. The prevalence of thyroid autoimmunity in patients with urticaria: a systematic review and meta-analysis. Endocrine. 2015;48(3):804-10.
  • Reference23. Nordyke RA, Gilbert FI, Jr., Miyamoto LA, et al. The superiority of antimicrosomal over antithyroglobulin antibodies for detecting Hashimoto's thyroiditis. Arch Intern Med. 1993;153(7):862-5.
  • Reference24. Sibbald RG, Cheema AS, Lozinski A, et al Chronic urticaria. Evaluation of the role of physical, immunologic, and other contributory factors. Int J Dermatol. 1991;30(6):381-6.
  • Reference25. Kirkpatrick CH. A mechanism for urticaria/angioedema in patients with thyroid disease. J Allergy Clin Immunol. 2012;130(4):988-90.
  • Reference26. Azkur D, Civelek E, Toyran M,et al. Clinical and etiologic evaluation of the children with chronic urticaria. Allergy Asthma Proc. 2016;37(6):450-7.
  • Reference27. Sahiner UM, Civelek E, Tuncer A,et al. Chronic urticaria: etiology and natural course in children. Int Arch Allergy Immunol. 2011;156(2):224-30.
  • Reference28. Mete N, Gulbahar O, Aydin A, et al. Low B12 levels in chronic idiopathic urticaria. J Investig Allergol Clin Immunol. 2004;14(4):292-9.
  • Reference29. Wu CH, Eren E, Ardern-Jones MR, et al. Association between Micronutrient Levels and Chronic Spontaneous Urticaria. Biomed Res Int. 2015;2015:926167.
  • Reference30. Thorp WA, Goldner W, Meza J, et al. Reduced vitamin D levels in adult subjects with chronic urticaria. J Allergy Clin Immunol. 2010;126(2):413; author reply -4.
  • Reference31. Greaves M. Chronic urticaria. J Allergy Clin Immunol. 2000;105(4):664-72.
  • Reference32. Fine LM, Bernstein JA. Urticaria Guidelines: Consensus and Controversies in the European and American Guidelines. Curr Allergy Asthma Rep. 2015;15(6):30.
  • Reference33. Siles R, Xu M, Hsieh FH. The utility of serum tryptase as a marker in chronic spontaneous urticaria. Acta Derm Venereol. 2013;93(3):354-5.
  • Reference34. Sanchez J, Sanchez A, Cardona R. Prevalence of Drugs as Triggers of Exacerbations in Chronic Urticaria. J Investig Allergol Clin Immunol. 2019;29(2):112-7.
  • Reference35. Zinelli C, Caffarelli C, Strid J, et al. Measurement of nitric oxide and 8-isoprostane in exhaled breath of children with atopic eczema. Clin Exp Dermatol. 2009;34(5):607-12.

Factors Affecting the Duration of Disease in Chronic Urticarial; Single-Center Experience

Yıl 2022, Cilt: 44 Sayı: 1, 45 - 52, 14.01.2022

Mehmet Bankir Güzin Özden

https://doi.org/10.20515/otd.962823

Öz

Chronic urticaria (CU) is characterized by recurrent itchy blisters, angioedema, or both for more than six weeks. We evaluated patients' clinical and demographic characteristics, laboratory results, and factors affecting the disease's duration followed up with the diagnosis of chronic urticaria in our clinic. In our study 101 patients who applied to our outpatient clinic between March and December 2020 were included in the study. Demographic features, comorbid illness of patients, skin prick test results, phadiatop, Total IgE, anti-TPO, vitamin B12, vitamin D, ferritin, complete blood count, autologous serum skin test, urticaria activity score over seven days (UAS7) were examined from hospital records retrospectively. Correlations between variables and their effects on the duration of the disease were statistically investigated. It was observed that the duration of the disease was longer in chronic urticaria patients with anti-TPO positivity (p=0.019). As a result of the multiple regression analysis, it had been determined that the UAS7 value had 2,989 folding effects on the duration of the disease. A positive correlation between the duration of the disease and the UAS7 (r=0,277; p=0,005) was determined. The patients in the study defined as a longer disease duration in the patients with angioedema (p=0,005), dermatographism (p=0,012) and gender of female (p=0,031) Anti-TPO positivity, concomitant angioedema, dermatographism, and higher UAS7 scores predicts that their chronic urticaria will last longer.

Anahtar Kelimeler

Chronic urticaria disease duration anti-TPO ASST Urticaria activity score (UAS7) dermatographism

Kaynakça

  • Reference1. Zuberbier T, Aberer W, Asero R, et al. The EAACI/GA(2)LEN/EDF/WAO guideline for the definition, classification, diagnosis and management of urticaria. Allergy. 2018;73(7):1393-414.
  • Reference2. Bracken SJ, Abraham S, MacLeod AS. Autoimmune Theories of Chronic Spontaneous Urticaria. Front Immunol. 2019;10:627.
  • Reference3. Sanchez-Borges M, Asero R, Ansotegui IJ , et al. Diagnosis and treatment of urticaria and angioedema: a worldwide perspective. World Allergy Organ J. 2012;5(11):125-47.
  • Reference4. Maurer M, Rosen K, Hsieh HJ, et al. Omalizumab for the treatment of chronic idiopathic or spontaneous urticaria. N Engl J Med. 2013;368(10):924-35.
  • Reference5. Cordeiro Moreira AS, Rosmaninho Lopes de Soares ESMI, Pereira Guilherme MA, et al. Use of omalizumab in the treatment of chronic urticaria. Eur Ann Allergy Clin Immunol. 2016;48(6):242-6.
  • Reference6. Holgate ST, Djukanovic R, Casale T, et al. Anti-immunoglobulin E treatment with omalizumab in allergic diseases: an update on anti-inflammatory activity and clinical efficacy. Clin Exp Allergy. 2005;35(4):408-16.
  • Reference7. Quaranta JH, Rohr AS, Rachelefsky GS, et al. The natural history and response to therapy of chronic urticaria and angioedema. Ann Allergy. 1989;62(5):421-4.
  • Reference8. Hiragun M, Hiragun T, Mihara S, et al. Prognosis of chronic spontaneous urticaria in 117 patients not controlled by a standard dose of antihistamine. Allergy. 2013;68(2):229-35.
  • Reference9. Kolkhir P, Church MK, Weller K, et al. Autoimmune chronic spontaneous urticaria: What we know and what we do not know. J Allergy Clin Immunol. 2017;139(6):1772-81 e1.
  • Reference10. Altrichter S, Peter HJ, Pisarevskaja D, et al. IgE mediated autoallergy against thyroid peroxidase--a novel pathomechanism of chronic spontaneous urticaria? PLoS One. 2011;6(4):e14794.
  • Reference11. Kolkhir P, Metz M, Altrichter S, et al. Comorbidity of chronic spontaneous urticaria and autoimmune thyroid diseases: A systematic review. Allergy. 2017;72(10):1440-60.
  • Reference12. Sugiyama A, Nishie H, Takeuchi S, et al. Hashimoto's disease is a frequent comorbidity and an exacerbating factor of chronic spontaneous urticaria. Allergol Immunopathol (Madr). 2015;43(3):249-53.
  • Reference13. Kim YS, Han K, Lee JH, et al. Increased Risk of Chronic Spontaneous Urticaria in Patients With Autoimmune Thyroid Diseases: A Nationwide, Population-based Study. Allergy Asthma Immunol Res. 2017;9(4):373-7.
  • Reference14. Pepys J. Skin tests for immediate, type I, allergic reactions. Proc R Soc Med. 1972;65(3):271-2.
  • Reference15. Konstantinou GN, Asero R, Maurer M, et al. EAACI/GA(2)LEN task force consensus report: the autologous serum skin test in urticaria. Allergy. 2009;64(9):1256-68.
  • Reference16. Zuberbier T, Aberer W, Asero R, et al. The EAACI/GA(2) LEN/EDF/WAO Guideline for the definition, classification, diagnosis, and management of urticaria: the 2013 revision and update. Allergy. 2014;69(7):868-87.
  • Reference17. Merrett J, Merrett TG. Phadiatop--a novel IgE antibody screening test. Clin Allergy. 1987;17(5):409-16.
  • Reference18. Sanchez-Borges M, Caballero-Fonseca F, Capriles-Hulett A, et al. Factors linked to disease severity and time to remission in patients with chronic spontaneous urticaria. J Eur Acad Dermatol Venereol. 2017;31(6):964-71.
  • Reference19. Marin-Cabanas I, Berbegal-de Gracia L, de Leon-Marrero F, et al. Management of Chronic Spontaneous Urticaria in Routine Clinical Practice Following the EAACI/GA(2)LEN/EDF/WAO Guidelines. Actas Dermosifiliogr. 2017;108(4):346-53.
  • Reference20. Kozel MM, Mekkes JR, Bossuyt PM, et al. Natural course of physical and chronic urticaria and angioedema in 220 patients. J Am Acad Dermatol. 2001;45(3):387-91.
  • Reference21. Confino-Cohen R, Chodick G, Shalev V, et al. Chronic urticaria and autoimmunity: associations found in a large population study. J Allergy Clin Immunol. 2012;129(5):1307-13.
  • Reference22. Pan XF, Gu JQ, Shan ZY. The prevalence of thyroid autoimmunity in patients with urticaria: a systematic review and meta-analysis. Endocrine. 2015;48(3):804-10.
  • Reference23. Nordyke RA, Gilbert FI, Jr., Miyamoto LA, et al. The superiority of antimicrosomal over antithyroglobulin antibodies for detecting Hashimoto's thyroiditis. Arch Intern Med. 1993;153(7):862-5.
  • Reference24. Sibbald RG, Cheema AS, Lozinski A, et al Chronic urticaria. Evaluation of the role of physical, immunologic, and other contributory factors. Int J Dermatol. 1991;30(6):381-6.
  • Reference25. Kirkpatrick CH. A mechanism for urticaria/angioedema in patients with thyroid disease. J Allergy Clin Immunol. 2012;130(4):988-90.
  • Reference26. Azkur D, Civelek E, Toyran M,et al. Clinical and etiologic evaluation of the children with chronic urticaria. Allergy Asthma Proc. 2016;37(6):450-7.
  • Reference27. Sahiner UM, Civelek E, Tuncer A,et al. Chronic urticaria: etiology and natural course in children. Int Arch Allergy Immunol. 2011;156(2):224-30.
  • Reference28. Mete N, Gulbahar O, Aydin A, et al. Low B12 levels in chronic idiopathic urticaria. J Investig Allergol Clin Immunol. 2004;14(4):292-9.
  • Reference29. Wu CH, Eren E, Ardern-Jones MR, et al. Association between Micronutrient Levels and Chronic Spontaneous Urticaria. Biomed Res Int. 2015;2015:926167.
  • Reference30. Thorp WA, Goldner W, Meza J, et al. Reduced vitamin D levels in adult subjects with chronic urticaria. J Allergy Clin Immunol. 2010;126(2):413; author reply -4.
  • Reference31. Greaves M. Chronic urticaria. J Allergy Clin Immunol. 2000;105(4):664-72.
  • Reference32. Fine LM, Bernstein JA. Urticaria Guidelines: Consensus and Controversies in the European and American Guidelines. Curr Allergy Asthma Rep. 2015;15(6):30.
  • Reference33. Siles R, Xu M, Hsieh FH. The utility of serum tryptase as a marker in chronic spontaneous urticaria. Acta Derm Venereol. 2013;93(3):354-5.
  • Reference34. Sanchez J, Sanchez A, Cardona R. Prevalence of Drugs as Triggers of Exacerbations in Chronic Urticaria. J Investig Allergol Clin Immunol. 2019;29(2):112-7.
  • Reference35. Zinelli C, Caffarelli C, Strid J, et al. Measurement of nitric oxide and 8-isoprostane in exhaled breath of children with atopic eczema. Clin Exp Dermatol. 2009;34(5):607-12.
Toplam 35 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm ORİJİNAL MAKALELER / ORIGINAL ARTICLES
Yazarlar

Mehmet Bankir 0000-0003-3284-2838

Güzin Özden 0000-0003-4856-2267

Yayımlanma Tarihi 14 Ocak 2022
Yayımlandığı Sayı Yıl 2022 Cilt: 44 Sayı: 1

Kaynak Göster

Vancouver Bankir M, Özden G. Factors Affecting the Duration of Disease in Chronic Urticarial; Single-Center Experience. Osmangazi Tıp Dergisi. 2022;44(1):45-52.


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