Zamir Calamita1, Andrea Bronhara Pelá Calamita. 1. Division of Allergy and Clinical Immunology of Marília Medical School (FAMEMA), Marília, São Paulo, Brazil. calamita@unimedmarilia.com.br
Abstract
BACKGROUND: Understanding the etiopathogenesis of chronic spontaneous urticaria (CSU) remains a challenge. The clinical and laboratory characteristics relating to its histocompatibility profile and autoimmunity are constant research topics. OBJECTIVES: To analyze the clinical and laboratory characteristics of patients with CSU by means of a cross-sectional study, focusing on the histocompatibility profile, presence of antinuclear antibodies (ANA) and presence of antithyroperoxidase antibodies (anti-TPO). MATERIALS & METHODS: Sixty-seven adults with CSU were analyzed. The autologous serum skin test (ASST), ANA and anti-TPO were performed in all cases and MHC classes I and II (loci A, B and DR) were evaluated in 49 patients. RESULTS: The factors that worsened urticaria included use of non-steroid anti-inflammatory drugs, emotional stress and physical stimuli, reported by 27%, 16% and 15% of these patients, respectively. The ASST test was positive in 49 patients (73%) and anti-TPO and ANA were present in 15 (22.4%) and 7 (10.5%), respectively. The OR (with 95% CI) for the association between ANA and anti-TPO was 5.94 (1.16-30.42), and thus statistically significant. There was a favorable association (with statistical significance) between HLA B*50 and patients with CSU, with OR (95% CI) of 2.96 (1.17- 7.48). CONCLUSION: A significant favorable association was found between these patients and HLA B*50, and between the presence of anti-TPO and ANA. The greater prevalence of HLA B*50 in these patients and the association between ANA and anti-TPO reinforce the possibility that an immunogenic mechanism may be the triggering factor for CSU.
BACKGROUND: Understanding the etiopathogenesis of chronic spontaneous urticaria (CSU) remains a challenge. The clinical and laboratory characteristics relating to its histocompatibility profile and autoimmunity are constant research topics. OBJECTIVES: To analyze the clinical and laboratory characteristics of patients with CSU by means of a cross-sectional study, focusing on the histocompatibility profile, presence of antinuclear antibodies (ANA) and presence of antithyroperoxidase antibodies (anti-TPO). MATERIALS & METHODS: Sixty-seven adults with CSU were analyzed. The autologous serum skin test (ASST), ANA and anti-TPO were performed in all cases and MHC classes I and II (loci A, B and DR) were evaluated in 49 patients. RESULTS: The factors that worsened urticaria included use of non-steroid anti-inflammatory drugs, emotional stress and physical stimuli, reported by 27%, 16% and 15% of these patients, respectively. The ASST test was positive in 49 patients (73%) and anti-TPO and ANA were present in 15 (22.4%) and 7 (10.5%), respectively. The OR (with 95% CI) for the association between ANA and anti-TPO was 5.94 (1.16-30.42), and thus statistically significant. There was a favorable association (with statistical significance) between HLA B*50 and patients with CSU, with OR (95% CI) of 2.96 (1.17- 7.48). CONCLUSION: A significant favorable association was found between these patients and HLA B*50, and between the presence of anti-TPO and ANA. The greater prevalence of HLA B*50 in these patients and the association between ANA and anti-TPO reinforce the possibility that an immunogenic mechanism may be the triggering factor for CSU.