Sedat Vezir1, Filiz Kaya2, Emine Vezir3, Nermin Karaosmanoğlu4, Ali Kudret Adiloğlu5. 1. Department of Medical Microbiology, Atatürk Chest Disease and Chest Surgery Training and Research Hospital, Health Sciences University, Ankara, Turkey. sedatvezir@gmail.com. 2. Department of Medical Microbiology, Ankara Education and Research Hospital, Health Sciences University, Ankara, Turkey. filizdemirelkaya@gmail.com. 3. Department of Pediatric Allergy and Immunology, Ankara Education and Research Hospital, Health Sciences University, Ankara, Turkey. eminevezir@gmail.com. 4. Department of Dermatology, Ankara Education and Research Hospital, Health Sciences University, Ankara, Turkey. nermin_kara@yahoo.com. 5. Department of Medical Microbiology, Ankara Education and Research Hospital, Health Sciences University, Ankara, Turkey. aliadiloglu@gmail.com.
Abstract
INTRODUCTION: Chronic spontaneous urticaria (CSU) which develops without a known stimulation is defined as the occurrence of spontaneous wheals, angioedema or both for longer than six weeks. Infections, autoimmunity, food intolerance and internal parasitic infections are supposed to be underlying causes of CSU. The aim of this study was to evaluate the intestinal parasites in children and adult patients diagnosed as CSU, to determine the frequency of parasites in chronic urticaria, and to compare these patients with healthy demographic control groups. METHODOLOGY: Seventy six children and 38 adult patients with CSU were examined in terms of parasitic infections. The patients whom parasites were detected received anti-parasitic therapy and the improvements in CSU symptoms were evaluated. Stool samples were examined with direct microscopic examination (native-lugol), stool concentration and trichrome staining methods. RESULTS: In pediatric patient group, 18.4% (n = 14) of the stool samples were positive for Blastocystis sp., 2.6% (n = 2), Dientamoeba fragilis and 1.3% (n = 1), Giardia duodenalis. In adult patient group, Blastocystis sp. was detected in 18.4% (n = 7) of the stool samples. Anti-parasitic therapy yielded substantial improvement in urticaria symptoms in 57.1% of pediatric and 60.0% of adult patients. CONCLUSIONS: Blastocystis sp. and D. fragilis may play a role in chronic urticaria which seriously disrupts the patient's quality of life. Parasitic infections should not be neglected in patients with cutaneous manifestations. Copyright (c) 2019 Filiz Kaya, Sedat Vezir, Emine Vezir, Nermin Karaosmanoglu, Ali Kudret Adiloglu.
INTRODUCTION: Chronic spontaneous urticaria (CSU) which develops without a known stimulation is defined as the occurrence of spontaneous wheals, angioedema or both for longer than six weeks. Infections, autoimmunity, food intolerance and internal parasitic infections are supposed to be underlying causes of CSU. The aim of this study was to evaluate the intestinal parasites in children and adult patients diagnosed as CSU, to determine the frequency of parasites in chronic urticaria, and to compare these patients with healthy demographic control groups. METHODOLOGY: Seventy six children and 38 adult patients with CSU were examined in terms of parasitic infections. The patients whom parasites were detected received anti-parasitic therapy and the improvements in CSU symptoms were evaluated. Stool samples were examined with direct microscopic examination (native-lugol), stool concentration and trichrome staining methods. RESULTS: In pediatric patient group, 18.4% (n = 14) of the stool samples were positive for Blastocystis sp., 2.6% (n = 2), Dientamoeba fragilis and 1.3% (n = 1), Giardia duodenalis. In adult patient group, Blastocystis sp. was detected in 18.4% (n = 7) of the stool samples. Anti-parasitic therapy yielded substantial improvement in urticaria symptoms in 57.1% of pediatric and 60.0% of adult patients. CONCLUSIONS:Blastocystis sp. and D. fragilis may play a role in chronic urticaria which seriously disrupts the patient's quality of life. Parasitic infections should not be neglected in patients with cutaneous manifestations. Copyright (c) 2019 Filiz Kaya, Sedat Vezir, Emine Vezir, Nermin Karaosmanoglu, Ali Kudret Adiloglu.