慢性特发性荨麻疹：抗FcepsilonRI或抗IgE自身抗体阳性与阴性患者的临床特征比较
Chronic idiopathic urticaria: comparison of the clinical features of patients with and without anti-FcepsilonRI or anti-IgE autoantibodies.
作者信息
Sabroe R A, Seed P T, Francis D M, Barr R M, Black A K, Greaves M W
机构信息
Professorial Unit, St John's Institute of Dermatology, Guy's, King's College and St Thomas's Hospitals' Medical and Dental Schools, London, United Kingdom.
出版信息
J Am Acad Dermatol. 1999 Mar;40(3):443-50. doi: 10.1016/s0190-9622(99)70495-0.
BACKGROUND
Previous studies defining the clinical features of patients with chronic idiopathic urticaria (CIU) were performed before the identification of functional autoantibodies against FcepsilonRI and/or IgE, now known to be present in approximately 30% of patients with CIU.
OBJECTIVE
Our purpose was to determine whether there are differences between patients with and those without autoantibodies in the clinical features or severity of CIU.
METHODS
The clinical features of 107 patients with CIU were evaluated prospectively. Patients were identified as having functional autoantibodies on the basis of the serum-evoked histamine release in vitro from the basophils of 2 healthy donors.
RESULTS
Patients with autoantibodies (31%) had more wheals (P = .005), a wider distribution of wheals (P = .009), higher itch scores for the most severe episodes of itching (P = .002), more systemic symptoms (P = .03), and lower serum IgE levels (P < .0005) than patients without autoantibodies.
CONCLUSION
The presence of autoantibodies indicates a subset of patients with more severe CIU.
背景
之前关于定义慢性特发性荨麻疹（CIU）患者临床特征的研究是在针对高亲和力IgE受体（FcepsilonRI）和/或IgE的功能性自身抗体被发现之前进行的，现在已知约30%的CIU患者存在此类抗体。
目的
我们的目的是确定CIU患者中存在自身抗体和不存在自身抗体的患者在临床特征或严重程度上是否存在差异。
方法
对107例CIU患者的临床特征进行前瞻性评估。根据来自2名健康供体嗜碱性粒细胞的体外血清诱导组胺释放情况，确定患者是否具有功能性自身抗体。
结果
与无自身抗体的患者相比，有自身抗体的患者（31%）风团更多（P = 0.005）、风团分布更广（P = 0.009）、最严重瘙痒发作时的瘙痒评分更高（P = 0.002）、全身症状更多（P = 0.03）且血清IgE水平更低（P < 0.0005）。
结论
自身抗体的存在表明一部分CIU患者病情更严重。
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