Leumit Health Services, Barzilai Medical Center, Ben Gurion University of Negev, Ashkelon, Israel.
Int J Dermatol. 2012 Jan;51(1):94-7. doi: 10.1111/j.1365-4632.2011.05172.x.
Autoimmune thyroiditis (AT) is more prevalent in patients with chronic idiopathic urticaria CIU) than in the general population. Previous small studies without any controlled comparison reported that CIU remits in patients with CIU and AT treated with L-thyroxine. To determine whether l-thyroxine treatment can improve the clinical course of CIU in patients with the co-occurrence of AT and CIU. A total of 749 patients with CIU were retrospectively studied. Clinical and laboratory evaluation and classification of chronic urticaria were performed according to the EAACI/GA(2)LEN/EDF/WAO guidelines. After L-thyroxine treatment for 53 ± 19 days, euthyroidism was restored in all subjects. Urticaria activity score (UAS) was evaluated at baseline and after three and six months. The control group consisted of matched 44 euthyroid subjects with CIU. A total of 44 (5.9%) patients were diagnosed to have hypothyroidism related to AT. Autologous serum skin test (ASST) was found to be positive in 17 (38.6%) of them. There was no statistically significant difference in baseline UAS, between the ASST+ (3.94 ± 1.52) and the ASST- (3.63 ± 1.42; P = 0.27) hypothyroid subjects and the euthyroid CIU controls (3.73 ± 1.74). During the L-thyroxine treatment, a significant reduction of UAS was observed in both hypothyroid ASST+ and ASST- subjects. However, the mean UAS after three and six months of L-thyroxine treatment remained not significantly different from that in control euthyroid subjects with CIU. L-Thyroxine treatment has no effect on the course of CIU in patients with CIU and AT.
自身免疫性甲状腺炎（AT）在慢性特发性荨麻疹（CIU）患者中比普通人群更为常见。以前的小样本研究没有任何对照比较报告称，CIU 和 AT 患者在接受 L-甲状腺素治疗后会缓解。为了确定 L-甲状腺素治疗是否可以改善 AT 合并 CIU 患者的 CIU 临床病程。回顾性研究了 749 例 CIU 患者。根据 EAACI/GA(2)LEN/EDF/WAO 指南进行临床和实验室评估以及慢性荨麻疹分类。在 L-甲状腺素治疗 53±19 天后，所有受试者均恢复了甲状腺功能正常。在基线和三个月及六个月时评估荨麻疹活动评分（UAS）。对照组由 44 名匹配的甲状腺功能正常的 CIU 患者组成。共有 44 名（5.9%）患者被诊断为与 AT 相关的甲状腺功能减退症。自身血清皮肤试验（ASST）阳性者 17 例（38.6%）。ASST+（3.94±1.52）和 ASST-（3.63±1.42；P=0.27）甲状腺功能减退症患者与甲状腺功能正常的 CIU 对照组（3.73±1.74）在基线 UAS 方面无统计学差异。在 L-甲状腺素治疗期间，ASST+和 ASST-甲状腺功能减退症患者的 UAS 均显著降低。然而，L-甲状腺素治疗三个月和六个月后的平均 UAS 与甲状腺功能正常的 CIU 对照组相比仍无显著差异。L-甲状腺素治疗对 CIU 和 AT 患者的 CIU 病程没有影响。
