Guarneri Fabrizio, Guarneri Claudio, Cannavò Serafinella Patrizia
Department of Clinical and Experimental Medicine - Dermatology, University of Messina, Messina, Italy.
Dermatol Ther. 2014 Jul-Aug;27(4):223-6. doi: 10.1111/dth.12122. Epub 2014 Mar 27.
Chronic urticaria (CU) is frequent, remains often idiopathic despite diagnostic efforts, and sometimes poorly responds to oral antihistamines and/or corticosteroids. We noticed that hyposideremia is often found in patients with chronic idiopathic urticaria poorly responsive to usual treatments (prCIU), and oral iron therapy is frequently associated to improvement or resolution of urticaria. Between 2003 and 2012, we observed 122 patients with prCIU, of which 81 had moderate hyposideremia at our first visit. They continued the antihistamines already practiced and received oral iron therapy for 30 or 45 days. Two months after our first visit, all had normal serum iron levels; 64 reported complete remission of urticaria and 17 reported improvement superior to 80%. No adverse reactions to treatment were observed. Follow-up visits confirmed stability of results over 6 months. Our preliminary data show that hyposideremia is the only abnormality in many patients with prCIU, and restoration of normal iron serum levels is associated to remission or remarkable clinical improvement of urticaria. In consideration of low cost and potential benefits for some patients, determination of serum levels of iron could be introduced in the diagnostic workup of chronic urticaria, maybe as a second-level exam in patients without other relevant clinical or laboratory abnormalities.
慢性荨麻疹（CU）很常见，尽管经过诊断努力，仍常常病因不明，且有时对口服抗组胺药和/或皮质类固醇反应不佳。我们注意到，在对常规治疗反应不佳的慢性特发性荨麻疹（prCIU）患者中经常发现低铁血症，口服铁剂治疗常与荨麻疹的改善或消退相关。在2003年至2012年期间，我们观察了122例prCIU患者，其中81例在初次就诊时患有中度低铁血症。他们继续服用已在使用的抗组胺药，并接受了30或45天的口服铁剂治疗。初次就诊两个月后，所有患者的血清铁水平均恢复正常；64例报告荨麻疹完全缓解，17例报告改善率超过80%。未观察到治疗的不良反应。随访证实结果在6个月内稳定。我们的初步数据表明，低铁血症是许多prCIU患者唯一的异常情况，血清铁水平恢复正常与荨麻疹的缓解或显著临床改善相关。考虑到成本低廉且对部分患者可能有益，血清铁水平测定可引入慢性荨麻疹的诊断检查中，或许作为对无其他相关临床或实验室异常患者的二级检查。
