甲状腺自身免疫与慢性自发性荨麻疹自身免疫与疾病严重程度、治疗反应及慢性自发性荨麻疹患者缓解时间相关。
Thyroid Autoimmunity and Autoimmunity in Chronic Spontaneous Urticaria Linked to Disease Severity, Therapeutic Response, and Time to Remission in Patients with Chronic Spontaneous Urticaria.
机构信息
Division of Dermatology, Department of Internal Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
出版信息
Biomed Res Int. 2018 Nov 1;2018:9856843. doi: 10.1155/2018/9856843. eCollection 2018.
BACKGROUND
Chronic spontaneous urticaria (CSU) is autoimmune in nature and associated with thyroid autoimmunity (TA), but evidence on autoimmunity in relation to CSU progression and prognosis is limited. We evaluated whether TA and autoimmunity in CSU are correlated with disease severity, therapeutic response, and time to remission and establish an association between CSU characteristics linked to thyroid autoantibody.
METHODS
Medical records of patients diagnosed with urticaria attending outpatient dermatology clinic at a university-based hospital from 2013 to 2017 were retrospectively reviewed. Data on the clinical characteristics, laboratory investigations particularly thyroid antibody titers, autologous serum skin test (ASST) and autologous plasma skin test (APST) results and their link to disease severity, treatments, and time to remission of CSU patients were analyzed.
RESULTS
Of 1,096 patients with urticaria, 60.2% had CSU. Three-hundred patients fulfilled the inclusion criteria for CSU with complete thyroid antibody testing. Positive TA was significantly associated with female gender and age > 35 years (p = 0.008). Antithyroid peroxidase (anti-TPO)-positive patients suffered from CSU longer than 12 and 18 months compared to anti-TPO-negative patients (100.0% vs. 82.6%, p = 0.042, and 100.0% vs. 75.9% p = 0.020, respectively). The presence of urticarial attacks > 4 days/week was significantly seen in ASST and APST-positive patients compared to those without (84.6% vs. 61.3%, p = 0.011, and 85.3% vs. 61.8%, p = 0.006, respectively). Positive APST patients were more difficult to treat than those with negative results (61.2% vs. 37.8%, p = 0.017).
CONCLUSIONS
Antithyroid peroxidase is a predictor of time to remission, while autologous skin testing is linked to disease severity (ASST and APST) and therapeutic response (APST) in CSU patients.
背景
慢性自发性荨麻疹（CSU）本质上是自身免疫性的，与甲状腺自身免疫（TA）有关，但有关 CSU 进展和预后的自身免疫证据有限。我们评估了 CSU 中的 TA 和自身免疫是否与疾病严重程度、治疗反应以及缓解时间有关，并确定了与甲状腺自身抗体相关的 CSU 特征之间的关联。
方法
回顾性分析了 2013 年至 2017 年在大学附属医院皮肤科门诊就诊的被诊断为荨麻疹的患者的病历。分析了临床特征、实验室检查（特别是甲状腺抗体滴度）、自身血清皮肤试验（ASST）和自身血浆皮肤试验（APST）结果及其与 CSU 患者疾病严重程度、治疗和缓解时间的关系。
结果
在 1096 例荨麻疹患者中，60.2%为 CSU。300 例符合 CSU 纳入标准且完成了完整的甲状腺抗体检测。TA 阳性与女性和年龄>35 岁显著相关（p = 0.008）。与抗甲状腺过氧化物酶（anti-TPO）阴性患者相比，抗-TPO 阳性患者的 CSU 持续时间超过 12 个月和 18 个月的比例更高（100.0% vs. 82.6%，p = 0.042，和 100.0% vs. 75.9%，p = 0.020）。与 ASST 和 APST 阴性患者相比，每周出现>4 天荨麻疹发作的患者在 ASST 和 APST 阳性患者中更为常见（84.6% vs. 61.3%，p = 0.011，和 85.3% vs. 61.8%，p = 0.006）。APST 阳性患者比结果阴性患者更难治疗（61.2% vs. 37.8%，p = 0.017）。
结论
抗甲状腺过氧化物酶是缓解时间的预测因素，而自身皮肤试验与 CSU 患者的疾病严重程度（ASST 和 APST）和治疗反应（APST）相关。
Zotero 插件