Gonzalez-Diaz Sandra Nora, Sanchez-Borges Mario, Rangel-Gonzalez Diana Maria, Guzman-Avilan Rosa Ivett, Canseco-Villarreal Jose Ignacio, Arias-Cruz Alfredo
Centro Regional de Alergia e Inmunología Clinica, Hospital Universitario "Dr. José Eleuterio González", Ave. Gonzalitos y Madero, s/n, Colonia Mitras Centro, CP. 64460, Monterrey, Nuevo Leon, Mexico.
Allergy and Clinical Immunology Department, Centro Medico Docente La Trinidad, Allergy Service, Clinica El Avila, 6a. Transversal Urb. Altamira, Piso 8, Consultorio 803, Caracas, 1060, Venezuela.
World Allergy Organ J. 2020 Mar 6;13(3):100101. doi: 10.1016/j.waojou.2020.100101. eCollection 2020 Mar.
Urticaria is defined as the sudden appearance of erythematous, itchy wheals of variable size, with or without angioedema (AE) (swelling of the deeper layers of the skin). Its classification depends on time course of symptoms and the presence of eliciting factors. When it lasts less than 6 weeks it is classified as acute urticaria (AU), and if the symptoms persist for more than 6 weeks, it is classified as chronic urticaria (CU). Current International Guidelines also classify CU as chronic spontaneous urticaria (CSU) and inducible urticarial, according to the absence or presence of environmental triggering factors. CSU is defined as urticaria and/or angioedema in which there is no evidence of a specific eliciting factor. CSU is associated with autoimmunity in 30-45% of the cases, sharing some immunological mechanisms with other autoimmune diseases, and is associated with autoimmune thyroid disease (ATD) in about 4.3%-57.4% patients. Several studies suggest that adequate therapy with -thyroid drugs or levothyroxine in early stages of ATD and CSU, may help to remit the latter; but there is still a lack of double-blind, placebo-controlled studies that support this hypothesis in patients without abnormal thyroid hormone levels. The objective of this review is to describe the pathophysiology of chronic spontaneous urticaria and its association with autoimmune thyroid disease.
荨麻疹的定义为突然出现大小不一的红斑性、瘙痒性风团，可伴有或不伴有血管性水肿（AE）（皮肤深层肿胀）。其分类取决于症状的病程以及诱发因素的存在情况。当病程持续少于6周时，被分类为急性荨麻疹（AU）；如果症状持续超过6周，则被分类为慢性荨麻疹（CU）。目前的国际指南还根据是否存在环境触发因素，将CU分为慢性自发性荨麻疹（CSU）和诱导性荨麻疹。CSU被定义为无特定诱发因素证据的荨麻疹和/或血管性水肿。在30%-45%的病例中，CSU与自身免疫相关，与其他自身免疫性疾病有一些共同的免疫机制，并且在约4.3%-57.4%的患者中与自身免疫性甲状腺疾病（ATD）相关。多项研究表明，在ATD和CSU的早期阶段，使用甲状腺药物或左甲状腺素进行充分治疗，可能有助于缓解后者；但仍缺乏在甲状腺激素水平无异常的患者中支持这一假设的双盲、安慰剂对照研究。本综述的目的是描述慢性自发性荨麻疹的病理生理学及其与自身免疫性甲状腺疾病的关联。
