Tropical Medicine and Infectious Diseases Department, Tanta, Egypt.
Clinical Pathology Department, Tanta, Egypt.
Am J Clin Pathol. 2021 Feb 11;155(3):405-411. doi: 10.1093/ajcp/aqaa134.
The association between Helicobacter pylori and chronic spontaneous urticaria (CSU) is controversial. Therefore, we aimed to directly diagnose H pylori by polymerase chain reaction (PCR) in gastric tissue from patients with CSU and to investigate the association between H pylori eradication therapy and CSU remission.
Twenty-seven of 72 patients with CSU who were positive for H pylori stool antigen and PCR in gastric biopsy specimens were randomized to receive either anti-H pylori treatment or placebo.
Patients with H pylori were found to have significantly lower hemoglobin concentrations with microcytic hypochromic anemia and a significantly higher occurrence of dyspepsia symptoms. All H pylori-treated patients (except two) showed significant improvement of the urticaria itching and red wheals after 2 weeks of therapy compared with the placebo group (P < .001). The response rate to treatment was 85.7% (12 patients; 95% confidence interval, 64.3%-100.0%). The two patients who failed to eradicate H pylori had an H pylori strain resistant to amoxicillin.
An association was observed between CSU and presence of H pylori infection in the gastric tissue. Whether this is a causal relationship or not remains to be discovered, but treatment of H pylori can significantly improve the symptoms of CSU.
幽门螺杆菌（H.pylori）与慢性自发性荨麻疹（CSU）之间的关联存在争议。因此，我们旨在通过聚合酶链反应（PCR）直接诊断 CSU 患者胃组织中的 H.pylori，并研究 H.pylori 根除治疗与 CSU 缓解之间的关系。
72 例 H.pylori 粪便抗原和胃活检标本 PCR 阳性的 CSU 患者中，有 27 例被随机分为接受抗 H.pylori 治疗或安慰剂组。
H.pylori 患者的血红蛋白浓度明显较低，呈小细胞低色素性贫血，消化不良症状的发生率明显较高。所有接受 H.pylori 治疗的患者（除两名患者外）在治疗 2 周后，荨麻疹瘙痒和红色风团均明显改善，与安慰剂组相比差异具有统计学意义（P＜0.001）。治疗的应答率为 85.7%（12 例；95%置信区间，64.3%-100.0%）。两名未能根除 H.pylori 的患者的 H.pylori 菌株对阿莫西林耐药。
CSU 与胃组织中 H.pylori 感染之间存在关联。这是否是因果关系还有待发现，但 H.pylori 的治疗可以显著改善 CSU 的症状。
