Department of Dermatology, Faculdade de Medicina do ABC, Santo André, SP, Brazil.
Infusion Center, Faculdade de Medicina do ABC, Santo André, SP, Brazil.
An Bras Dermatol. 2021 Mar-Apr;96(2):148-154. doi: 10.1016/j.abd.2020.07.006. Epub 2021 Feb 1.
The pathophysiology of urticaria is still poorly understood. Recent studies demonstrate that the activation of coagulation is correlated with the clinical activity of Chronic Spontaneous Urticaria. Coagulation and inflammation are strongly linked.
To correlate the severity and activity of Chronic Spontaneous Urticaria with the levels of D-dimer, C-reactive protein, and autologous serum test in patients with Chronic Spontaneous Urticaria.
The study included 55 patients diagnosed with chronic spontaneous urticaria. D-dimer levels were measured using enzyme-linked fluorescent assay and C-reactive protein levels were measured using the nephelometric method; autologous serum testing was performed on patients who discontinued antihistamine therapy. The severity of the disease was assessed using the urticaria activity score.
patients with severe, spontaneous, and difficult-to-control chronic urticaria had elevated serum levels of D-dimer, as well as a positive autologous serum test. Little correlation was demonstrated between the severity of chronic spontaneous urticaria and the levels of C-reactive protein.
The authors concluded that patients with severe Chronic Spontaneous Urticaria showed signs of activated fibrinolysis. Most patients with high clinical scores had high D-dimer values. Patients with positive results for the autologous serum test also had more severe Chronic Spontaneous Urticaria and needed more drugs to control the disease. Finally, little correlation was found between C-reactive protein levels and disease severity.
The main limitation was the small sample of patients. In the present patients, it was demonstrated that serum D-dimer levels and the autologous serum test can act as predictive markers of severity and activity of Chronic Spontaneous Urticaria.
荨麻疹的病理生理学仍知之甚少。最近的研究表明，凝血的激活与慢性自发性荨麻疹的临床活动相关。凝血和炎症密切相关。
将慢性自发性荨麻疹患者的 D-二聚体、C 反应蛋白和自身血清试验水平与慢性自发性荨麻疹的严重程度和活动度进行相关性分析。
该研究纳入了 55 例确诊为慢性自发性荨麻疹的患者。使用酶联荧光分析法测量 D-二聚体水平，使用散射比浊法测量 C 反应蛋白水平；在停止抗组胺治疗的患者中进行自身血清检测。使用荨麻疹活动评分评估疾病的严重程度。
患有严重、自发性、难以控制的慢性荨麻疹的患者血清 D-二聚体水平升高，自身血清试验阳性。慢性自发性荨麻疹的严重程度与 C 反应蛋白水平之间几乎没有相关性。
作者得出结论，患有严重慢性自发性荨麻疹的患者存在纤维蛋白溶解激活的迹象。大多数临床评分较高的患者 D-二聚体值较高。自身血清试验阳性的患者也患有更严重的慢性自发性荨麻疹，需要更多的药物来控制疾病。最后，C 反应蛋白水平与疾病严重程度之间几乎没有相关性。
主要的局限性是患者样本量小。在本研究中，证明了血清 D-二聚体水平和自身血清试验可以作为慢性自发性荨麻疹严重程度和活动度的预测标志物。
