Department of Allergy and Clinical Immunology, Rappaport Faculty of Medicine, Technion, Haifa, Israel.
Proteomic and Flow Cytometry Unit, Bnai-Zion Medical Center, Rappaport Faculty of Medicine, Technion, Haifa, Israel.
J Dermatol. 2021 Nov;48(11):1786-1788. doi: 10.1111/1346-8138.16119. Epub 2021 Sep 14.
When chronic spontaneous urticaria (CSU) is resolved, patients are often apprehensive about the likelihood of recurrence, and want to know if we can predict this using clinical or laboratory markers. This question is crucial because CSU is frequently accompanied by a high incidence of stressful comorbidities, and the fear of experiencing this again can be devastating to the patient. This study was designed with the aim of focusing on the prevalence and characteristics of the recurrence of CSU. We used our CSU patient registry that includes data on 180 patients who are followed periodically. In 23 (13%) patients, CSU was resolved during the first year. In 47 (26%) patients, CSU lasted more than 5 years. The recurrence of CSU was recorded in 21% of our patients after having experienced a full remission anywhere between 1 to 10 years (mean ± 2.9 years). While investigating predictive clinical or laboratory markers, we noticed that bronchial asthma existed in 10/25 (40%) of patients in whom CSU recurred as compared with 45/180 (25%) in the general CSU population (p = 0.049). In addition, increased levels of total immunoglobulin (Ig)E were found in 10/25 (40%) of the recurrence group as compared with 34/150 (23%) of the general CSU group (p = 0.04). Anti-thyroid peroxidase antibodies were also found in 11/25 (44%) of the recurrence group as compared with 32/160 (20%) of the general group (p = 0.003). The prevalence of CSU recurrence after a full remission is significantly higher among patients with existing bronchial asthma, increased levels of total IgE, and autoimmunity. Further studies are required in order to substantiate this important issue.
当慢性自发性荨麻疹（CSU）得到缓解后，患者通常会担心其复发的可能性，并希望知道我们是否可以使用临床或实验室标志物来预测这种情况。这个问题至关重要，因为 CSU 常伴有高发生率的应激性合并症，再次经历这种疾病的恐惧可能对患者造成毁灭性的影响。本研究旨在关注 CSU 复发的患病率和特征。我们使用了包含定期随访的 180 名患者数据的 CSU 患者登记处。在 23 名（13%）患者中，CSU 在第一年得到缓解。在 47 名（26%）患者中，CSU 持续了 5 年以上。在经历了 1 至 10 年（平均 2.9 年）的完全缓解后，我们的患者中有 21%记录到了 CSU 的复发。在研究预测性的临床或实验室标志物时，我们注意到支气管哮喘存在于 25 名（40%）复发患者中，而在一般 CSU 人群中，有 180 名（25%）患者存在支气管哮喘（p = 0.049）。此外，在复发组中，10/25（40%）名患者的总免疫球蛋白（Ig）E 水平升高，而在一般 CSU 组中，有 34/150（23%）名患者的总 IgE 水平升高（p = 0.04）。在复发组中，还发现了 11/25（44%）名患者存在抗甲状腺过氧化物酶抗体，而在一般组中，有 32/160（20%）名患者存在抗甲状腺过氧化物酶抗体（p = 0.003）。在完全缓解后复发 CSU 的患者中，现有的支气管哮喘、总 IgE 水平升高和自身免疫的患病率明显更高。需要进一步的研究来证实这个重要问题。
