Ashraf Raihan, Bishnoi Anuradha, Mehta Hitaishi, Parsad Davinder, Kumaran Muthu Sendhil
Department of Dermatology, Venereology, and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Indian Dermatol Online J. 2024 Jun 26;15(4):630-633. doi: 10.4103/idoj.idoj_703_23. eCollection 2024 Jul-Aug.
Comprehensive long-term follow-up data regarding chronic spontaneous urticaria (CSU) among general populations, especially from the Indian subcontinent is scanty.
The aim of the study were to analyze the clinico-epidemiological profile, comorbidities of CSU patients, and factors affecting patient response to various doses of levocetirizine.
In this retrospective cohort study, complete history regarding demographic profile, clinical examination, investigations, treatment given, and follow-up details of all CSU patients attending urticaria clinic between 2010 and 2019 were analyzed. These were considered variables to determine the factors playing a role in response to various doses of levocetirizine.
Totally, 1104 files of CSU were analyzed. The male-to-female ratio was 1:1.5 with a mean age of 33.03 ± 14.33 years. Thyroid dysfunction and atopy were seen in 142 (12.8%) and 184 (16.7%) patients, respectively. Vitamin D deficiency and high serum immunoglobulin E (IgE) levels were seen in 461 (41.7%) and 340 (30.7%) patients, respectively. Immunosuppressives were required at some point in 196 (17.7%) patients. Patients with higher levels of serum IgE and D-dimer ( < 0.05) were found to require frequent updosing of levocetirizine, while age, sex, duration of illness, presence of angioedema, co-morbidities, identifiable precipitating factors, presence of diurnal variation, family history, and vitamin D deficiency were found to not have an effect on levocetirizine dosing.
Ours is a large single-center study exemplifying the biomarkers including baseline serum IgE and D-dimer levels, which could identify a CSU patient who could warrant a higher dose of antihistamine/antihistamine refractory urticaria.
关于普通人群中慢性自发性荨麻疹（CSU）的全面长期随访数据较少，尤其是来自印度次大陆的数据。
本研究旨在分析CSU患者的临床流行病学特征、合并症以及影响患者对不同剂量左西替利嗪反应的因素。
在这项回顾性队列研究中，分析了2010年至2019年间就诊于荨麻疹门诊的所有CSU患者的人口统计学资料、临床检查、检查结果、治疗情况及随访细节等完整病史。将这些作为变量来确定影响对不同剂量左西替利嗪反应的因素。
共分析了1104份CSU病例档案。男女比例为1:1.5，平均年龄为33.03±14.33岁。分别有142例（12.8%）和184例（16.7%）患者存在甲状腺功能障碍和特应性。分别有461例（41.7%）和340例（30.7%）患者存在维生素D缺乏和血清免疫球蛋白E（IgE）水平升高。196例（17.7%）患者在某个阶段需要使用免疫抑制剂。血清IgE和D-二聚体水平较高（<0.05）的患者需要更频繁地增加左西替利嗪剂量，而年龄、性别、病程、血管性水肿的存在、合并症、可识别的诱发因素、昼夜变化的存在、家族史和维生素D缺乏对左西替利嗪的剂量没有影响。
我们的研究是一项大型单中心研究，确定了包括基线血清IgE和D-二聚体水平在内的生物标志物，这些生物标志物可以识别出需要更高剂量抗组胺药/抗组胺药难治性荨麻疹的CSU患者。
