Journal article

Authors list: Kolkhir, Pavel; Altrichter, Sabine; Asero, Riccardo; Daschner, Alvaro; Ferrer, Marta; Gimenez-Arnau, Ana; Hawro, Tomasz; Jakob, Thilo; Kinaciyan, Tamar; Kromminga, Arno; Konstantinou, George N.; Makris, Michael; Metz, Martin; Skov, Per Stahl; Staubach, Petra; Sussman, Gordon; Zhang, Ke; Maurer, Marcus

Publication year: 2021

Pages: 545-559

Journal: Allergy Asthma and Immunology Research

Volume number: 13

Issue number: 4

ISSN: 2092-7355

eISSN: 2092-7363

Open access status: Gold

DOI Link: https://doi.org/10.4168/aair.2021.13.4.545

Publisher: The Korean Academy of Asthma Allergy and Clinical Immunology / The Korean Academy of Asthma, Allergy and Clinical Immunology; the Korean Academy of Pediatric Aller

Abstract: 

Purpose: Patients with chronic spontaneous urticaria (CSU) have an increased risk for comorbid autoimmune diseases. In this retrospective multicenter study of CSU patients, we evaluated clinical and laboratory features of CSU associated with a higher risk of comorbid autoimmune diseases.

Methods: We analyzed records of CSU patients (n = 1,199) for a history or presence of autoimmune diseases. Patients were diagnosed with type IIb autoimmune CSU (aiCSU) if all 3 tests were positive: autologous serum skin test (ASST), basophil histamine release assay (BHRA) and/or basophil activation test (BAT), and IgG autoantibodies against Fc epsilon RI alpha/IgE detected by immunoassay.

Results: Twenty-eight percent of CSU patients had at least 1 autoimmune disease. The most prevalent autoimmune diseases were Hashimoto's thyroiditis (HT) (>= 21%) and vitiligo (2%). Two percent of CSU patients had >= 2 autoimmune diseases, most frequently HT plus vitiligo. Comorbid autoimmune diseases, in patients with CSU, were associated with female sex, a family history of autoimmune diseases, and higher rates of hypothyroidism and hyperthyroidism (P < 0.001). Presence of autoimmune diseases was linked to aiCSU (P = 0.02). The risks of having autoimmune diseases were 1.7, 2.9 and 3.3 times higher for CSU patients with a positive ASST, BHRA and BAT, respectively. In CSU patients, markers for autoimmune diseases, antinuclear antibodies and/or IgG anti-thyroid antibodies were associated with non-response to omalizumab treatment (P = 0.013).

Conclusions: In CSU, autoimmune diseases are common and linked to type IIb autoimmune CSU. Our results suggest that physicians assess and monitor all adult patients with CSU for signs and symptoms of common autoimmune diseases, especially HT and vitiligo.

Harvard Citation style: Kolkhir, P., Altrichter, S., Asero, R., Daschner, A., Ferrer, M., Gimenez-Arnau, A., et al. (2021) Autoimmune Diseases Are Linked to Type IIb Autoimmune Chronic Spontaneous Urticaria, Allergy Asthma and Immunology Research, 13(4), pp. 545-559. https://doi.org/10.4168/aair.2021.13.4.545

APA Citation style: Kolkhir, P., Altrichter, S., Asero, R., Daschner, A., Ferrer, M., Gimenez-Arnau, A., Hawro, T., Jakob, T., Kinaciyan, T., Kromminga, A., Konstantinou, G., Makris, M., Metz, M., Skov, P., Staubach, P., Sussman, G., Zhang, K., & Maurer, M. (2021). Autoimmune Diseases Are Linked to Type IIb Autoimmune Chronic Spontaneous Urticaria. Allergy Asthma and Immunology Research. 13(4), 545-559. https://doi.org/10.4168/aair.2021.13.4.545