Comorbidities in Patients with Chronic Urticaria

Abstract

Several comorbidities are frequently associated with chronic urticaria (CU), and some can cause worse prognosis to the disease. The objective was to describe the frequency of comorbidities in patients with CU. This is a retrospective study with data collected from electronic medical records of patients with CU followed up in a tertiary service. Epidemiological data, CU’s classification, frequency of comorbidities were analyzed: esophagitis/gastritis, obesity, systemic arterial hypertension, diabetes mellitus, thyroid diseases, respiratory diseases (rhinitis and/or asthma) and psychological diseases; the frequency of angioedema (AE), exacerbation by NSAIDs and refractoriness to H1 antihistamines. Patients were classified according to the concomitance of comorbidities. There were 102 sequentially selected patients. Respiratory diseases were the most frequent comorbidity (42.2%), followed by systemic arterial hypertension (26.5%). When patients were classified according to the their frequency of comorbidities, there was no statistical difference in relation to the frequency of angioedema, exacerbation by NSAIDs or refractiveness to antihistamines. The greater the number of comorbidities, the greater the number of each disease, progressively, except for thyroid disease and psychic conditions. The group with four or more comorbidities had a higher mean age (57.3 years), longer urticaria time (12.8 years) and greater refractoriness to antihistamines (54.5%). Patients with multiple comorbidities were older, had longer urticaria duration and were more refractory to antihistamines, which may indicate worse prognosis. The progressive increase in the number of comorbidities, in the same patient, favors the hypothesis of CU to behave as a low-grade systemic inflammatory disease.