Abstract
Chronic Urticaria (CU) is a diseases characterized by occurrence of spontaneous wheels observed by the patient for more than 6 weeks duration. The prevalence of CU varies from 0.5-5% in adult population. This is a disease of complex etiologies with more areas to be explored by researches. The aim of the study was to detect the Prevalence of allergen sensitizations among adult chronic urticaria patients without other allergic diseases. This study is a cross-sectional case control study. 70 patients with CU without evident cause and 50 healthy control individuals were included in the study. Patients with any other allergic diseases (such as Asthma, allergic Rhinitis, Allergic Conjunctivitis, Drug Allergy, atopic Dermatitis, Anaphylaxis….), patients with other chronic or systemic Diseases (such as Cardiac, respiratory, renal, hepatic, hematological, thyroid or other skin Diseases, etc….) and smokers were excluded from the study. Each patient and control individual was subjected to full medical history, complete medical examination and routine lab test. Determination of allergen-specific IgE (for 20 separate food and 20 aeroallergens) in serum for the patients was done by using EUROLINE Atopy Screen. Each of the patients and control groups were comparable according to age and gender. There was a significant difference between the CU patients and the control group as regard the prevalence of any allergen sensitization (65.7% for CU patients and 18% in control group) p<0.05. There was also a significant difference between the sensitized individual in each group as regard the number of allergens per each individual; for sensitized CU patients the mean was 3 allergens and interquartile range was (2-4), for the sensitized control individuals the mean was 2 and interquartile range was (1-2) with p= 0.014. The mostly frequent allergens were found in the CU sensitized patients was the house dust mite allergens (34.8% of the sensitized CU patients were sensitized to one or more of the two types of mites; dermatophagoides pteronyssinus and or dermatophagoides farinae). The study concluded that; a great prevalence of CU patients proved to be sensitized to common allergens which open the door to start a trials to examine the value of environmental control, food avoidance and specific allergen immunotherapy in this group of patients.
Highlights
Chronic Urticaria (CU) is a disease characterized by the appearance of spontaneous wheals with or without angioedema for more than 6 weeks duration [1]
70 patients with CU and 50 healthy control individuals were included in the study, table 1 shows a statistical significant difference in the prevalence of allergen sensitization by the specific IgE in-between the patients group and the control group
Aeroallergens the used method was specific IgE not Skin Prick Test (SPT), Liutu et al found a positive SPT in 51.7% of 91 CU patients to 17 aeroallergens [18], a higher percent of Allergen sensitization was found by Yi Zhou et al who found a sensitization of 95.83% of children with CU aged 4-10 years when examimnig 34 alleregens by specific IgE [19]
Summary
Chronic Urticaria (CU) is a disease characterized by the appearance of spontaneous wheals with or without angioedema for more than 6 weeks duration [1]. The mast cell known to be the most important effector cell in CU through releasing of its mediators; From them the histamine with its inflammatory action, stimulation of peripheral nerves and increasing vascular permeability. Other mediators such as leukotriene, tryptase and heparin sharing in the pathogenesis of CU [4]. The role of IgE in the activation of mast cell is well known its role in CU as part of activation of mast cell in this disease [5]. A significant higher total serum IgE level in CU patients (34%) than the healthy control (8.6%) with a significant correlation between elevated level of serum total IgE (above 175 U/ml) with CU symptoms severity [6] were found
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