Urticaria: clinical profile, laboratory evaluation, serum IgE evaluation and its significance

Abstract

Background: Urticaria is a recurrent pruritic skin disease characterised by wheals and or angioedema. The recurrent nature of urticaria, pruritus and wheals impacts negatively on the quality of life of patients. Prevalence studies, type, trigger factors and patient related factors including serum IgE vary depending on site of study. These factors were not documented in our patients. The aim of this study is to determine the clinical characteristics of our urticaria patients and determine the proportion of urticaria patients who have elevated Sr IgE, Eosinophilia, Basophilia, Hepatitis B and C virus seropositivity. Also, to correlate elevated Sr IgE with age, gender, presence of atopy, dermographism, type of urticaria, raised eosinophil count and resolution with anti-histamines.
 Methods: A retrospective case review was conducted on 43 patients who attended the dermatology outpatient clinic from January 2017 to December 2018. The sociodemographic and clinical parameters of patients was documented using a questionnaire. Investigation results (Sr IgE levels, Eosinophil and Basophil counts, Hepatitis B and C virus seropositivity, stool ova and parasite) were extracted from cases records. Data was analyzed using SPSS version 22. Univariate descriptive statistics such as means, medians, frequencies and proportions are presented.
 Results: Prevalence of urticaria was 4.2% and the mean age of the patients was 40.6±15.6 years. Patients were made up 62.8% males and 37.2% females. A history of atopy was noted in 34.9%, urticaria was acute and chronic in 4.7% and 95.3% respectively. Angioedema was present in 44.2% and absent in 53.5%. Majority of the patients (67.4%) were treated with anti-histamines. Serum IgE was elevated in 43.8%, Eosinophilia in 27.30%, Basophilia in 0%, hepatitis B seropositivity in 10%, hepatitis C seropositivity in 0% and a positive stool ova/parasite test in 2.3%.
 Conclusions: Urticaria is more prevalent in males. Prevalence is more in those over 40 years of age and prevalence increases with age. Atopy and angioedema is demonstrable in some patients. Basophilia is low in urticaria. Eosinophilia and a raised serum IgE is found in some patients. Parasitology is low in urticaria.