PMID- 16724623
OWN - NLM
STAT- MEDLINE
DCOM- 20060801
LR  - 20220408
IS  - 1088-5412 (Print)
IS  - 1088-5412 (Linking)
VI  - 27
IP  - 2
DP  - 2006 Mar-Apr
TI  - Chronic urticaria: pathophysiology and etiology, or the what and why.
PG  - 90-5
AB  - Chronic urticaria (CU) is a relatively common but vexing disease. The 
      pathophysiology is based on the cutaneous mast cell release of mediators, 
      predominantly histamine. Release can be induced via specific immunoglobulin E 
      (IgE), components of complement activation and nonspecifically by various 
      compounds including endogenous peptides, endorphins, and enkephalins. In >30% of 
      CU patients, autoimmune phenomena have been found, characterized by positive 
      autologous serum skin test, antibodies to the alpha-subunit of the basophil IgE 
      receptor, to IgE itself, and, perhaps, the most clinically relevant, thyroid 
      autoimmunity. Studies suggest that the products of the activated immune system 
      can lower the cutaneous mast cell release threshold, possibly allowing activation 
      by endogenous compounds. The resulting release of mediators produces the clinical 
      picture of recurrent hives. Although the goal of management of CU is the 
      identification of a treatable cause, in most CU patients, especially adults, a 
      cause is not frequently found. Identified causes include drugs, foods, 
      infections, immune complex production leading to urticarial vasculitis, 
      autoantibody production, and underlying autoimmune disease, particularly 
      autoimmune thyroiditis. The treatment of the thyroiditis with suppressive doses 
      of thyroid hormone often results in the remission of the CU. Given the marginally 
      effective and sometimes dangerous medical therapy available for CU, a systematic 
      and thorough approach to identify a treatable cause in difficult CU patients is 
      warranted.
FAU - Schocket, Alan L
AU  - Schocket AL
AD  - Division of Allergy and Clinical Immunology, University of Colorado School of 
      Medicine, Denver, USA. ashocket@aol.com
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PL  - United States
TA  - Allergy Asthma Proc
JT  - Allergy and asthma proceedings
JID - 9603640
RN  - 37341-29-0 (Immunoglobulin E)
SB  - IM
MH  - Chronic Disease
MH  - Histamine Release/physiology
MH  - Humans
MH  - Immunoglobulin E/physiology
MH  - Urticaria/*etiology/*physiopathology
RF  - 60
EDAT- 2006/05/27 09:00
MHDA- 2006/08/02 09:00
CRDT- 2006/05/27 09:00
PHST- 2006/05/27 09:00 [pubmed]
PHST- 2006/08/02 09:00 [medline]
PHST- 2006/05/27 09:00 [entrez]
PST - ppublish
SO  - Allergy Asthma Proc. 2006 Mar-Apr;27(2):90-5.