Alerjinin Bilinmez Sorununa Tanısal Yaklaşım: Kronik Ürtiker ve Anjioödem

Altı haftadan uzun süren ürtiker olarak tanımlanan kronik ürtikerin nedeni çoğunlukla bulunamamaktadır. Kronik ürtikerli vakaların yarısına anjioödem de eşlik eder. Tanı temel olarak hastanın anamnezine dayanmaktadır. Kronik otoimmün ürtikerli çocukların % 30-40’ında IgE ya da IgE reseptörüne karşı fonksiyonel otoantikorlar saptanmakta- dır. Otolog serum deri testi kronik otoimmün ürtiker için yapılması gereken bir tarama testidir
Anahtar Kelimeler:

Kronik ürtiker, anjioödem, çocuk

Unknown Problem of Allergy: Chronic Urticaria and Angioedema

The etiology of chronic urticaria CU , defined as recur- ring attacks of hives lasting for 6 weeks, often remains unrecognized. Half of patients with chronic urticaria have also angioedema. The diagnosis is based principally on the patient’s history. It has been shown that approximately 30 %-40 % of children with CU produce functionally acti- ve autoantibodies directed against IgE or IgE receptor defined as chronic autoimmune urticaria COU . Autologous serum skin test possibly should be performed in children as a screening test for idiopathic autoimmune CU

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  • 1. Grattan CEH, Sabroe RA, Greaves MW. Chronic urticaria. J Am Acad Dermatol 2002; 46:645-57.
  • 2. Powell RJ, Du Toit GL, Siddique N, et al. BSAIC guidelines for the management of chronic urticaria and angioedema. Clinical and Experimental Allergy 2007; 37:631-50.
  • 3. Kaplan AP. Clinical practice Chronic urticaria and angioedema. N Engl J Med 2002; 346:175-9
  • 4. Vazquez NF, Meida Arvizu VM, Sanchez Nuncio HR, Villanueva Carreto ML, Guidos Fogelbach GA. Prevalence and potential triggering factors of chronic urticaria and angioedema in an urban area of northeastern Mexico. Rev Alerg Mex 2004; 51:181-8.
  • 5. Zuberbier T, Bindslev-Jensen C, Canonica W, et al. EAACI/GA2LEN/EDF guideline: definition, classification and diagnosis of urticaria. Allergy 2006; 61:316-20.
  • 6. Greaves MW. Chronic idiopathic urticaria. Curr Opin Allergy Clin Immunol 2003; 3:363-8.
  • 7. Smith CH, Kepley C, Schwartz LB, Lee TH. Mast cell number and phenotype in chronic idiopathic urticaria. J Allergy Clin Immunol 1995; 96:360-4.
  • 8. Be´dard PM, Brunet C, Pelletier G, He´bert J. Increased compound 48/80 induced local histamine release from nonlesional skin of patients with chronic urticaria. J Allergy Clin Immunol 1986; 78:1121-5.
  • 9. Ley K. Integration of inflammatory signals by Rolling neutrophils. Immunol Rev 2002; 186:8-18.
  • 10. Zuberbier T, Chantraine-Hess S, Hartmann K, Czarnetzki BM. Pseudoallergen-free diet in the treatment of chronic urticaria. A prospective study. Acta Derm Venereol 1995; 75:484-7.
  • 11. Siddique N, Pereira BN, Hasan AS. Hepatitis C and urticaria: cause and effect? Allergy 2004; 59:668.
  • 12. Vaida GA, Goldman MA, Bloch KJ. Testing for hepatitis B virus in patients with chronic urticaria and angioedema. J Allergy Clin Immunol 1983; 72:193-8.
  • 13. Papadopoulou N, Kalogeromitros D, Staurianeas NG, Tiblalexi D, Theoharides TC. Corticotropin-releasing hormone receptor-1and histidine decarboxylase expression in chronic urticaria. J Invest Dermatol 2005; 125:952-5.
  • 14. Dyke SM, Carey BS, Kaminski ER. Effect of stres on basophil function in chronic idiopathic urticaria. Clin Exp Allergy 2008; 38(1):86-92.
  • 15. Bakos N, Fekete B, Prohaszka Z, Fust G, Kalabay L. High prevalence of IgG and IgA antibodies to 19-kDa Helicobacter pylori-associated lipoprotein in chronic urticaria. Allergy 2003; 58:663-7.
  • 16. Gaig P, Garcia-Ortega P, Enrique E, Papo M, Quer JC, Richard C. Efficacy of the eradication of Helicobacter pylori infection in patients with chronic urticaria. A placebocontrolled double blind study. Allergol Immunopathol 2002; 30:255-8.
  • 17. Burova GP, Mallet AI, Greaves MW. Is H.pylori a cause of chronic urticaria? Br J Dermatol 1998; 139:42.
  • 18. Grattan CEH. Autoimmune urticaria. Immunol Allergy Clin N Am 2004; 24:163-81.
  • 19. Sabroe RA, Seed PT, Francis DM, Barr RM, Black AK, Greaves MW. Chronic idiopathic urticaria: comparison of the clinical features of patients with and without anti-FcepsilonRI or anti-IgE autoantibodies. J Am Acad Dermatol 1999; 40: 443-50.
  • 20. Sabroe RA, Fiebiger E, Francis DM, et al. Classification of anti- FcepsilonRI and anti-IgE autoantibodies in chronic idiopathic urticaria and correlation with disease severity. J Allergy Clin Immunol 2002; 110:492-9.
  • 21. Du Toit G, Prescott R, Lawrence P, et al. Autoantibodies to the high-affinity IgE receptor in children with chronic urticaria. Ann Allergy Asthma Immunol 2006; 96:341-4.
  • 22. Brunetti L, Francavilla R, Miniello VL, et al. High prevalence of autoimmune urticaria in children with chronic urticaria. J Allergy Clin Immunol 2004; 114:922–7
  • 23. Malmros H. Autoserumtest (AST). Nordisk Med 1946; 29:150-1.
  • 24. Grattan CEH, Wallington TB, Warin RP, Kennedy CTC, Bradfield JW. A serological mediator in chronic idiopathic urticaria-a clinical, immunological and histological evaluation. Br J Dermatol 1986; 114:583-90.
  • 25. Sabroe RA, Grattan CEH, Francis DM, Barr RM, Kobza Black A, Greaves MW. The autologous serum skin test: a screening test for autoantibodies in chronic idiopathic urticaria. Br J Dermatol 1999; 140:446-53.
  • 26. Guttman-Yassky E, Bergman R, Maor C, Mamorsky M, Pollack S, Shahar E. The aotulogous serum skin test in a cohort of chronic urticaria patients compared to respiratory allergy patients and healthy individuals. JEADV 2007; 21:35-9.
  • 27. Mari A. Allergy-like asthma and rhinitis. A cross-sectional survey of a respiratory cohort and a diagnostic approach using the autologous serum skin test. Int Arch Allergy Immunol 2004; 133:29-39.
  • 28. Taskapan O, Kutlu A, Karabudak O. Evaluation of autologous serum skin test in patients with chronic idiopathic urticaria, allergic/non-allergic asthma or rhinitis and healthy people. Clin Exp Dermatol 2008; 33:754-8.
  • 29. Godse KV. Autologous serum skin test in chronic urticaria. Indian J Dermatol Venereol Leprol 2004; 70:283-4.
  • 30. Kulthanan K, Jiamton S, Thumpimukvatana N, Pinkaew S. Chronic idiopathic urticaria: prevalance and clinical course. J Dermatol 2007; 34:294-301.
  • 31. Kılıç G, Güler N, Tamay Z. Kronik ürtikerli çocukların değerlendirilmesi (poster sunumu). XV. Ulusal Alerji ve Klinik İmmunoloji Kongresi, Antalya, Program ve Özet Kitabı, 2007.
  • 32. O’Donnell BF, Neill CM, Francis DM, et al. Human leucocyte antigen class II associations in chronic urticaria. Br J Dermatol 1999; 140:853-8.
  • 33. Sabroe RA, Greaves MW. Chronic urticaria with functional autoantibodies: 12 years on. Br J Dermatol 2006; 154:813- 19.
  • 34. Kikuchi Y, Kaplan AP. Mechanisms of autoimmune activation of basophils in chronic urticaria. J Allergy Clin Immunol 2001; 107:1056-62.
  • 35. Ferrer M, Luquin E, Kaplan AP. IL3 effect on basophils histamine release upon stimulation with chronic urticaria sera. Allergy 2003; 58:802-7.
  • 36. Asero R, Lorini M, Chong SU, Zuberbier T, Tedeshi A. Assessment of histamine-releasing activity of sera from patients with chronic urticaria showing positive autologous skin test on human basophils and mast cells. Clin Exp Allergy 2004; 34:1111-14.
  • 37. Ebo DG, Sainte-Laudy J, Bridts CH, et al. Flow-assisted allergy diagnosis: Current applications and future perspectives. Allergy 2006; 61:1028-39.
  • 38. Gyimesi E, Sipka S, Danko K, et al. Basophil CD63 expres sion assay on highly sensitized atopic donor leucocytes-a useful method in chronic autoimmune urticaria. Br J Dermatol 2004; 151:388-96.
  • 39. Szegedi A, Irinyi B, Gal M, et al. Significant correlation between the CD63 assay and the histamine release assay in chronic urticaria. Br J Dermatol 2006; 155:67-75.
  • 40. Frezzolini A, Provini A, Teofoli P, Pomponi D, De Pita O. Serum-induced basophil CD63 expression by means of tricolour cytometric method for the in vitro diagnosis of chronic urticaria. Allergy 2006; 61(9):1071-7.
  • 41. Buhring H-J, Streble A, and Valent P. The basophil-specific ectoenzyme E-NPP3 (CD203c) as a marker for cell activation and allergy diagnosis. Int Arch Allergy Immunol 2004; 133:317-29.
  • 42. Yasnowsky KM, Schoen DJ, Vedanthan PK, et al. Chronic urticaria sera increase basophil CD203c surface expression. J Allergy Clin Immunol 2005; 115:179.
  • 43. Boguniewicz M. The autoimmune nature of chronic urticaria. Allergy Asthma Proc 2008; 29:433-38.
  • 44. Asero R, Tedeschi A, Riboldi P, et al. Plasma of chronic urticaria patients shows signs of thrombin generation and its intradermal injection causes wheal-and-flare reactions much more frequently than autologous serum. J Allergy Clin Immunol 2006; 117:1113-17.
  • 45. Asero R, Roboldi P, Tedeschi A, et al. Chronic urticaria: A disease at a crossroad between autoimmunity and coagulation. Autoimmun Rev 2007; 7:71-6.
  • 46. Leznoff A, Sussman FL. Syndrome of idiopathic chronic urticaria and angioedema with thyroid autoimmunity: a study of 90 patients. J Allergy Clin Immunol 1989; 84:66-71.
  • 47. Kaplan AP, Finn A. Autoimmunity and the etiology of chronic urticaria. Can J Allergy Clin Immunol 1999; 4:286-92.
  • 48. Kikuchi Y, Fann T, Kaplan AP. Antithyroid antibodies in chronic urticaria and angioedema. J Allergy Clin Immunol 2003; 112, 218
  • 49. Dibbern DA, Dreskin SC. Urticaria and angioedema: an overview. Immunol Allergy Clin N Am 2004; 24:141-62.
  • 50. Kaplan AP, Greaves MW. Angioedema. J Am Acad Dermatol 2005; 53:373-88.
  • 51. Bork K, Barnstedt SE, Koch P, Traupe H. Hereditary angioedema with normal C1 INH activity in women. Lancet 2000; 356:213-7.
  • 52. Kaplan AP, Greaves MW. Angioedema. J Am Acad Dermatol 2005; 53:373-88.
  • 53. Agostoni A, Cicardi M. Hereditary and acquired C1einhibitor deficiency: biological and clinical characteristics in 235 patients. Medicine 1992; 71:206-15.
  • 54. Kozel MM, Mekkes JR, Bossuyt PM, Bos JD. The effectiveness of a history-based diagnostic approach in chronic urticaria and angioedema. Arch Dermatol 1998; 134:1575- 80.