Nihal METE, Okan GÜLBAHAR, Aytül SİN, ALİ KOKULUDAĞ, Filiz SEBİK

Kronik idiopatik ürtikerde otolog serum testi

Kronik ürtiker hastalarının % 75 inden fazlasında yoğun araştırmalara rağmen etiyoloji saptanamaz. Kronik idiopatik örtiker (KlU) tanısı konulan bu hastalarda otoimmun mekanizmaların ürtiker oluşumundan sorumlu olduğuna dair bulgular gün geçtikçe artmaktadır. KlU hastalarında otolog serum test pozitifliğini belirlemek amacı ile alerji polikliniğine ürtiker şikayeti He başvuran 60 hasta çalışmaya alınmıştır, 28 hastaya KlO tanısı konulmuştur. Hastalardan elde edilen serumlar ön kol fleksor bölümüne 50 /A. volümünde intradermal enjekte edilmiştir. Deri reaktivitesini belirlemek amacı He pozitif kontrol (histamin) ve negatif kontrol (serum fizyolojik) kullanılmıştır. Otolog serumun enjeksiyon yerinde serum fizyolojiğin oluşturduğundan 1,5 mm veya daha fazla kızarıklığın eşlik ettiği kabarıklık oluşması pozitif test reaksiyonu olarak yorumlanmıştır. Bu çalışmada KlU hastalarının %82.1'inde otolog serum testi pozitif bulunmuştur. Yapılan çalışmalarda otolog serum testi pozitif hastalarda semptomların daha şiddetli olduğu ve klasik antihistaminik tedavisine yanıt vermedikleri saptanmıştır. Bu nedenle otolog serum testi pozitif hastalarda immunomodülatör tedavilerin kullanılması gerekebilir. Sonuç olarak otolog serum testi, rutinde uygulanması gereken verilecek tedaviyi belirleyici test olarak önem kazanmaktadır.

Anahtar Kelimeler:

IgE, Otoantikorlar, Kronik hastalık, Deri testleri, Ürtiker

Autologous serum test positivity in patients with chronic idiopathic urticaria

The etiology of chronic urticaria cannot be identified in more than 75% of the patients even after an exhaustive search. However, recent studies indicate that autoimmune mechanisms may be involved in the etiology in patients with chronic idiopathic urticaria (CIU). In this study, 60 patients who presented to the allergy clinic with urticaria were studied to determine the positivity of the autologous serum test in CIU. Twenty-eight patients were diagnosed with CIU. Patients were injected with 5OuI autologous serum in the forearm intradermally. Histamine and normal saline were also injected as a positive and negative control, respectively. An area of skin redness that is at least 1.5 mm larger in diameter than that observed with saline was considered positive. The autologous serum test was positive in 82.1% of the patients with CIU. The urticaria symptoms were more severe and unresponsive to antihistaminic therapy in patients with a positive autologous serum test. Therefore, immunomodulatory therapies may be indicated in the CIU patients with a positive autologus serum test.In conclusion, the autologous serum test appears to be useful tool in CIU especially in identification of the patients who are unlikely to respond to the conventional antihistaminic therapy.

Keywords:

IgE, Autoantibodies, Chronic Disease, Skin Tests, Urticaria,

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