Autoinmunidad en urticaria crónica. Perspectiva histórica y actual

Autores/as

  • María Guadalupe Hurtado-Avilés Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Centro Médico Nacional 20 de Noviembre, Servicio de Inmunología Clínica y Alergia, Ciudad de México https://orcid.org/0000-0001-6936-0344
  • María Guadalupe Carmen Martínez-Reculez Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Centro Médico Nacional 20 de Noviembre, Servicio de Inmunología Clínica y Alergia, Ciudad de México https://orcid.org/0000-0002-6180-5967
  • María Eugenia Vargas-Camaño Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Centro Médico Nacional 20 de Noviembre, Servicio de Inmunología Clínica y Alergia, Ciudad de México https://orcid.org/0000-0002-6180-5967
  • María Eugenia Vargas-Camaño Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Centro Médico Nacional 20 de Noviembre, Servicio de Inmunología Clínica y Alergia, Ciudad de México https://orcid.org/0000-0002-6620-6322
  • María Isabel Castrejón-Vázquez Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Centro Médico Nacional 20 de Noviembre, Servicio de Inmunología Clínica y Alergia, Ciudad de México https://orcid.org/0000-0002-7556-5810

DOI:

https://doi.org/10.29262/ram.v69iSupl1.1037

Palabras clave:

Urticaria crónica, Células cebadas, Enfermedad tiroidea autoinmune

Resumen

La urticaria crónica espontánea es una afección que persiste durante más de seis semanas y ocurre en ausencia de un factor desencadenante identificable y resulta de la activación patógena de células cebadas y basófilos. Se plantea la posible etiología autoinmune hasta en 40 % de los pacientes, seguida de infecciones subclínicas y factores psicológicos. Se han propuesto dos mecanismos principales de la patogénesis de la urticaria crónica: la desregulación de las vías de señalización intracelular dentro de las células cebadas y basófilos que conduce a defectos en el tráfico o la función de estas células, así como el desarrollo de autoanticuerpos contra FcεRIα o IgE, tanto en células cebadas como en basófilos. Numerosas enfermedades autoinmunes como lupus eritematoso sistémico, polimiositis, dermatomiositis y artritis reumatoide se han asociado a urticaria crónica; sin embargo, la enfermedad tiroidea autoinmune merece una mención especial. Se ha encontrado una mayor prevalencia de anticuerpos antitiroideos, independientemente de la función tiroidea (eutiroidismo, hipo e hipertiroidismo), en pacientes con urticaria crónica espontánea. Varias infecciones se han relacionado a urticaria crónica. Existe la mejor evidencia de infección por Helicobacter pylori. Por último, el estrés está asociado al inicio de la enfermedad mediante la activación del sistema simpático y adrenomedular y el eje hipotálamo hipófisis suprarrenal. El diagnóstico puede variar en las diferentes regiones del mundo, pero el rasgo común es la realización de una historia clínica completa.

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2022-01-08

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