Abstract
Background: Chronic urticaria (CU) affects 5 % of the general population and it is associated with thyroid disease in up to 54 % of patients. There is scarce information on the activity of urticaria in patients with and without alterations in the thyroid function.
Objective: To compare the activity rate of urticaria using the UAS7 (Urticaria Activity Score 7) in patients with and without hypothyroidism.
Methods: A descriptive, cross-sectional, and comparative study of patients with CSU (chronic spontaneous urticaria) who were older than 18 years of age, who were classified into two groups based on their thyroid function: hypothyroid and euthyroid patients. UAS7 was applied to all of them.
Results: We analyzed 60 patients with CSU; 30 of them were euthyroid and 30 were hypothyroid. The female sex was predominant (76 %) and the average age was 49.1 years old. The activity in 40 % was moderate, in 25 % was severe, and it was mild in 23 %; only 12 % of them were controlled. In the group with hypothyroidism, the median TSH (Thyroid Stimulating Hormone) was of 6.8 μUI/mL. No statistically significant differences were found in matters of age, body mass index, comorbidities, or in the UAS7.
Conclusions: We did not find a statistically significant difference in the Urticaria Activity Index between both groups. Identifying the influencing factors shall improve the quality of life of patients.
References
Zuberbier T, Aberer W, Asero R, Abdul-Latiff AH, Baker D, Ballmer-Weber B, et al. The EAACI/GA²LEN/EDF/WAO Guideline for the Definition, Classification, Diagnosis and Management of Urticaria. Allergy. 2018;73(5):1393-1414. DOI: 10.1111/all.13397
Powell RJ, Leech SC, Till S, Huber PAJ, Nasser SM, Clark AT. BSACI Guideline for the Management of Chronic Urticaria and Angioedema. Clin Exp Allergy. 2015;45(3):547-565. DOI: 10.1111/cea.12494
Larenas-Linnemann D, Medina-Ávalos MA, Ortega-Martell JA, Beirana-Palencia AM, Rojo-Gutiérrez MI, Morales-Sánchez MA, et al. Guía Mexicana para el Diagnóstico y el Tratamiento de la Urticaria. Rev Alerg Mex. 2014;61(2):117-193. Disponible en: http://eprints.uanl.mx/18394/1/Gui%CC%81a%20Mex%20Dx%20Tx%20Urticaria.pdf
Tabi A. Leslie. Advances in chronic urticaria. Curr Derm Rep. 2017;4(6):256-252. DOI: 10.1007/s13671-017-0198-1
Quirt Jaclyn, Lima Hermenio, Waserman S. Urticaria: a multidiciplinary disease. Where are we now? Curr Derm Rep. 2015;1(4)8-14. DOI: 10.1007/s13671-014-0095-9
Aguilar-Hinojosa N, Segura-Méndez NH, del Rivero-Hernández L. Urticaria crónica autoimune. Alerg Asma Immunol Pediatr. 2011;2(20):82-87. Disponible en: https://www.medigraphic.com/pdfs/alergia/al-2011/al112e.pdf
Stitt JM, Deskin SC. Urticaria and autoimmunity: where are we now. Curr Allergy Asthma Rep. 2013;5(13):555-562. DOI: 10.1007/s11882-013-0366-8
de Lorenzo G, Leto-Barone MS, lá Paina S, Sei dita A, Battista-Rini G. Chronica espontâneos urticaria: an autoimune dissesse? A revision of the literature. Clin Exp Med. 2013;13(3):159-164. DOI: 10.1007/s10238-012-0188-3
Czarnecka-Operacz M, Sadowska-Przytocka A, Jenerowicz D, Szeliga A, Adamski Z, Łącka K. Thyroid function and thyroid autoantibodies in patients with chronic spontaneous urticarial. Postepy Dermatol Allergol. 2017;34(6):566-572. DOI: 10.5114/ada.2017.72464
Banco M, Vínculo PL, Chiava M, Saraceno G, Ganem S, Benvenga S. Urticaria ande thyroid autoimmunity. Thyroid. 2011;21(4):401-410. DOI: 10.1089/thy.2010.0103
Xi-Feng P, Jian-Qiu G, Zhong-Yan S. The prevalence of thyroid autoimmunityt in patients with urticaria: a systematic review and meta-analysis. Endocrine. 2014;48(3):804-810. DOI: 10.1007/s12020-014-0367-y
Kolkhin P, Metz M, Altrichter S, Mauer M. Comorbidity of chronic spontaneous urticarial and autoimmune thyroid diseases: a systematic review. Allergy. 2017;72(10):1440-1460. DOI: 10.1111/all.13182
Selvendran SS, Aggarwal N. Chronic urticarial and thyroid autoimmunity: a perplexing association. Oxf Med Case Reports. 2018;2018(2):61-63. DOI: 10.1093/omcr/omx099
Staubach P, Eckhardt-Henn A, Dechene M, Vonend A, Metz M, Margerl M, et al. Quality of life in patients with chronic urticarial is differentially impaired and determined by psychiatric comorbidity. Br J Dermatol. 2016;154(2):294-298. DOI: 10.1111/j.1365-2133.2005.06976.x
Marcus M, Staubach P, Raap U, Richter-Huhn G, Bauer A, Ruëff F, et al. H1-antihistamine-refractory chronic spontaneous urticaria: It’s worse than we thought – first results of the multicenter real-life AWARE study. Clin Exp Allergy. 2017;47(5):684-692. DOI: 10.1111/cea.12900
Mathias SD, Crosby RD, Zazzali JL, Mauer M, Saini SS. Evaluating the minimally important difference of the urticarial activity score and other measures of disease activity in patients with chronic idiopathic urticaria. Ann Allergy Asthma Immunol. 2012;108(1):20-24. DOI: 10.1016/j.anai.2011.09.008
Sánchez-Borges M, Caballero-Fonseca F, Capriles-Hulett A, González-Aveledo L, Maurer M. Factors linked to disease severity and time to remission in patients with chronic spontaneous urticaria. J Eur Acad Dermatol Venereol. 2017;31(6):964-971. DOI: 10.1111/jdv.14221
Folci M, Heffler E, Canonica GW, Furlan R, Brunetta E. Cutting edge: biomarkers for chronic spontaneous urticaria. J Immunol Res. 2018;2018(4):1-12. DOI: 10.1155/2018/5615109
Valero A, Herdman M, Bartra J, Ferrer M, Jáuregui I, Dávila I, et al. Adaptation and validation of the Spanish version of the chronic urticaria quality of life questionnaire (CU-Q2oL). J Investig Allergol Clin Immunol. 2008;18(6):426-432. Disponible en: https://www.researchgate.net/profile/Ignacio_Davila/publication/23758475_Adaptation_and_Validation_of_the_Spanish_Version_of_the_Chronic_Urticaria_Quality_of_Life_Questionnaire_CU-Q2oL/links/00463518e693ed452c000000/Adaptation-and-Validation-of-the-Spanish-Version-of-the-Chronic-Urticaria-Quality-of-Life-Questionnaire-CU-Q2oL.pdf
Weller K, Groffik A, Church MK, Hawro T, Krause K, Metz M, et al. Development and validation of the urticaria control test: a patient-reported outcome instrument for assessing urticarial control. J Allergy Clin Immunol. 2014;133(5):1365-1372. DOI: 10.1016/j.jaci.2013.12.1076
Hollis K, Proctor C, McBrider D, Maria-Magdalena B, McLeod L, Hunter S. Comparison of urticaria activity score over 7 days (UAS7) values obtained from once-daily and twice-daily versions: results from the ASSURE-CSU study. Am J Clin Dermatol. 2018;19(2):267-274. DOI: 10.1007/s40257-017-0331-8
Karaayvaz M, Çaliskaner Z, Turan M, Akar A, Öztürk S, Ozangüç N. Levothyroxine versus ketotifen in the treatment of patients with chronic urticarial and thyroid autoimmunity. J Dermatolog Treat. 2002;13(4):165-172. DOI: 10.1080/09546630212345673
Kaandel AA, Zeid M, Helm T, Lillie MA, Donahue E, Ambrus JL. Evaluation of chronic urticaria in patients with Hashimoto tyroiditis. J Clin Immunol. 2001;21(5):335-347. DOI: 10.1023/a:1012288602962

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