What association has been described between autoantibodies and chronic urticaria? In two studies, antithyroid microsomal antibodies have been reported in 12% to 14% of patients with chronic urticaria; however, thyroid status did not relate to the occurrence of urticaria and typically hives did not revert when a euthyroid state was achieved. A number of patients with chronic urticaria react to intradermal injection of their own serum by developing a wheal and flare that persists up to 8 hours. Many of these patients have IgG antibodies in their serum that react with the alpha subunit of the high-affinity IgE receptor on mast cells and basophils. In other patients, the IgG antibody appears to react with IgE itself. The frequency of these IgG autoantibodies in patients with chronic urticaria is not yet established but has been reported to be as high as 40% and 10%, respectively, in a referral clinic. Grattan CEH, Francis DM, Hide M, Greaves MW: Detection of circulating histamine-releasing autoantibodies with functional properties of anti-IgE in chronic urticaria, Clin Exp Allergy 21:695–704, 1991. Hide M, Francis DM, Grattan CEH, et al: Autoantibodies against the high-affinity IgE receptor as a cause of histamine release in chronic urticaria, N Engl J Med 328:1599–1604, 1993. Leznoff A, Sussman GL: Syndrome of idiopathic chronic urticaria and angioedema with thyroid autoimmunity: a study of 90 patients, J Allergy Clin Immunol 84:66–71, 1989. Tong LJ, Balakrishnan G, Kochan JP, et al: Assessment of autoimmunity in patients with chronic urticaria, J Allergy Clin Immunol 99:461–465, 1997. |
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