Algorhythmic approach to the etiopathogenesis of chronic urticaria:  practical benefits

Su, �zlem; Onsun, Nahide; At�lgano�lu, Ulviye; Kural, Yasemin Balsever; Ayg�n, Serkan; Konuk, Emel

Algorhythmic approach to the etiopathogenesis of chronic urticaria: practical benefits [Turkderm-Turk Arch Dermatol Venereol]

Turkderm-Turk Arch Dermatol Venereol. 2002; 36(1): 24-28

Algorhythmic approach to the etiopathogenesis of chronic urticaria: practical benefits

�zlem Su¹, Nahide Onsun¹, Ulviye At�lgano�lu¹, Yasemin Balsever Kural¹, Serkan Ayg�n¹, Emel Konuk¹

Background and Design: Chronic urticaria remains a major problem in terms of etiology and investigation. Physical stimuli and functional autoantibodies are main causes of chronic urticaria. Appropriate challenge tests to identify patient whom physical urticaria and autologous serum skin test to identify patients who have functional autoantibodies are most important tests to show the etiology of chronic urticaria. Materials and Methods: Basic blood, urine and stool examinations and appropriate challenge tests to determine physical urticaria had been performed in 88 patients with
chronic urticaria. The patients associated with angioedema were investigated for the level of C4. The patients who had cholinergic urticaria were examined for atopic dermatitis, allergic asthma, allergic rhinitis and investigated for the level of total IgE /specific IgE. The patients with cold urticaria evaluated for cryoglobulin, cold agglutinin and cryofibrinogen. Autolog serum skin test was performed in 35 patients with chronic urticaria. Results and Conclusion: Challenge tests to determine physical urticaria were positive in 73 (%83,3) of the 88 patients. Cholinergic urticaria was present in 29 (%39,72) of the 73 patients and was the most common of all the physical urticaria. Twenty- seven patients (%36,98) had physical urticaria types concurrently. Autologous serum skin test was positive in 24 (%63,15) of 35 patients with chronic urticaria. We suggest that
physical stimuli and autoimmune antibodies play the most important role in the etiopathogenesis of chronic urticaria.

Keywords: Chronic urticaria, etiopathogenesis, algorhytmic approach, practical benefits

Kronik �rtiker etyopatogenezinde algoritmik yakla��m�n pratikte sa�lad�� yararlar

�zlem Su¹, Nahide Onsun¹, Ulviye At�lgano�lu¹, Yasemin Balsever Kural¹, Serkan Ayg�n¹, Emel Konuk¹
SSK Vak�f Gureba Hastanesi Deri ve Z�hrevi Hastal�klar Klini�i

Kronik �rtikerin etyolojisi ve yap�lacak ara�t�rmalar halen �ok �nemli bir problemdir. B�y�k grubu olu�turan fizik �rtikerlerin ay�rt edilmesine y�nelik uygun "challenge" testler ve fonksiyonel otoantikorlar�n tespitine dayal� otolog serum testi etyolojiyi ayd�nlatabilecek y�ntemlerdir. Buradan yola ��karak kronik �rtiker tan�s� alan 88 olguya belli bir algoritmik yakla��m dahilinde kan, idrar, gayta incelemeleri ve s�k g�r�len fizik �rtikerler i�in uygun "challenge" testler uyguland�. Olgular�n 73'�nde (%83,3) fizik �rtiker saptand�. En s�k kolinerjik �rtiker (29 olgu, %39,72) g�r�ld�. Fizik �rtikerli olgular�n 27'sinde (%36,98) birden fazla fizik �rtiker mevcuttu. T�m olgular�n 38'ine otolog serum testi uyguland�. Yirmid�rd�nde (%63,15) test pozitif idi. Bu sonu�lar fizik uyaranlar ile otoimmun mekanizman�n kronik �rtiker etyolojisindeki �nemini ortaya koyarak, pahal� ve ayr�nt�l� ara�t�rmalar�n gereksizli�ini g�sterdi.

Anahtar Kelimeler: Kronik �rtiker, etyopatogenez, algoritmik yakla��m, pratik yararlar

�zlem Su, Nahide Onsun, Ulviye At�lgano�lu, Yasemin Balsever Kural, Serkan Ayg�n, Emel Konuk. Algorhythmic approach to the etiopathogenesis of chronic urticaria: practical benefits. Turkderm-Turk Arch Dermatol Venereol. 2002; 36(1): 24-28

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