Accompanying conditions in patients with chronic spontaneous urticaria and urticarial vasculitis: Results of a retrospective study

Background and Design: Chronic spontaneous urticaria (CSU), the most common form of chronic urticaria, is characterized by spontaneous wheals and/or angioedema lasting longer than six weeks. Urticarial vasculitis (UV) is a small vessel vasculitis; but is also included in the various classification systems of chronic urticaria by some authors. The aim of our study was to evaluate the frequency of accompanying conditions, and to compare the demographic, clinical and laboratory features of patients with CSU and UV.
Materials and Methods: In this study, the files of CSU (n=146) and UV (n=43) patients who had been hospitalized between January 2010-December 2013 were retrospectively reviewed in terms of demographic data, disease-specific history, accompanying diseases, medications and laboratory findings.
Results: When comparing between the two groups for statistical differences, it was found that the frequencies of personal atopy and angioedema were significantly higher in patients with CSU; however, the patients with UV had significantly higher rates for female gender and the presence of systemic symptoms compared to those with CSU. It was determined that the mean values for erythrocyte sedimentation rate and C-reactive protein, as well as the rates of antinuclear antibody positivity and hypocomplementemia were significantly higher in the UV group, compared with those in the CSU group. Accompanying factors were determined as infections, medications, autoimmune diseases and malignities in order of frequency in both CSU and UV groups, but only the frequency of autoimmune diseases was significantly higher in patients with UV group.
Conclusion: Although various authors have reported that a large number (up to 40-60%) of patients with UV may present only with wheals (clinically indistinguishable from CSU); we assumed that it would be more appropriate to be considered UV as a priority in patients especially who had systemic symptom, autoimmune disease, hypocomplementemia and raised serologic inflammatory parameters.

Kronik spontan ürtiker ve ürtikeryal vaskülitli olgulardaki eþlik eden durumlar: Retrospektif bir çalýþmanýn sonuçlarý

Amaç: En sýk görülen kronik ürtiker formu olan kronik spontan ürtiker (KSÜ), altý haftadan uzun süren spontan ürtikeryal lezyonlar ve/veya anjiyoödem ile karakterizedir. Ürtikeryal vaskülit (ÜV) ise bir küçük damar vasküliti olmasýna raðmen, bazý yazarlar tarafýndan çeþitli kronik ürtiker sýnýflama sistemlerine de dahil edilmiþtir. Çalýþmamýzda KSÜ ve ÜV’li olgularýn demografik, klinik ve laboratuvar bulgularý yanýnda eþlik eden durumlarýn sýklýðýnýn belirlenerek birbiriyle karþýlaþtýrýlmasý amaçlanmýþtýr.
Gereç ve yöntemler: Bu çalýþmada Ocak 2010-Aralýk 2013 tarihleri arasýnda kliniðimizde yatan KSÜ (n=146) ve ÜV (n=43)’li olgularýn dosyalarý demografik verileri, hastalýða özgün öyküleri, eþlik eden hastalýklarý, medikasyonlarý ve laboratuar bulgularý açýsýndan retrospektif olarak taranmýþtýr.
Bulgular: Her iki grup arasýnda yapýlan karþýlaþtýrmada KSÜ grubunda kiþisel atopi ve anjiyoödem öyküsünün, ÜV grubunda ise kadýn olgularýn ve sistemik semptomlarýn varlýðýnýn istatistiksel olarak anlamlý oranda daha fazla olduðu belirlenmiþtir. Serolojik tetkiklerden ortalama eritrosit sedimentasyon hýzý ve C-reaktif protein deðerleri, antinükleer antikor pozitifliði ve hipokomplemantemi varlýðý ÜV grubunda KSÜ grubuna göre anlamlý olarak daha yüksek oranda saptanmýþtýr. Eþlik eden faktörler her iki grupta da sýklýk sýrasýna göre enfeksiyonlar, medikasyonlar, otoimmün hastalýklar ve maligniteler olarak belirlenmiþ, ancak sadece otoimmün hastalýklarýn ÜV grubunda KSÜ grubuna göre anlamlý olarak daha yüksek oranda saptandýðý görülmüþtür.
Sonuç: Çeþitli yazarlar tarafýndan ÜV’li olgularýn önemli bir kýsmýnda (%40-60’ýna varan oranlarda) klinik olarak KSÜ lezyonlarýndan ayýrdedilemeyecek þekilde sadece kaþýntýlý kabarýklýklar görülebileceði bildirilmiþ olsa da, özellikle sistemik semptom tanýmlayan, otoimmün bir hastalýðý olan, yapýlan incelemelerde hipokomplemantemi ve serolojik inflamatuar parametrelerinde yükseklik saptanan olgularda ÜV’in ön planda düþünülmesinin daha uygun olacaðý kanaatindeyiz.