Etiologic Factors in Patients with Chronic Urticaria

In our study, we aimed to evaluate the sufficiency and necessity of anamnesis, clinical findings, routine diagnostic tests, and autologous serum and plasma skin tests (ASST and APST) in determining the factors that may cause chronic urticaria. Fifty-two adult patients with urticaria and/or angioedema symptoms for more than six weeks were included in the study. All patients were investigated for allergic, autoimmune, infectious and internal diseases. Differential diagnosis of urticaria and urticarial vasculitis was made by histopathological evaluation. Autologous serum and plasma skin tests were applied to 51 patients and 28 healthy volunteers. Physical urticaria was detected in 32.7% of all patients. Emotional stress was the most frequent (75%) trigger. Autologous serum and plasma skin tests were found positive in 55.5% and 16% respectively in patients with chronic spontaneous urticaria and the difference was statistically significant (p = 0.021). There was a statistically significant relationship between thyroid autoantibodies and ASST positivity (p=0.031). Physical urticaria is the subtype of urticaria that should be excluded primarily in patients presenting with chronic urticarial symptoms. Psychosocial support should be provided to patients by taking emotional stress control into consideration in management of the disease. Patients with positive ASST should be evaluated for thyroid autoimmunity. Instead of routine and extensive laboratory studies, etiologic investigations should be planned based on the data obtained by anamnesis and physical examination