الفهرس 
AllergyOnly 14 pages are availabe for public view
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Abstract
Chronic urticaria (CU) is a common skin disorder, affecting 0.1% -1% of the general population. It is characterized by recurrent and transitory (<24 hours) pruritic erythematous wheals that present at least twice weekly for at least 6 weeks (Abd El-Azim and Abd El-Azim, 2011).
30% chronic idiopathic urticaria, is the chronic autoimmune urticaria. The chronic autoimmune urticaria is caused by high affinity of IgE receptors (anti-FcRI) and less frequently by anti-IgE autoantibodies (Soundararajan et al., 2005).
The association of chronic urticaria with autoimmune thyroid disease has frequently been reported in adults. The prevalence in adult series ranges from 14% to 33% (Concha et al., 2004).
The autologous serum skin test has proved to be a useful screening in vivo test for autoimmune urticaria (Sabroe et al., 1999) .
Some recent studies have shown an association between anti-thyroid antibodies and autologous serum skin test (ASST) positive urticaria patients. However, a connection between thyroid and this reliable skin test for mast cell autoreactivity, ASST, has not been reported yet (Turkoglu et al., 2012) Furthermore, case control studies on this relationship are scarce.
The study aimed to detect prevalence of markers of thyroid autoimmunity (thyroid auto antibodies with or without underlying abnormal thyroid functions) among ASST positive patients with CAU in comparison to ASST negative CAU patients and healthy controls, and its correlation with the severity of symptoms and level of total IgE.
Our study was carried on 80 patients attending the allergy and immunology clinic of Ain Shams University Hospitals having chronic urticarial after exclusion of secondary causes of urticaria by history and routine laboratory investigations (CBC, stool analysis , KFT, LFT, HBsAg , HCV Ab, ESR, ANA, total IgE, and skin prick test).
The patients were subdivided into two groups according to ASST positivity into:
• group A : ASST positive.
• group B : ASST negative.
• 40 patients were recruited as healthy controls
Both groups A and B were matched according to age and gender.
Patients and controls were then subjected to free T3, free T4 , TSH, anti-thyroperoxidase antibody (Ab), anti microsomal (Ab), Urticaria activity score (UAS-7).
Our study detected female predominance in the patients two groups.
As regards severity of symptoms (UAS-7) and the level of total IgE, there were no statistically significant relation between both groups, denoting that there was no correlation between total IgE level or urticaria severity between ASST +ve and ASST –ve patients.
Level of Thyroid anti bodies (TgAbs and AMA Abs) showed high prvelance in ASST +ve group than ASST –ve group. 37.5% of group A patients (ASST +VE) also were AMA+ve and 32.5% of patients were +ve TgAB. While in group B (ASST –VE) only 12.5% patients were AMA+ve and 2.5% patients were TgAB+ve.
Anti microsomal ABs were found to be more specific than anti thyroglobulins in ASST+ve CU patients Our study showed that 15 (37.5%) patients in group A (ASST +VE) were AMA+ve and 13 (32.5%)patients were TgAB +VE, showing higher prevalence of AMA than TgAB in group A.
TgABs are more common to be associated with AMA+ve in CU patients than TgAB alone or AMA +ve alone , as our study showed 12 out of 40 (30%) patients in group A were both AMA and TgAB positive with high statistical significance but in group B only 1 out of 40 (2.5%) patients sshowed positivity in both antibodies.
These findings suggest the role of thyroid diseases in chronic autoimmune urticaria patients confirmed by the presence of thyroid ABs more frequently than ASST –ve patients and controls.