الفهرس 
Chronic idiopathic urticariaOnly 14 pages are availabe for public view
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Abstract
Chronic urticaria is a common disorder presenting as
cutaneous wheals with or without angioedema for more
than 6 weeks, caused by release of vasoactive mediators
from mast cells within the dermis, occurring on a
continuous or recurrent basis over prolonged periods of
time. The majority of patients have no definable
underlying disease or specific physical precipitants, and
can be termed ’chronic idiopathic urticaria’ (CIU).
The etiology and pathogenesis of chronic idiopathic
urticaria are poorly understood. However, in 30–50% of
cases, autoimmune processes have been suggested as
causative factors. It has been reported that mast cells may
show profibrinolytic activity. Extensive evidence suggests
that, abnormalities in sex hormones metabolism and/or
secretion may modulate activity of some immunologic
diseases.
Dehydroepiandrosterone sulfate (DHEA-S) and
prolactin exert multiple immunomodulatory effects and
their circulating levels change in a contrasting manner in the course of some immune-inflammatory diseases. It was
found that DHEA-S levels are lower in patients suffering
from chronic idiopathic urticaria compared to normal
controls, whereas only some scarce information is
available on the prolactin levels in these patients. Whether
the changes in the level of these hormones in CIU is a
cause or a result is still debatable.
In our study, the role of DHEA-S and prolactin was
evaluated by estimating the plasma level of these two
hormones in patients with CIU in correlation with disease
severity.
Sixty female patients with CIU were diagnosed by
disease history, clinical picture and investigations to
exclude any other possible causes of CU. Patients were
divided into 2 groups based on their autologous serum skin
test (ASST) results into 30 patients with positive
ASST(ASST+ve) and 30 patients with negative
ASST(ASST -ve). Thirty apparently healthy subjects group
matched for age were included as controls.
At presentation, all patients were subjected to full
history taking, full general examination, as well as estimation of DHEA-S and Prolactin using the
commercially available ELISA kits.
Age was comparable between the 3 study groups
with no significant difference between them. Disease
duration was comparable between ASST +ve and ASST –
ve patients with CIU, with no significant difference
between them. However, CIU patients with a positive
ASST reaction showed a significantly greater degree of
disease severity than those with a negative ASST reaction.
There was a highly significant difference in levels of
DHEA-S across the 3 study groups. DHEA-S was
significantly higher among controls than among CIU
patients with positive or negative ASST reactions.
However, there was no significant difference in DHEA-S
levels between CIU patients with a positive ASST reaction
and those with a negative ASST reaction. DHEA-S levels
did not differ significantly according to the severity of
disease among any group.
DHEA-S levels were significantly and inversely
correlated with age among all CIU patients combined, and
among ASST +ve CIU patients, but not among ASST -ve
CIU patients or controls. Furthermore, DHEA-S did not correlate significantly with disease duration or prolactin
levels among any of the groups.
There was no significant difference in levels of
prolactin between patients with CIU and controls. Prolactin
was significantly higher among CIU patients with a
positive ASST reaction than among ASST negative CIU
patients and controls. However, there was no significant
difference in prolactin levels between CIU patients with a
negative ASST reaction and controls. Prolactin levels were
significantly associated with disease severity among ASST
+ve CIU patients, but not among ASST –ve CIU patients.
Prolactin levels showed no significant correlations with
age or disease duration among any of the groups.