Serum Autologous Skin Test in Children with Chronic Urticaria: Is it Related to The Severity of The Disease?

Yıl 2020, Cilt: 18 Sayı: 1, 85 - 84, 15.04.2020

Deniz Özçeker , Esra Özek Yücel Sevgi Sipahi Çimen Fatih Dilekci , Nermin Güler , Zeynep Tamay

Öz

INTRODUCTION: We aimed to contribute to the limited number of studies that investigated the association between autologous serum test positivity and the severity of childhood chronic spontaneous urticaria.

MATERIALS and METHODS: Eighty-seven pediatric patients who underwent autologous serum test for chronic spontaneous urticaria were retrospectively investigated. Urticaria severity was assessed according to urticaria activity score.

RESULTS: In 19 of our patients (21.83%), the autologous serum test was positive. When clinical and laboratory parameters of patients with positive and negative autologous serum test are evaluated; age, sex, onset of symptoms, total IgE and eosinophil (%) were not statistically significant. Patients with positive autologous serum test had significantly higher urticaria activity scores (p 0.001).

CONCLUSIONS: In our study, urticaria activity score was found higher in patients with autologous serum test positive. The choice of treatment for patients with a positive autologous serum test will ensure that symptoms and the quality of life of the patients will be improved faster if they are taken into consideration that the disease may be more severe.

Anahtar Kelimeler

children, autologous serum test

Kronik Ürtiker’li Çocuklarda Serum Otolog Deri Testi: Hastalığın Ağırlığı İle İlişkisi Var Mı?

Öz

GİRİŞ ve AMAÇ: Çalışmamızda Otolog serum testi pozitifliği ile çocukluk çağı kronik spontan ürtikerinin ağırlığı arasındaki ilişkiyi araştıran kısıtlı sayıda çalışmaya katkıda bulunmak amaçlanmıştır.

YÖNTEM ve GEREÇLER: Kronik spontan ürtiker nedeniyle otolog serum testi yapılmış 87 çocuk hastanın verileri geriye dönük incelendi. Ürtiker ağırlığı ürtiker aktivite skoruna göre değerlendirildi.

BULGULAR: Hastalarımızın 19’ında (%21.83) otolog serum testi pozitif olarak tespit edildi. Otolog serum testi pozitif ve negatif olan hastaların klinik ve laboratuvar parametreleri değerlendirildiğinde; yaş, cins, semptomların başlama yaşı, total IgE ve eozinofil (%) açısından istatistiksel anlamlılık saptanmadı. Otolog serum testi pozitif olan hastaların ürtiker aktivite skorları anlamlı olarak daha yüksek saptandı (p 0,001).

TARTIŞMA ve SONUÇ: Çalışmamızda otolog serum testipozitif hastalarda ürtiker aktivite skoru daha yüksek bulunmuştur. Pozitif otolog serum testine sahip hastaların tedavi seçimi hastalığın daha şiddetli olabileceği ihtimalini dikkate alarak yapıldığında daha çabuksemptom kontrolünü ve hastaların yaşam kalitesinin düzelmesini sağlayacaktır.

Anahtar Kelimeler

çocuk, otolog serum testi, kronik spontan ürtiker, ürtiker aktivite skoru

Kaynakça

• 1. Bernstein, JA, Lang, DM, Khan, DA, et al. The diagnosis and management of acute and chronic urticaria: 2014 update. Practice Parameter. J Allergy ClinImmunol 2014;133:1270-77.
• 2. Zuberbier T, Aberer W, Asero R, et al. The EAACI/GA(2) LEN/EDF/WAO Guideline for the definition, classification, diagnosis, and management of urticaria: the 2013 revision and update.Allergy 2014;69:868-87. 3. George M, Balachandran C, Prabhu S.Chronic idiopathic urticaria: comparison of clinical features with positive autologous serum skin test.Indian J Dermatol Venereol Leprol2008; 74:105-8.
• 4. Niimi N, Francis DM, Kermani F, et al. Dermal mast cell activation by autoantibodies against the high affi nity IgE receptor in chronic urticaria. J Invest Dermatol 1996;106:1001-6.
• 5. Grattan CE, Wallington TB, Warin RP, Kennedy CT, Bradfi eld JW. A Serological mediator in chronic idiopathic urticaria — A clinical, immunological and histological evaluation. Br J Dermatol 1986;114:583-90.
• 6. Fiebiger E, Maurer D, Holub H, et al. Serum IgG autoantibodies directedagainst the alpha chain of Fc epsilon RI: A selective markerand pathogenetic factor for a distinct subset of chronicurticaria patients? J Clin Invest 1995;96:2606-12.
• 7. Kumar YH, Bhaskar S, Shankar K. Comparative Study of Positive Versus Negative Autologous Serum Skin Test in Chronic Spontaneous Urticaria and its Treatment Outcome. N Am J Med Sci 2016; 8:25-30.
• 8. Sabroe KA, Grattan CE, Francis DM, Barr RM, Kobza Black A, Greaves MW. The autologous serum skin test: A screening test for autoantibodies in chronic idiopathic urticaria. Br J Dermatol 1999;140:446-52.
• 9. Aktar S, Akdeniz N, Ozkol HU, Calka O, Karadag AS. The relation of autologous serum and plasma skin test results with urticarial activity score, sex and age in patients with chronic urticaria. Postepy Dermatol Alergol2015; 32:173-8.
• 10. Caproni M, Volpi W, Giomi B, et al. Chronic idiopathic and chronic autoimmune urticaria: clinical and immunopathological features of 68 subjects.Acta Derm Venereol 2004; 84:288-90
• 11. Hide M, Francis DM, Grattan CE, Hakimi J, Kochan JP, Greaves MW. Autoantibodies against the high-affinity IgE receptor as a cause of histamine release in chronic urticaria. N Engl J Med 1993; 328:1599-604.
• 12. Fiebiger E, Hammerschmid F, Stingl G, Maurer D. Anti-FcepsilonRIalpha autoantibodies in autoimmune-mediated disorders. Identification of a structure-function relationship.J Clin Invest 1998 ; 101:243-51.
• 13. Zuberbier T, Henz BM, Fiebiger E, Maurer D, Stingl G. Anti-FcepsilonRIalpha serum autoantibodies in different subtypes of urticaria. Allergy 2000; 55:951-4.
• 14. Jirapongsananuruk O, Pongpreuksa S, Sangacharoenkit P,Visitsunthorn, N,Vichyanond P.Identification of the etiologies of chronic urticaria in children: a prospective study of 94 patients.Pediatr Allergy Immunol 2010;21:508-14.
• 15. Sahiner, UM, Civelek, E, Tuncer A, et al. Chronic urticaria: Etiology and natural course in children. Int Arch Allergy Immunol 2011;156:224-30.
• 16. Kılıç, G, Guler N, Suleyman A, Tamay Z. Chronic urticaria and autoimmunity in children. Pediatr Allergy Immunol 2010;21:837-42.
• 17. Fusari A, Colangelo C, Bonifazi F, Antonicelli L. The autologous serum skin test in the follow-up of patients with chronic urticaria.Allergy2005; 60:256-8.
• 18. Altrich ML, Halsey JF, Altman LC. Comparison of the in vivo autologous skin test with in vitro diagnostic tests for diagnosis of chronic autoimmune urticaria.Allergy Asthma Proc2009; 30:28-34.
• 19. Yıldız H, Karabudak O, Doğan B, Harmanyeri Y.Evaluation of autologous plasma skin test in patients with chronic idiopathic urticaria.Br J Dermatol 2011; 165:1205-9.
• 20. Kumaravel S, Manjula J, Balamurugan L, Sinhuja SD, Anandan H. Choronic autoimmun urticaria and efficacy of autologous serum therapy. International Journal of Scientific Study 2017; 11: 163-66.
• 21. Ashraf MO, Dina SS, Asmaa SM, Alyaa AS , Nesrine AM, Manar FA. . Association between thyroid autoimmunity and chronic urticaria in patients versus healthy controls. Egypt J Obes Diabetes Endocrinol 2015; 1:84-89.
• 22. Jindal R, Roy S, Nagrani P.Chronic idiopathic urticaria and autoimmunity: frequency and association in patients with positive versus negative autologous serum skin test. Int J Res Med Sci 2017; 5: 1103-06.
• 23. De Swerdt A, Van Den Keybus C, Kasran A,et al. Detection of basophil-activating IgG autoantibodies in chronic idiopathic urticaria by induction of CD 63.J Allergy Clin Immunol 2005; 116:662-7
• 24. Ryhal B, DeMera RS, Shoenfeld Y, Peter JB, Gershwin ME. Are autoantibodies present in patients with subacute and chronic urticaria?J Investig Allergol Clin Immunol 2001; 11:16-20.
• 25. Mete N, Gülbahar O, Onbaşı K, Sin A, Kokuludag A, Sebik F. Otolog Serum Testi Pozitif Kronik İdiopatikÜrtikerli Hastalarda Otoantikorlar. Turkiye Klinikleri J Allergy-Asthma 2003; 5:61-6.
• 26. Krupashankar DS, Ramnane M, Rajouria EA. Etiological approach to chronic urticaria. Indian J Dermatol 2010;55:33-8.
• 27. Kumaran MS, Mangal S, Narang T, Parsad D. Autologous Serum and Plasma Skin Tests in Chronic Spontaneous Urticaria: A Reappraisal.Indian Dermatol Online J 2017; 8: 94-9.
• 28. Dilek F, Ozceker D, Ozkaya E, et al. Elevated nitrosative stress in children with spontaneous urticaria. Int Arch Allergy Immunol 2017; 172 (1): 33-39 doi: 10.1159/000453334. Epub 2017 Feb 21.