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Artigo Acesso aberto Produção Nacional Revisado por pares
BIBTEX RIS

CHRONIC URTICARIA: DIAGNOSIS AND THERAPEUTIC PROFILES AMONG PATIENTS RECEIVING CARE AT A REFERENCE CENTER

2019; Elsevier BV; Volume: 143; Issue: 2 Linguagem: Inglês

10.1016/j.jaci.2018.12.153

ISSN

1097-6825

Autores

Orlando Trevisan Neto, Juliana Augusta Sella, Daniel L. Cordeiro, Débora Corazza Biazin, Guilherme Erlo, Laira Kobarg Cercal Rogério Gomes, Thais Nociti Mendonça, Janaína Michelle Lima Melo, Mariana Paes Leme Ferriani, L. Karla Arruda,

Tópico(s)

Mast cells and histamine

Resumo

Management of Chronic Urticaria (CU) is often a challenge to the Allergist/Immunologist. We aimed to evaluate diagnostic and therapeutic profiles among patients with CU in a UCARE Center in Brazil. Retrospective analysis of medical records of 383 CU patients who attend an Urticaria Specialty Clinic at a reference center from 2011 to 2018. The majority of patients were female (81%), with median age at diagnosis 41 years. Angioedema was associated with urticaria in 61.2%. Isolated angioedema was present in 7.3%; chronic inducible urticarial (CIndU) in 11.4%; chronic spontaneous urticaria(CSU) in 32.6%; CSU and CIndU in 27.9%; other conditions in 20.8% of the patients. Features of autoimmunity were observed in 149 (39%) patients. Of the 220 patients to whom ASSTs were performed, 93(42.2%) gave positive results; 10.7% had positive ANA and/or anti-thyroid antibodies. 55% presented elevated total IgE. Most patients were treated with second-generation antihistamines (AH), including 138(37%) with regular doses, 147(39%) doubled dose, 15(3.9%) tripled dose, and 76(20%) fourfold dose. Therapy with omalizumab was initiated in 25 patients refractory to fourfold doses of AH. All patients were responders (UAS7<6), including 13(52%) with response after the first dose, 6(24%) between 2nd and 4th dose, 4(16%) between 4th and 6th dose, and 2(8%) after the 6th dose. Omalizumab was discontinued in two patients, one following prolonged remission, and one due to pregnancy. A high proportion of our CU patients presented features of autoimmunity. Treatment of patients refractory to fourfold doses of AH with omalizumab was highly effective in the majority of patients.

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