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Thyroid autoimmunity in chronic idiopathic urticaria: implications for therapy
Daniela Zauli1, Alberto Grassi, Giorgio Ballardini
1Department of Internal Medicine, Cardioangiology, Hepatology, S. Orsola Hospital, University of Bologna, Via Massarenti 9, 40138 Bologna, Italy. dzauli@almadns.unibo.it
American Journal of Clinical Dermatology
|October 3, 2002
Summary
Screening for thyroid antibodies is recommended for chronic idiopathic urticaria patients. Thyroid dysfunction requires treatment, and levothyroxine may improve urticaria symptoms in euthyroid individuals.
Area of Science:
- Immunology
- Endocrinology
- Dermatology
Background:
- Thyroid autoimmunity is linked to chronic idiopathic urticaria (CIU), with prevalence varying between 12-29%.
- Most CIU patients with thyroid autoimmunity are euthyroid, complicating therapeutic implications.
Purpose of the Study:
- To investigate the association between thyroid autoimmunity and CIU.
- To evaluate the role of thyroid antibody screening and functional assessment in CIU management.
- To explore therapeutic strategies for CIU patients with thyroid autoimmunity.
Main Methods:
- Screening CIU patients for thyroid antibodies (antithyroperoxidase and antithyroglobulin).
- Assessing thyroid functional status via serum thyrotropin levels in antibody-positive patients.
- Evaluating treatment outcomes with levothyroxine or antithyroid drugs based on thyroid function.
Main Results:
- Thyroid antibody screening is indicated in CIU patients of unknown origin.
- Thyroid dysfunction (hypo- or hyper-function) necessitates specific treatment.
- Levothyroxine showed the best urticaria symptom remission rates in euthyroid patients, despite risks.
Conclusions:
- Routine screening for thyroid antibodies and thyrotropin is crucial for CIU patients.
- Treatment of thyroid dysfunction is essential.
- Levothyroxine therapy in euthyroid CIU patients can improve symptoms but requires careful monitoring for hyperthyroidism, especially in the elderly.