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Autoimmune urticaria.

Clive E H Grattan¹

¹Dermatology Centre, Norfolk and Norwich University Hospital, Colney, Norwich NR4 7UY, UK. clive.grattan@nnuh.nhs.uk

Immunology and Allergy Clinics of North America

|May 4, 2004

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At least 40% of chronic urticaria patients have functional autoantibodies, suggesting an autoimmune basis. This review explores autoimmune urticaria, its diagnosis, and management strategies.

Area of Science:

Immunology
Dermatology
Allergy

Background:

Chronic urticaria (CU) affects many patients with unknown causes.
A significant subset of CU patients exhibit autoantibodies targeting the high-affinity IgE receptor (FcεRI).
These autoantibodies are implicated in histamine release from mast cells and basophils.

Purpose of the Study:

To review evidence supporting the autoimmune hypothesis in chronic urticaria.
To define autoimmune urticaria and its place in current classifications.
To propose diagnostic criteria and discuss management for autoimmune urticaria.

Main Methods:

Literature review of studies on autoimmune urticaria.
Analysis of evidence for autoantibodies and other serum factors.

Related Experiment Videos

Examination of existing urticaria classifications.

Main Results:

At least 40% of idiopathic chronic urticaria patients possess functional autoantibodies to FcεRI.
Autoimmune urticaria is characterized by continuous ordinary urticaria.
Evidence supports non-antibody serum factors also contributing to histamine release.

Conclusions:

Autoimmune urticaria represents a distinct subset of chronic urticaria.
Diagnostic criteria are proposed to aid clinicians.
Management strategies require consideration of the autoimmune pathogenesis.