Chronic urticaria and thyroid autoimmunity: a meta-analysis of case-control studies

Area of Science:

• Immunology
• Endocrinology
• Dermatology

Background:

• Autoimmunity is increasingly recognized as a factor in idiopathic chronic urticaria (CU).
• Autoimmune thyroid diseases are common and warrant investigation for their association with CU.

Purpose of the Study:

• To determine the association between thyroid autoimmunity and chronic urticaria (CU).
• To quantify the extent of the association between anti-thyroperoxidase antibodies (TPOAbs) and CU.

Main Methods:

• A systematic literature search was conducted across major scientific databases (PubMed, Scopus, Web of Science, Cochrane).
• Meta-analysis of 19 studies involving 14,351 CU patients and 12,404 controls was performed to calculate the odds ratio (OR) for TPOAbs positivity.
• Study quality was assessed using the Newcastle-Ottawa Scale, and heterogeneity was evaluated using Cochrane Q and I² tests.

Main Results:

• Patients with CU demonstrated a significantly increased risk of TPOAbs positivity (pooled OR 5.18, P < 0.00001).
• After adjusting for publication bias, the OR remained elevated (4.42, P < 0.0001).
• In high-quality studies, the OR for TPOAbs positivity in CU patients was 6.72 (P < 0.00001) with no significant heterogeneity.

Conclusions:

• Individuals with chronic urticaria exhibit a substantially higher risk (five- to nearly sevenfold) of having anti-thyroperoxidase antibodies.
• Screening for thyroid autoimmunity should be considered for all patients diagnosed with chronic urticaria.