Skip to main content

Chronic Urticaria as a New Autoimmune Disease?

  • Chapter
Book cover Autoimmune Diseases of the Skin
  • 283 Accesses

Abstract

Urticaria is conventionally classified as acute, intermittent and chronic (Greaves 2000a). Acute urticaria which frequently involves an IgE-mediated immunological mechanism, is common, its causes often recognised by the patient, and will not be considered further. Intermittent urticaria — frequent bouts of unexplained urticaria at intervals of weeks or months — will be discussed here on the same basis as ‘ordinary’ chronic urticaria. The latter is conventionally defined as the occurrence of daily or almost daily whealing for at least six weeks. The etiology of chronic urticaria is usually obscure. The different clinical varieties of chronic urticaria will be briefly considered here, and attention will be devoted to a newly emerged entity — autoimmune chronic urticaria, since establishing this diagnosis has conceptual, prognostic and therapeutic implications. Contact urticaria and angioedema without urticaria will not be dealt with in this account.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 74.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • Adams DD (1988) Long-acting thyroid stimulator: how receptor autoimmunity was discovered. J Autoimmunity 1: 3–9

    CAS  Google Scholar 

  • Bentley-Phillips CB, Black AK, Greaves MW (1976) Induced tolerance in cold urticaria caused by cold-evoked histamine release. Lancet 11: 63–66

    Article  Google Scholar 

  • Black AK, Lawlor F, Greaves MW (1996) Consensus meeting on the definition of physical urticarias and urticarial vasculitis. Clin Exp Dermatol 21: 424–426

    Article  PubMed  CAS  Google Scholar 

  • Burova GP, Mallet AI, Greaves MW (1998) Is Helicobacter pylori a cause of chronic urti caria? Br J Dermatol 139 (Suppl): 42

    Google Scholar 

  • Commens CA, Greaves MW (1978) Tests to establish the diagnosis in cholinergic urticaria. Brit J Dermatol 98: 47–51

    Article  CAS  Google Scholar 

  • Fiebiger E, Maurer D, Holubar H, Reininger B, Hartmann G, Woisetschlager M, Stingl G (1995) Serum IgG autoantibodies directed against the alpha chain of FcERI: a selective marker and pathogenetic factor for a distinct subset of chronic urticaria patients. J Clin Invest 96: 2606–2612

    Article  PubMed  CAS  Google Scholar 

  • Fiebiger E, Hammerschmid F, Stingl G, Maurer D (1998) Anti- FcERIa autoantibodies in autoimmune-mediated disorders. J Clin Invest 101: 243–261

    Article  PubMed  CAS  Google Scholar 

  • Fung-Leung W-P, Sousa-Hitzien JD, Ishaque A (1996) Transgenic mice expressing the human high affinity immunoglobulin ( Ig)E receptor a chain, respond to human IgE in mast cell degranulation and allergic reactions. J Exp Med 183: 49–56

    Google Scholar 

  • Grattan CEH, Wallington TB, Warin RP (1986) A serological mediator in chronic idiopathic urticaria: a clinical immunological and histological evaluation. Br J Dermatol 114: 583–590

    Article  PubMed  CAS  Google Scholar 

  • Grattan CEH, Francis DM, Slater NGP, Greaves MW (1992) Plasmapheresis for severe unremitting chronic urticaria. Lancet 339: 1078–1080

    Article  PubMed  CAS  Google Scholar 

  • Grattan CEH, Francis DM (1999) Autoimmune urticaria. Advances Dermatol 15, 311–340

    Google Scholar 

  • Grattan CEH, O’Donnell BF, Francis DM, Niimi N, Barlow RJ, Seed PT, Black AK, Greaves MW (2000) Randomised double blind study of cyclosporin in chronic idiopathic urticaria. Br J Dermatol 143: 365–372

    Article  PubMed  CAS  Google Scholar 

  • Greaves MW (1995) Current concepts in chronic urticaria. New Eng J Med 332: 1767–1772

    Article  PubMed  CAS  Google Scholar 

  • Greaves MW (2000a) Management of urticaria. Hosp Med 61: 463–469

    PubMed  CAS  Google Scholar 

  • Greaves MW (2000b) Chronic urticaria. J Allergy Clin Immunol 105: 664–672

    Article  PubMed  CAS  Google Scholar 

  • Greaves MW (2001) Chronic idiopathic urticaria (CIU) and Helicobacter pylori–not di-rectly causative, but could there be a link? Allergy Clin Immunol Internat 13: 23–26

    Article  Google Scholar 

  • Hayashi S Hashimoto S (1999) Anti-inflammatory actions of new antihistamines Clin Exp Allergy 29: 1593–1596

    Article  CAS  Google Scholar 

  • Herxheimer A (1956) The nervous pathway mediating cholinergic urticaria. Clin Sci 15: 195–205

    PubMed  CAS  Google Scholar 

  • Hide M, Francis DM, Grattan CH, Greaves MW (1993) Autoantibodies against the high affinity IgE receptor as a cause for histamine release in chronic urticaria. New Eng J Med 328: 1599–1604

    Article  PubMed  CAS  Google Scholar 

  • Hide M, Francis DM, Grattan CEH, Barr RM, Winkelmann RK, Greaves MW (1994) The pathogenesis of chronic urticaria: new evidence suggests an autoimmune basis and implications for treatment. Clin Exp Allergy 24: 624–627

    Article  PubMed  CAS  Google Scholar 

  • Hirschmann JV, Lawlor F, English SJC, Lowback JB, Winkelmann RK, Greaves MW (1987) Cholinergic urticaria. Arch Dermatol 123: 462–467

    Article  PubMed  CAS  Google Scholar 

  • Holgate ST Bradding P Sampson AP (1996) Leukotriene antagonists and synthesis inhibitors: new directions in asthma therapy. J Allergy Clin Immunol 98: 1–13

    Article  Google Scholar 

  • Juhlin L, Michaelsson G (1969) Cutaneous reactions to kallikrein, bradykinin and histamine in healthy subjects and in patients with urticaria. Acta Derm Venereol (Stockh) 49: 26–36

    CAS  Google Scholar 

  • Keahey TM, Greaves MW (1980) Cold urticaria: dissociation of cold-evoked histamine release and urticaria following cold challenge. Arch Dermatol 116: 174–177

    Article  PubMed  CAS  Google Scholar 

  • Kermani F, Niimi N, Francis DM, Barr RM, Black AK, Greaves MW (1995) Characterisation of a novel mast cell-specific histamine-releasing activity in chronic idiopathic urticaria. J Invest Dermatol 105: 452

    Google Scholar 

  • Koro O, Dover JS, Francis DM, Black AK, Kelly RW, Barr RM, Greaves MW (1986) Release of prostaglandin D2 and histamine in a case of localised heat urticaria, and effect of treatment. Br J Dermatol 115: 721–728

    Article  PubMed  CAS  Google Scholar 

  • Lawlor F, Black AK, Milford Ward A, Morris R, Greaves MW (1989a) Delayed pressure urti-caria: objective evaluation of a variable disease using a dermographometer and assessment of treatment using colchicine. Br J Dermatol 120: 403–408

    Article  PubMed  CAS  Google Scholar 

  • Lawlor F, Black AK, Breathnach AS, Greaves MW (1989b) Vibratory angioedema: lesion induction, clinical features, ultrastructural findings and response to therapy. Br J Dermatol 120: 93–99

    Article  PubMed  CAS  Google Scholar 

  • Lawrence CM, Jorizzo JL, Black AK, Coutts A, Greaves MW (1981) Cholinergic urticaria associated with angioedema. Br J Dermatol 105: 543–550

    Article  PubMed  CAS  Google Scholar 

  • Leznoff A, Josse RG, Denburg J, Dolovich J (1983) Association of chronic urticaria and angioedema with thyroid autoimmunity. Arch Dermatol 119: 636–640

    Article  PubMed  CAS  Google Scholar 

  • Leznoff A, Sussman GL (1989) Syndrome of idiopathic chronic urticaria and angioedema with thyroid autoimmunity–a study of 90 patients. J Allergy Clin Immunol 84: 66–71

    Article  PubMed  CAS  Google Scholar 

  • Lowman MA, Rees PH, Benyon RC (1988) Human mast cell heterogeneity. Histamine release from mast cells dispersed from skin, lung, adenoids, tonsils and colon in response to IgE-dependent and non-immunological stimuli. J Allergy Clin Immunol 81: 590–597

    Google Scholar 

  • MacGlashan DW, Bochner BS, Adelman DC (1987) Down regulation of FccRI expression on human basophils during in vivo treatment of atopic human patients with anti-IgE antibody. J Immunol 158: 1438–1445

    Google Scholar 

  • May CD (1985) Are confusion and controversy about food hypersensitivity really necessary? J Allergy Clin Immunol 75: 329–333

    Article  PubMed  CAS  Google Scholar 

  • Misch K, Black AK, Greaves MW (1983) Almosauri T, Stanworth DR, Passive transfer of cold urticaria to monkeys. Acta Derm Venereol (Stockh) 63: 163–164

    Google Scholar 

  • Murphy GM, Black AK, Greaves MW (1983) Persisting cholinergic erythema–a variant of cholinergic urticaria. Br J Dermatol 109: 343–348

    Article  PubMed  CAS  Google Scholar 

  • Murphy GM, Zollman PE, Greaves MW, Winkelmann RK (1987) Symptomatic dermographism (factitious urticaria)–passive transfer experiments from human to monkey. Br J Dermatol 116: 801–804

    Article  PubMed  CAS  Google Scholar 

  • Niimi N, Francis DM, Kermani F, Black AK, Barr RM, Grattan CEH, Greaves MW (1996) Dermal mast cell activation by autoantibodies against the high affinity IgE receptor in chronic urticaria. J Invest Dermatol 106: 1001–1006

    Article  PubMed  CAS  Google Scholar 

  • O’Donnell BF, Black AK (1995) Urticarial vasculitis. Int Angiol 14: 166–174

    PubMed  Google Scholar 

  • O’Donell BF, Lawlor F, Simpson J, Morgan M, Greaves MW (1997) The impact of chronic urticaria on quality of life. Br J Dermatol 136: 197–201

    Article  Google Scholar 

  • O’Donnell BF, Barr RM, Black AK, Francis DM, Greaves MW (1998) Intravenous immunoglobulin in chronic autoimmune urticaria. Br J Dermatol 138: 101–6

    Article  PubMed  Google Scholar 

  • O’Donnell BF, O’Neill CM, Francis DM, Niimi N, Barr RM, Barlow RJ, Greaves MW, Welsh K (1999) Human leucocyte antigen class II associations in chronic idiopathic urticaria. Br J Dermatol 140: 853–858

    Article  PubMed  Google Scholar 

  • Ozkaya-Bayazit E, Demir K, Ozgaroglu E, Kaymakoglu S, Ozamagar G (1998) Helicobacter pylori eradication in patients with chronic urticaria. Arch Dermatol 314: 1165–1166

    Article  Google Scholar 

  • Pastorello EA (1995) Evaluating new tests for the diagnosis of food allergy. Allergy 50: 289–291

    Article  PubMed  CAS  Google Scholar 

  • Pirisi A (2000) Antihistamines impair driving as much as alcohol. Lancet 355: 905

    Article  Google Scholar 

  • Ramsay CA (1977) Solar urticaria treatment by inducing tolerance to artificial radiation and natural light. Arch Dermatol 113: 1222–1225

    Article  PubMed  CAS  Google Scholar 

  • Rorsman H (1961) Basopenia in urticaria. Acta Allergol 16: 185–215

    Article  PubMed  CAS  Google Scholar 

  • Sabroe RA, Francis DM, Barr RM, Black AK, Greaves MW (1998) Anti- FccRI autoantibodies and basophil histamine release ability in chronic idiopathic urticaria. J Allergy Clin Immunol 102: 651–658

    Article  PubMed  CAS  Google Scholar 

  • Sabroe RA, Seed PT, Francis DM, Barr RM, Black AK, Greaves MW (1999a) Chronic idiopathic urticaria: comparison of clinical features of patients with or without anti- FccRI or anti-IgE autoantibodies. J Am Acad Dermatol 40: 443–450

    Article  PubMed  CAS  Google Scholar 

  • Sabroe RA, Poon E, Orchard GE, Lane D, Francis DM, Barr RM, Black AK, Greaves MW (1999b) Cutaneous inflammatory cell infiltrate in chronic idiopathic urticaria: comparison of patients with and without anti-Fc RIa or anti-IgE autoantibodies. J Allergy Clin Immunol 103: 484–493

    Article  PubMed  CAS  Google Scholar 

  • Sabroe RA, Grattan CEH, Francis DM, Black AK, Barr RM, Greaves MW (1999c) The autologous serum skin test: a screening test for autoantibodies in chronic idiopathic urticaria. Br J Dermatol 140: 446–452

    Article  PubMed  CAS  Google Scholar 

  • Schnyder B, Helbling A, Pichler WJ (1999) Chronic idiopathic urticaria: natural course and association with Helicobacter pylori infection. Int Arch Allergy Immunol 119: 60–63

    Article  PubMed  CAS  Google Scholar 

  • Sibbald RG, Black AK, Eady RAJ, James M, Greaves MW (1981) Aquagenic Urticaria: evidence of a cholinergic and histaminergic basis. Br J Dermatol 105: 297–302

    Article  PubMed  CAS  Google Scholar 

  • Tong LJ, Balakrishnan G, Kochan JP, Kinet J-P, Kaplan AP (1997) Assessment of auto immunity in chronic urticaria. J Allergy Clin Immunol 99: 461–465

    Article  PubMed  CAS  Google Scholar 

  • Wedi B, Wagner S, Werfil T, Mann MP, Kapp A (1998) Prevalence of Helicobacter pyloriassociated gastritis in chronic urticaria. Int Arch Allergy Immunol 116: 288–294

    Article  PubMed  CAS  Google Scholar 

  • Weiner HL (1997) Oral tolerance immune mechanisms and treatment of autoimmune diseases. Immunol Today 18: 335–343

    Article  PubMed  CAS  Google Scholar 

  • Wolfrom E, Chene G, Boisseau H, Beylot C, Geniaux M, Taleb A (1995) Chronic urticaria and Toxocara canis. Lancet 345: 196

    Article  PubMed  CAS  Google Scholar 

  • Zuberbier T, Bohm M, Czarnetski BM (1993) Food intake in combination with a rise in body temperature: a newly defined cause of angioedema. J Allergy Clin Immunol 91: 1226–1227.

    Article  PubMed  CAS  Google Scholar 

  • Zweiman B, Valenzano M, Atkins PC, Tanus T, Getsy JA (1996) Characteristics of histamine-releasing activity in sera of patients with chronic idiopathic urticaria. J Allergy Clin Immunol 98: 89–98

    Article  PubMed  CAS  Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2001 Springer-Verlag Wien

About this chapter

Cite this chapter

Greaves, M.W. (2001). Chronic Urticaria as a New Autoimmune Disease?. In: Hertl, M. (eds) Autoimmune Diseases of the Skin. Springer, Vienna. https://doi.org/10.1007/978-3-7091-3704-8_10

Download citation

  • DOI: https://doi.org/10.1007/978-3-7091-3704-8_10

  • Publisher Name: Springer, Vienna

  • Print ISBN: 978-3-7091-3706-2

  • Online ISBN: 978-3-7091-3704-8

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics