scholarly journals Oral mini-pulse steroid therapy in severe chronic urticaria

2021 ◽  
Vol 12 (e) ◽  
pp. e83-e83
Author(s):  
Mohammad Abid Keen ◽  
Faizan Younus Shah
Keyword(s):  
Chronic Urticaria ◽  
Maximum Dose ◽  
Autologous Serum ◽  
Once Daily ◽  
Autologous Serum Skin Test ◽  
Pulse Steroid Therapy ◽  
End Of Treatment ◽  
Urticaria Activity Score ◽  
Pulse Steroid

Background: Treatment of chronic urticaria can be difficult at times. The present study aimed to evaluate the efficacy of oral mini-pulse (OMP) therapy with methylprednisolone in management of severe chronic urticaria (CU). Methods and material: 100 patients with severe chronic urticaria, not controlled with maximum dose of a second generation antihistamine, were enrolled in the study after an informed written consent. All patients were treated with methylprednisolone 16 mg tablet on two consecutive days of a week for 2 months along with levocetirizine 5 mg tablet once daily. All patients were reviewed at 0, 2, 4, and 8 weeks with urticaria activity score (UAS). Results: The study comprised of 100 patients (33 males and 67 females) with severe chronic urticaria. 29 patients (29%) had raised TSH levels while Autologous Serum Skin Test was positive in 37 patients. Mean UAS in patients treated with OMP was 5.76 at baseline which reduced to 0.6 at the end of treatment period. Conclusion: Mean UAS showed a significant decline following OMP therapy with methylprednisolone. Most of the patients maintained the benefits of therapy at the end of follow up period of 4 months.

The autologous serum skin test in the follow-up of patients with chronic urticaria

Allergy ◽  
2005 ◽  
Vol 60 (2) ◽  
pp. 256-258 ◽  
Author(s):  
A. Fusari ◽  
C. Colangelo ◽  
F. Bonifazi ◽  
L. Antonicelli
Keyword(s):  
Skin Test ◽  
Chronic Urticaria ◽  
Autologous Serum ◽  
Autologous Serum Skin Test

scholarly journals Evaluation of Serum Substance P Level in Chronic Urticaria and Correlation with Disease Severity

2020 ◽  
Author(s):  
Javad Fadaee ◽  
Maryam Khoshkhui ◽  
Maryam Emadzadeh ◽  
Seyed Isaac Hashemy ◽  
Reza Farid Hosseini ◽  
...  
Keyword(s):  
Substance P ◽  
Serum Level ◽  
Chronic Urticaria ◽  
Healthy Subjects ◽  
Background Information ◽  
Autologous Serum ◽  
Control Group ◽  
Autologous Serum Skin Test ◽  
Urticaria Activity Score

Substance P (SP) is a neurotransmitter emitted from neurons that plays a role in the pathogenesis of itching conditions including chronic urticarial (CU). The present research aims to investigate the serum level of S.P among CU patients and compare them with healthy subjects and explore how it correlates with the severity of urticaria. The present research was conducted on 87 CU patients who visited the allergy clinic of Ghaem Hospital, Mashhad, Iran from October 2017 to June 2018. Besides, 86 healthy subjects were recruited as the control group. Background information of patient was collected including age, sex, duration of the disease and the co-occurrence of angioedema. S.P serum level was measured in two groups by ELISA method. In the patients group, the autologous serum skin test (ASST) was performed along with the urticaria evaluation questionnaire include Urticaria Activity Score 7 (UAS7), Urticaria Control Test (UCT) and Chronic Urticaria Quality of Life (CU-Q2OL). Among the patients, the SP serum level showed to be about two times higher than the healthy subjects (p˂0.001). SP showed to be increased as patients’ age grew (p=0.010). In patients with a positive ASST, SP level was higher (p=0.012). No correlation was found between SP and the presence of angioedema among patients. There was no correlation between the SP serum level and the scores obtained from urticaria evaluation questionnaires. SP among CU patients was higher than healthy subjects. SP was also higher among female, older and positive ASST patients. The SP value was not correlated with the severity of urticaria, angioedema. In conclusion, Using SP antagonist drugs could be a potential treatment for chronic urticaria.

scholarly journals The Autologous Serum Skin Test as a Prognostic Factor for the Severity and Duration of Chronic Urticaria after five years of Follow-up

2018 ◽  
Vol 141 (2) ◽  
pp. AB46
Author(s):  
Karen Milena Lozano Mosquera ◽  
Beatriz Moya Camacho ◽  
Ruth Mielgo Ballesteros ◽  
Alicia Enriquez Matas ◽  
Miguel Angel Díaz ◽  
...  
Keyword(s):  
Prognostic Factor ◽  
Skin Test ◽  
Chronic Urticaria ◽  
Autologous Serum ◽  
Autologous Serum Skin Test

scholarly journals Autologous Serum Skin Test in Chronic Idiopathic Urticaria

2016 ◽  
Vol 12 (2) ◽  
pp. 6-10 ◽  
Author(s):  
Kumar Pokhrel ◽  
S. Subedi ◽  
S. Acharya
Keyword(s):  
Skin Test ◽  
Chronic Urticaria ◽  
Cost Effective ◽  
Activity Score ◽  
Autologous Serum ◽  
Cross Sectional ◽  
Dermatology Department ◽  
Autologous Serum Skin Test ◽  
Autoimmune Urticaria ◽  
Urticaria Activity Score

Background: Urticaria is a short-lived swelling of skin and mucosa due to plasma leakage by immune and non immune mediated activation and released of mediators from mast cell and basophil. Autoimmune urticaria tends to have a high itch and wheal score than other type of urticaria. Its diagnosis is practically relied upon clinical suspicion and autologous serum skin test. Autologous serum skin test (ASST) is the simple and cost effective test to differentiate autoimmune urticaria from the bulk of chronic urticaria patients. Objective: To compare the features of chronic urticaria in patients having positive versus negative autologous serum skin test (ASST).Materials and methods: Cross-sectional hospital based study was conducted among 90 chronic urticaria patients (CIU) attending the outpatient dermatology department of Nepalgunj Medical College, Nepalgunj, during one year period. The study was conducted after ethical approval from the institutional committee. The patients were diagnosed on the basis of the appearance of continuous or recurrent hives with or without angioedema for more than 6 weeks. Patients who suffered from either acute urticaria or urticarial vasculitis or physical urticaria or other systemic diseases known to cause urticaria were excluded. Standard tools and techniques were used to prepare antilogous serum and injection of the serum and interpretation of the result. The test result was Interpreted as positive and negative autologous serum skin test.Results: ASST was positive in 42% of the patients and negative in 58% of the patients. The ASST-positive patients had a higher mean urticaria activity score and median duration of wheals in comparison with the ASST-negative patients. Wheals lasted for significantly longer duration in patients with positive ASST. Patients with positive ASST had more frequent attacks which was statistically significant compared to the ASST-negative group. The mean urticaria activity score was significantly higher in the ASST-positive patients than that in the ASST-negative patients.Conclusions: Autologous serum skin test may be a useful screening test for autoimmune urticaria and may be used as a simple and cost-effective test for the classification of chronic urticaria.JNGMC Vol. 12 No. 2 December 2014, page: 6-10

scholarly journals Efficacy of Injection Histaglobulin in Treatment of Chronic Urticaria

2021 ◽  
Author(s):  
Usha Naraindas Khemani ◽  
Avinash Aba Sajgane
Keyword(s):  
Chronic Urticaria ◽  
Treatment Options ◽  
Poor Response ◽  
Treatment Modalities ◽  
Autologous Serum ◽  
Prospective Clinical Study ◽  
Weekly Dose ◽  
Autologous Serum Skin Test ◽  
Secondary Objective ◽  
Urticaria Activity Score

Introduction: Patients of Chronic Urticaria (CU) suffer from the morbidity that arise from irritable itch and wheals and it also shows a poor response to drug treatment. Treatment options which increase the duration of remission and those which address the key factors involved in the disease pathogenesis are the need of the hour. Aim: To assess the efficacy of injection histaglobulin a complex of histamine and human immunoglobulin in producing relief in patients with CU. Secondary objective was to compare effect of histaglobulin in between Autologous Serum Skin Test (ASST) positive and ASST negative group of CU patients. Materials and Methods: The present study was a prospective clinical study in which 40 patients with CU were enrolled. Patients were administered injection histaglobulin as a weekly dose of 1 mL subcutaneously for eight consecutive weeks. Patients were permitted to take Tab Levocetirizine 5 mg as and when required not exceeding the recommended permitted dose. The efficacy of the drug was assessed using Urticaria Activity Score (UAS 7) a unified, validated and simple scoring system. The assessment was done at every weekly visit and the final assessment was done after 24 weeks. Results: Out of 40 patients enrolled, 32 patients had completed the entire schedule of dosage of eight weeks and final follow-up at 24th week. The mean basal UAS 7 was 12.6 at the time of enrolment to the study and it reduced to 2.57 at the end of 8th week which marginally increased to 2.8 at the end of 24 weeks, the antihistamine pill burden also reduced. No adverse effects were observed in the study group. Conclusion: Histaglobulin was found to be effective in producing long term remission and it reduced the antihistamine need as well. Thus, it can be an effective alternative to existing treatment modalities.

scholarly journals Autologous Serum Skin Test for Initial Identification of Auto- Antibodies in Chronic Urticaria

2018 ◽  
Vol 19 (2) ◽  
pp. 100-103
Author(s):  
Mohammad Nura Alam ◽  
Mohammad Ali ◽  
Mohammad Moniruzzaman Khan ◽  
Keya Tarafder ◽  
Goutam Kumar Acherjya ◽  
...  
Keyword(s):  
Skin Test ◽  
Chronic Urticaria ◽  
Cost Effective ◽  
Autologous Serum ◽  
P Value ◽  
Effective Measure ◽  
Autologous Serum Skin Test ◽  
Physical Urticaria ◽  
Retrospective Data Analysis ◽  
Initial Identification

Background: Autologous serum skin test (ASST) is easy to perform, cost effective measure for initial identification of auto-antibody in patients suffering from chronic urticaria which may occur due to autoimmune trigger by spontaneously developed auto-antibodies against FcμRI receptor of skin mast cells.Objective: This review is designed to see the positivity of ASST in patients suffering from chronic urticaria.Materials & Methods: This a retrospective data analysis conducted from the records of patients suffered from at least two episodes of urticaria or more in a week for 6 weeks and who did ASST aged more than 10 years between July 2015 to June 2017. These subjects were not pregnant or lactating mother, did not had urticarial vasculitis, predominant co-existing physical urticaria and had negative Hepatitis B antigen and anti-nuclear antibody reports.Results: Total 53 were included in this study of them 33 were female. Mean age was 32 years with a standard deviation (SD) of 11 years. Among study patients 16 (30.2% of total) had a positive ASST result. No age or sex difference was observed in positive ASST cases. In positive cases significant (p-value:<0.001) mean induration difference of 2.75mm with a SD of 1.00 mm observed than induration produced by negative control.Conclusion: ASST is easy and effective tool for initial identification of auto-reactive urticaria.J MEDICINE JUL 2018; 19 (2) : 100-103

Autologous Whole Blood Injections to Patients with Chronic Urticaria and a Positive Autologous Serum Skin Test: A Placebo-Controlled Trial

Dermatology ◽  
2006 ◽  
Vol 212 (2) ◽  
pp. 150-159 ◽  
Author(s):  
P. Staubach ◽  
K. Onnen ◽  
A. Vonend ◽  
M. Metz ◽  
F. Siebenhaar ◽  
...  
Keyword(s):  
Skin Test ◽  
Chronic Urticaria ◽  
Whole Blood ◽  
Controlled Trial ◽  
Autologous Serum ◽  
Autologous Serum Skin Test ◽  
Autologous Whole Blood

scholarly journals HLA among Brazilian patients with spontaneous chronic urticaria and positive autologous serum skin test

2012 ◽  
Vol 87 (4) ◽  
pp. 578-583 ◽  
Author(s):  
Zamir Calamita ◽  
Andrea Bronhara Pelá ◽  
Márcia Gamberini ◽  
Wilson Baleotti Júnior ◽  
Odilon Marques de Almeida Filho ◽  
...  
Keyword(s):  
Major Histocompatibility Complex ◽  
Skin Test ◽  
Chronic Urticaria ◽  
Population Group ◽  
Autologous Serum ◽  
Major Histocompatibility ◽  
Allele Distribution ◽  
Autologous Serum Skin Test ◽  
Histocompatibility Complex ◽  
Oligonucleotide Hybridization

BACKGROUND: An association between class I and II alleles of the major histocompatibility complex and idiopathic chronic urticaria has previously been observed in different populations, but there are still no studies on Brazilian populations in this regard. OBJECTIVE: The involvement of the major histocompatibility complex classes I and II (loci A, B and DR) in Brazilian patients with idiopathic chronic urticaria and a positive autologous serum skin test was investigated and compared with a healthy population group. METHODS: DNA was extracted from the blood of 42 patients with idiopathic chronic urticaria and major histocompatibility complex classes I and II alleles were determined using the polymerase chain reaction and a laboratory test for oligonucleotide hybridization using a single-filament probe. The frequencies of these alleles in patients with chronic urticaria were compared with the frequencies in 1000 genetically unrelated voluntary blood donors from the same region of Brazil. The diagnosis of idiopathic chronic urticaria was based on the patients' clinical history and routine laboratory tests. Only the patients with positive autologous serum skin test were selected. The allele distribution resulted from the patient and control groups were analyzed using odds ratios and 95% confidence intervals. RESULTS: No statistically significant differences were found between the positive autologous serum skin test patients with chronic urticaria and the control group. CONCLUSIONS: We found that in this population group, there was no specific association between the HLA alleles studied and chronic urticaria. We believe that further population studies are needed in order to investigate the possible existence of this association.

Twice Daily Use of Deferasirox Is More Effective in Decreasing Serum Ferritin

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 2675-2675 ◽  
Author(s):  
Fatma Gumruk ◽  
Sule Unal ◽  
Turan Bayhan ◽  
Tuncay Hazirolan ◽  
A. Murat Tuncer ◽  
...  
Keyword(s):  
Serum Ferritin ◽  
Half Life ◽  
Conflicts Of Interest ◽  
Maximum Dose ◽  
Iron Chelation ◽  
Beta Thalassemia ◽  
Iron Loading ◽  
Once Daily ◽  
T2 Mri

Abstract Patients with beta-thalassemia major (BTM) are prone to tissue iron overloading in case that not adequately chelated. Among the iron chelators, development of oral chelators have improved patients’adherence to treatment. Deferasirox is a tridentate iron chelator, used once daily with a half life of 8-16 hours. The negative chelation effect is achieved at doses above 30 mg/kg/day and the currently FDA-approved maximum dose for use in patients is 40 mg/kg/day. However, some of the deferasirox side effects are dose-dependent increasing the occurences of adverse events at high doses. Additionally, although there is data that non-transferrin bound iron is effectively decreased by once daily dosing, the iron chelation effects of the drug may increase since in some of the patients half-life of the drug has been reported to be even less than 7 hours. Herein, we compared the iron chelation effect and tolerability of deferasirox in the same patients who were using deferasirox at a dose of 40 mg/kg/day. The patients with BTM who were under iron chelation with deferasirox at a dose of median 40 mg/kg/day (38-41) once daily for at least 6 months were included (n=10). These patients were receiving deferasirox at a maximum dose in the enrollment to the study related to either serum ferritin levels above 1500 ng/ml or moderate to severe iron loading in cardiac or liver tissues. These patients were put on a twice daily regimen of the same dose and followed up at a median time period of 7 months (4-17). The serum ferritin, ALT, creatinine levels and T2* MRI of heart and liver were obtained at the beginning of the twice daily dosing and by the end of the follow-up time. Patients were given a questionairre to investigate the tolerability and satisfaction of once daily and twice daily use. The median age of the study group was 21 years (3-34), hal were males. The patients’ serum ferritin, cardiac and hepatic iron loading levels were summarized in Table 1. There was a statistically significant decrease in serum ferritin levels with twice daily use of deferasirox compared to once daily use of the same dose. The initial and follow-up ALT and serum creatinine levels did not differ significantly (p>0.05). None of the patient required a dose reduction or cessation of the drug related to a toxicity. The major tolerability concern of the patients in once daily dosing was nausea in 2 of the patients (20%). After twice daily dosing the major concern of the patients was twice daily use of the drug itself in 2 patients (20%). None of the patients reported nausea in twice-dosing. The patients’ satisfaction survey in the end of the study for once or twice daily use was for once daily use revealed preference for twice-use in 5 (50%) of the patients for either no nausea (n=2) with twice-use or better decrease in serum ferritin levels (n=3). Three (30%) preferred once daily use as a better way, related to lesser drug use. Two patients reported that there were no difference in terms of satisfaction. In conclusion, twice daily use of deferasirox at higher doses is much better tolerated and causes a better decline in serum ferritin levels of already high iron burden. Further studies in larger sample groups may be more definitive. Table 1. The initial and follow-up iron overloading evaluations Mean ± SD (Range) p Initial SF (ng/ml) Follow-up SF 2020±983 (1016-4128) 1533±1026 (521-4003) 0.047 Initial cardiac T2* MRI (ms) Follow-up cardiac T2* MRI 25.4±8.6 (14.6-38) 21.5±7.8 (13.8-30) 0.068 Initial liver T2* MRI (ms) Follow-up liver T2* MRI 3.6±1.9 (1.3-8) 6.7±5.1 (2.1-13.6) 0.465 SF: serum ferritin; SD: standard deviation Disclosures No relevant conflicts of interest to declare.

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