Medicus, Vol. 16 No. 1_Dermatologija, 2007.
Pregledni rad
Diagnosis and Treatment Issues in Chronic Idiopathic Urticaria
Višnja Milavec-Puretić
Sažetak
Urticaria is one of the most frequent allergic
skin diseases (up to 15% of population). Approximately one third
of patients with chronic idiopathic urticaria (CIU) have autoantibodies
directed against either the high-affi nity IgE receptor or,
less frequently, against IgE. However, there are several unsolved
problems relating to the role of such autoantibodies in the disease.
Additionally, it is not clear whether CIU with autoantibodies
can be classifi ed as an autoimmune disease. The detection
of patients with autoantibodies also poses challenges. The in
vivo method, the autologous serum skin test, is at best 80%
sensitive and specifi c using in vitro basophil histamine release
assays. The H. pylori assay, Candida-positive stool culture, and
antithyroid antibodies are important diagnostic methods. The
important elements of the CIU treatment include elimination
and hypoallergenic diet, antihistamines (sedative and not sedative),
tricyclic antidepressants (doxepin), dapson and pentoxifylline
in combination, azathioprine, methotrexate, leukotriene
antagonists (e.g. montelukast), sulphasalazine, cyclosporine,
PUVA therapy, plasmapheresis, immunoglobulins, coumarin,
and monoclonal antibodies against CD 20 antigens (rituximab
and omalizumab).
Ključne riječi
autoimmune urticaria; high-affi nity IgE receptor; diagnostics; treatment of chronic idiopathic urticaria
Hrčak ID:
23020
URI
Datum izdavanja:
25.1.2007.
Posjeta: 8.139 *