Thyroid Autoimmunity and Autoimmunity in Chronic Spontaneous Urticaria Linked to Disease Severity, Therapeutic Response, and Time to Remission in Patients with Chronic Spontaneous Urticaria
Table 1
Demographic data, severity of CSU, laboratory values, treatment regimens, disease duration according to the presence of thyroid autoimmunity, and results of thyroid autoantibodies.
Characteristics
Total
TA (+)
TA (-)
p-value
Anti-TPO (+)
Anti-TPO (-)
p-value
Anti-Tg (+)
Anti-Tg (-)
p-value
n = 72
n = 228
n = 53
n = 247
n = 55
n = 245
Gender [n = 300], n (%)
0.003
0.010
0.024
Male
46 (15.3)
3 (4.2)
43 (18.9)
2 (3.8)
44 (17.8)
3 (5.5)
43 (17.6)
Female
254 (84.7)
69 (95.8)
185 (81.1)
51 (96.2)
203 (82.2)
52 (94.5)
202 (82.4)
Age at onset (years) [n = 296], mean (SD)
41.3 (14.9)
0.008
0.187
0.006
≤ 35, n (%)
18 (25.0)
95 (42.4)
16 (30.2)
97 (39.9)
12 (21.8)
101 (41.9)
> 35, n (%)
54 (75.0)
129 (57.6)
37 (69.8)
146 (60.1)
43 (78.2)
140 (58.1)
Duration of symptoms (months) [n=291], median (range)
4 (1.5, 360)
3 (1.5, 120)
4 (1.5, 360)
0.434
3.3 (1.5, 120)
4 (1.5, 360)
0.840
3 (1.5, 120)
4 (1.5, 360)
0.524
History of NSAID hypersensitivity [n=300], n (%)
18 (6.0)
6 (8.3)
12 (5.3)
0.392
6 (11.3)
12 (4.9)
0.103
6 (10.9)
12 (4.9)
0.112
History of atopy [n = 129), n (%)
80 (62.0)
20 (64.5)
60 (61.2)
0.742
15 (65.2)
65 (61.3)
0.727
14 (56.0)
66 (63.5)
0.490
History of systemic symptoms [n = 195], n (%)
61 (31.3)
16 (35.6)
45(30.0)
0.481
15 (41.7)
46 (28.9)
0.137
12 (34.3)
49 (30.6)
0.672
Angioedema
61 (31.3)
15 (33.3)
46 (30.7)
0.735
14 (38.9)
47 (29.6)
0.276
11 (31.4)
50 (31.3)
0.984
Anaphylaxis
4 (2.1)
1 (2.2)
3 (2.0)
1.000
1 (2.8)
3 (1.9)
0.561
1 (2.9)
3 (1.9)
0.550
Dermographism [n = 186], n (%)
57 (30.7)
15 (34.9)
42 (29.4)
0.492
11 (33.3)
46 (30.1)
0.712
11 (37.9)
46 (29.3)
0.354
Duration of daily attacks (hours) [n=97], median (range)
3 (0.5, 24)
3 (0.5, 12)
3 (0.5, 24)
0.434
3 (0.5, 12)
3 (0.5, 24)
0.690
2 (0.5, 12)
3 (0.5, 24)
0.220
Frequency of attacks [n=216], n (%)
0.721
0.363
0.606
≤4 days per week
5 (25.5)
15 (27.3)
40 (24.8)
13 (31.0)
42 (24.1)
12 (28.6)
43 (24.7)
>4days per week
161 (74.5)
40 (72.7)
121 (75.2)
29 (69.0)
132 (75.9)
30 (71.4)
131 (75.3)
Wheal size [n = 79], n (%)
0.331
0.166
0.720
≤ 1.25 cm
20 (25.3)
2 (13.3)
18 (28.1)
1 (7.7)
19 (28.8)
2 (18.2)
18 (26.5)
> 1.25 cm
59 (74.7)
13 (86.7)
46 (71.9)
12 (92.3)
47 (71.2)
9 (81.8)
50 (73.5)
Number of wheals [n = 69], n (%)
0.748
0.740
0.283
≤ 7 wheals
23 (33.3)
5 (38.5)
18 (32.1)
3 (27.3)
20 (34.5)
5 (50.0)
18 (30.5)
> 7 wheals
46 (66.7)
8 (61.5)
38 (67.9)
8 (72.7)
38 (65.5)
5 (50.0)
41 (69.5)
Severity of [n = 78], n (%)
0.729
0.469
1.000
None to mild
16 (20.5)
4 (25.0)
12 (19.4)
4 (28.6)
12 (18.8)
2 (15.4)
14 (21.5)
Moderate to severe
62 (79.5)
12 (75.0)
50 (80.6)
10 (71.4)
52 (81.2)
11 (84.6)
51 (78.5)
Impairment of work [n = 76], n (%)
54 (71.1)
10 (66.7)
44 (72.1)
0.754
8 (61.5)
46 (73.0)
0.504
9 (81.8)
45 (69.2)
0.494
Disturbance of sleep [n = 76], n (%)
51 (67.1)
9 (60.0)
42 (68.9)
0.549
8 (61.5)
46 (68.3)
0.748
6 (60.0)
45 (68.2)
0.721
High ESR [n = 133], n (%)
65 (48.9)
23 (63.9)
42 (43.3)
0.035
19 (67.9)
46 (43.8)
0.024
15 (62.5)
50 (45.9)
0.140
ANA titer ≥ 1:320 (+) [n = 232], n (%)
32 (13.8)
13 (23.6)
19 (10.7)
0.015
12 (29.3)
20 (10.5)
0.002
10 (23.3)
22 (11.6)
0.046
CAU (+) [n = 125], n (%)
101 (80.8)
20 (74.1)
81 (82.7)
0.316
17 (81.0)
84 (81.0)
1.000
14 (73.7)
87 (82.1)
0.363
ASST (+) [n = 125], n (%)
91 (72.8)
18 (66.7)
73 (74.5)
0.419
15 (71.4)
76 (73.1)
0.877
12 (63.2)
79 (74.5)
0.305
APST (+) [n = 125], n (%)
88 (70.4)
18 (66.7)
70 (71.4)
0.631
15 (71.4)
73 (70.2)
0.910
13 (68.4)
75 (70.8)
0.837
Treatment regimen, [n = 295], n (%)
0.667
0.296
0.819
H1 antagonist(s), standard dose
127 (43.1)
29 (40.9)
98 (43.8)
19 (36.5)
108 (44.4)
24 (44.4)
103 (42.7)
H1 antagonist(s), any exceeding standard dose
168 (57.0)
42 (59.2)
126 (56.3)
33 (63.5)
135 (55.6)
30 (55.6)
138 (57.3)
Disease duration > 12 months [n= 131], n (%)
112 (85.5)
28 (93.3)
84 (83.2)
0.240
22 (100.0)
90 (82.6)
0.042
17 (89.5)
95 (84.8)
0.739
Disease duration > 18 months [n= 101], n (%)
81 (80.2)
23 (92.0)
58 (76.3)
0.088
18 (100)
63 (75.9)
0.020
13 (86.7)
68 (79.1)
0.729
The definition of severity of itch: none = no itch, mild = present but not annoying or troublesome, moderate = troublesome but does not interfere with normal daily activity or sleep, severe = sufficiently troublesome to interfere with normal daily activity or sleep. Considering ANA positivity at high titer (≥1:320), homogenous pattern was the most commonly observed (53.1%). Of 32 patients with high titer ANA, one had the validation to the diagnosis of systemic lupus erythematosus (SLE) via the Systemic Lupus International Collaborating Clinics Criteria with lupus nephritis class IVa, whereas the other had biopsy-proven subacute cutaneous lupus erythematosus. Abbreviations Used in Table 1. ANA; anti-nuclear antibody (high titer at ≥ 1:320), Anti-Tg; anti-thyroglobulin antibody (normal range = 0-115 IU/mL), Anti-TPO; anti-thyroid peroxidase antibody (normal range = 0-34 IU/mL), APST; autologous plasma skin test, ASST; autologous serum skin test, CAU; chronic autoimmune urticaria, CSU; chronic spontaneous urticaria, ESR; erythrocyte sedimentation rate (normal range = 0-20 mm/hr), NSAID; nonsteroidal anti-inflammatory drug, TA; thyroid autoimmunity.
