ASSOCIATION OF AUTOIMMUNE STATUS WITH ASST, AUTOIMMUNE AND ATOPIC DISEASES IN CSU PATIENTS

Abstract

Chronic spontaneous urticaria (CSU) is a mast cell-driven skin disease characterized by the recurrence of transient wheals, angioedema, or both for more than 6 weeks. Autoimmunity is thought to be one of the most frequent causes of CSU.CSU represents an important burden that compromises patient’s quality of life, interferes with routine daily activities. Aim of the study: The aim of this study is to make an association of autologous skin serum test (ASST), autoimmune diseases and atopic diseases with the autoimmune status in patients with HSU. Materials and methods: This study assessed 230 patients with CSU. The study is prospective, proceeding at the Department of Dermatology at City General Hospital “8mi Septemvri”, Skopje, in the period from January - November 2021. The study and the data collection were conducted with the approval of the institutional and ethical committee. Inform consent was obtained from all patients. Patients were divided in two groups according to their autoimmune status: patients with positive and patients with negative autoimmune status. Autoimmunity was defined in the case of a personal history of autoimmune disease or in the presence of at least one type of autoimmune antibodies (AAbs) (included anti- TPO, anti-nuclear antibodies (ANA) and rheumatoid factor (RF)).ASST was performed on untreated patients by the intradermal injection of 50 μL of the patient’s own serum into the volar part of the forearm. Anamnestic data on the course of the disease, accompanying autoimmune diseases and allergic diseases were taken. Results: Positive autoimmune status was confirmed in 40.28% of patients with HSU. Patients with a positive autoimmune status significantly more often than patients without an autoimmune status had a certain autoimmune disease (75.17% vs 10.59%):Hashimoto Tireoiditis39.31% vs10.59 %,Vitiligo13.79% ,Arthritis Rheumatica9.66 %,Morbus Crohn 5.52%, Hashimoto Tireoiditis + Vitiligo6.9% . Patients had a personal history of atopy (67.59% vs 55.29%), asthma (61.38% vs 44.71%), personal history for allergic rhinitis (57.24% vs 49.41%), positive ASST (86.9% vs 16.47%). To conclude, in this study, we obtained a high incidence of association of ASST, autoimmune diseases and atopic diseases with positive autoimmune status in CSU patients, thus providing additional evidence in the association of HSU with autoimmunity.