Very often the cause for chronic urticaria seems unknown. The episodes of urticaria subside with a few doses of anti histamine. Even on detailed history the onset is vague, no particular time or duration. Basic investigations show normal range of blood counts. Can histamine levels be estimated in these patients?
https://www.researchgate.net/publication/233535088_EAACI_taskforce_position_paper_evidence_for_autoimmune_urticaria_and_proposal_for_defining_diagnostic_criteria?ev=srch_pub
Article EAACI taskforce position paper: Evidence for autoimmune urti...
One possible cause is not related to systemic condition but with the topical exposure. Some people can presernt an impaired skin barrier, and this could lead to an increased exposure to agents that can induce sensitization or even turn the skin more sucpetible to irritant agents. No matter what is the starter, these people could start a skin reaction that could lead to chronic urticaria. I guess, besides analysing specif mimmunologic mechanisms, which area really a very important poisnt to investigate, you should also try to evaluate their skin barrier. This can be done using, simultaneously cormeometry and TEWL measurements. I am pretty sure that this will help in clariifying some mechanisms and future developments.
An impaired skin barrier is more often seen in the aged and atopic individuals, how to educate them for improving their skin barrier effect.
Dear all Urticaria as we all know is an idiopathic disease affects monocytes especially Mast cells with high affinity IgE receptor. Chronic idiopathic urticaria proved in some researches to be due to some bacterial like H.pylori as antigenic cause leading to gene expression through epidermal growth Factor receptor (Bashir et al, 2011 CRO)
Bashir AHH, MD
Dermatologist
Many a time CU is autoimmune in origin. To establish the etiology is definitely cumbersome. All the tests suggested so far are either non specific or less sensitive. In this context the recent paper from Mayo clinic on their experience indirectly suggest the possibility of paraproteinaemia. This is so far not seriously considered. So this possibility should also be kept in mind when CU is being evaluated.
Prof Criton
Dear Ana as far as we know skin Staphylococcus is one of the bacteria inhabitants of skin but at same time considered as highly antigenic one that provoking immune system just as Chlamydia and H. Pylori to produce specific Ig specifically G&A to attack certain tissues through specific receptors to transducted and so express the condition.
Dr Bashir AHH. MD
Dermatologist.
Dear Ana , thank you for posting your problems on this portal and open for dicussion. Very often we have to face clients with chronic urticaria who have a very troublesome itch disturbing their lives.
Immunity of the body is desinged in such a way to either eliminate or warn the body of intrusions.
In your case it seems that the summer aggravation coupled with probable staph bacterial overproduction due to favourable conditions either in the form of sweat, or an underlying atopic condition might have aggravted the condition.
Also te higher Ige levels also contribute to the itch.
i would not like to suggest any medication on this portal as this is purely for discussion.
Urticaria is still surrounded with many queries but some observations may push researchers to make more efforts to reach the possible underlying causes for such conditions serious and annoying. Malaria in endemic areas was noticed to be presented in some cases with acute urticaria and sometimes recurrent with every attack.
Dear Dr Bani-Hani thanks for the link as its an informative knowledge specially the point of H. pylori sub mentioned and coincided with the research we had done at 2011 Clinical Reviews and Opinions Vol. 3(2), pp. 14-19, February 2011
Available online http://www.academicjournals.org/cro
ISSN 2141-2553 ©2011 Academic Journals
What causes chronic urticaria?
A germ (bacterium) called Helicobacter pylori (H. pylori) which is commonly found in the stomach may be a factor in some cases. If you are infected with this bacterium and it is cleared with treatment, it may cure the problem with urticaria.
Dear Dr. Satyaprasad Venkata , dear Dr. Adil H.H. Bashir, dear all,
I work on autoallergens as cause of CSU. So if there is no exogenous allergen/antigen, no drug related induction and no infection, there might be an autoallergy as cause.
I fully agree that H. pylori can be a trigger, however it is quite common in many people: up to 50% in screenings. So to prove that it is relevant in CSU is quite hard.
However based on my resarch on IgE in CSU patients, I truely believe that modified IgE is the key mediator of the symptoms and that this IgE can be boosted by various mechanisms, even in the same patient. So to eliminiate all those triggers can be a way together with psychotherapy. Most patients have high amounts of this IgE which in my view is also preferebly bound by omalizumab.
Maybe you like my recent paper:
Article IL-24 is a common and specific autoantigen of IgE in chronic...
or here as a poster:
Poster IL-24 is a common and specific autoantigen of IgE in chronic...
here is also an extensive overview on the evidence we have:
Article Autoimmune chronic spontaneous urticaria: What we know and w...
here is a discussion of treatment options:
https://www.researchgate.net/post/What_is_the_best_treatment_for_chronic_urticaria#view=5a2cc9b996b7e4c43c7344e9
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