慢性荨麻疹患者自体血清皮肤试验结果分析

目的 :探讨慢性荨麻疹患者自体血清皮肤试验的意义。方法 :对 4 0例慢性荨麻疹患者以及2 0例正常对照者、1 0例皮肤划痕症、1 0例异位性皮炎患者进行自体血清皮肤试验。结果 :4 0例慢性荨麻疹患者中 1 3例 (32 5 % )自体血清皮肤试验阳性 ,正常对照组和皮肤划痕症及异位性皮炎患者均为阴性 ,慢性荨麻疹患者的自体血清皮肤试验阳性率显著高于正常对照组及皮肤划痕症和异位性皮炎组 (P值均 <0 0 5 )。结论 :自体血清皮肤试验的测定对自身免疫性慢性荨麻疹有一定的诊断意义。     

154例慢性自发性 荨麻疹患者自体血清皮肤试验结果分析

目的探讨慢性自发性荨麻疹患者自体血清皮肤试验在临床中的应用价值。方法对154例慢性自发性荨麻疹患者及30名健康志愿者做自体血清皮肤试验,并对结果进行分析。结果 154例患者中67例(43.5%)患者检出阳性结果,对照组全部阴性;自体血清皮肤试验阳性与阴性的慢性自发性荨麻疹患者在性别、年龄分布及病程上差异无统计学意义(P0.05),自体血清皮肤试验阳性的慢性自发性荨麻疹患者症状评分及瘙痒持续时间明显高于阴性患者(P0.05),自体血清皮肤试验阳性程度与瘙痒持续时间呈正相关(P0.05)。自体血清皮肤试验阳性的慢性自发性荨麻疹患者伴发过敏史(药物、食物、吸入物)的比例高于阴性的患者(P0.05)。结论自体血清皮肤试验阳性的慢性自发性荨麻疹患者较阴性者病情重,该试验作为慢性荨麻疹功能性自身抗体的筛选试验可在临床上广泛应用。     

自体血清皮肤试验阳性与阴性慢性荨麻疹患者临床特点分析

目的 探讨自体血清皮肤试验阳性的慢性荨麻疹患者的临床特点。方法 从82例慢性荨麻疹患者中筛选出29例自体血清皮肤试验阳性患者,对其症状体征及病史等进行分析,并用放免法测定其血清中的抗甲状腺球蛋白抗体(TG-AB)和抗甲状腺微粒体抗体(TM-AB),与自体血清皮肤试验阴性的慢性荨麻疹患者进行对比。结果 自体血清皮肤试验阳性与阴性的慢性荨麻疹患者在年龄分布、病程上差异无统计学意义(P>0.05)。两组患者症状体征评分比较,自体血清皮肤试验阳性患者皮疹发作时风团较大(P<0.05),数量较多(P<0.01),每次发作持续时间较长(P<0.05),瘙痒更剧烈(P<0.05);但风团外观较红,隆起不明显(P<0.01);而两组患者的皮疹发作频次差异无统计学意义(P>0.05)。自体血清皮肤试验阳性的慢性荨麻疹患者伴发血管神经性水肿及系统症状的比例较高,伴随其他自身免疫相关疾病和甲状腺抗体阳性的比例也明显高于自体血清皮肤试验阴性患者(P<0.05)。结论 自体血清皮肤试验阳性的慢性荨麻疹多表现为较严重的慢性荨麻疹。     

荨麻疹

20 0 4 0 94 2　自身免疫性慢性荨麻疹患者血清IL - 4、IFN-︽水平测定/孙蔚凌(南京医大一院皮肤科)…∥南京医科大学学报.- 2 0 0 3,2 3(6 ) .- 54 8～54 9采用双抗体夹心EL ISA法对15例自身免疫性慢性荨麻疹(自体血清皮肤试验阳性)、2 5例非自身免疫性慢性荨麻疹患者(自体血清皮肤试验阴性)及2 6例正常人血清IL - 4、IN F-γ水平进行测定。结果:自身免疫性慢性荨麻疹与非自身免疫性荨麻疹患者的血清IL- 4水平均显著高于正常对照组(P<0 .0 1) ,IN F- γ水平较正常对照组均显著降低(P<0 .0 1,P<0 .0 5) ;自身免疫性与非自身免疫性…     

慢性荨麻疹患者变应原检测及自体血清试验临床分析

目的:探讨慢性荨麻疹患者变应原检测和自体血清皮肤试验的临床意义。方法:皮肤点刺试验(SPT)检测30种变应原皮试液(包括吸入性和食物性),以生理盐水作阴性对照,以组胺作阳性对照,注射于前臂屈侧,20-30分钟后观察结果。自体血清试验(ASST)以自体血清注射于一侧前臂,另一侧注射生理盐水作阴性对照,30分钟后观察结果。结果:787例慢性荨麻疹患者中SPT有550例阳性(69.89%),6种以上变应原阳性332例(42.19%),吸入组阳性516例(65.57%)明显高于食物组309例(39.26%);ASST阳性为244例(31.00%),SPT阴性组ASST阳性率明显高于SPT阳性组。结论:SPT可以帮助我们寻找引起慢性荨麻疹的相关变应原。ASST阳性表明患者血清中存在自身抗体,可以作为自身免疫性荨麻疹的筛选试验。     

慢性荨麻疹患者甲状腺自身抗体检出情况及其临床特征研究

目的 探讨伴有甲状腺自身抗体阳性的慢性荨麻疹患者临床与血清学特点.方法 2016年1-12月,杭州市第三人民医院皮肤科70例慢性荨麻疹住院患者,依据是否伴有甲状腺自身抗体进行分组.对比两组患者的荨麻疹临床表现、自身皮肤血清试验结果、住院天数、出院转归、血常规、抗体、血清总IgE和IgG.结果 70例慢性荨麻疹患者中有26例(37.1％)伴有甲状腺自身抗体阳性,44例(62.9％)甲状腺自身抗体阴性.甲状腺自身抗体阳性的慢性荨麻疹患者较甲状腺自身抗体阴性组风团更大,瘙痒更剧烈(z=4.399,P＜0.001)、持续时间更长(z=4.43,P＜0.001)、发作频率更高(z=7.362,P＜0.001)、更易伴发系统症状(x2=7.068,P＜0.05)、自身皮肤血清试验阳性率更高(x2=6.559,P＜0.05)、住院时间更长(t=3.184,P＜0.05)、出院时痊愈率更低(x2=5.524,P＜0.05)、嗜碱性粒细胞数量更低(t=3.19,P＜0.05).结论 伴有甲状腺自身抗体阳性的慢性荨麻疹患者多表现为病情较重的荨麻疹,多伴有自身皮肤血清试验阳性和嗜碱性粒细胞水平降低.     

荨麻疹

20 0 4 2 2 4 7　慢性荨麻疹患者血清特异性 Ig E及甲状腺自身抗体的检测 /杨文彪 (广州江门市中心医院皮肤科 )… //岭南皮肤性病科杂志 .- 2 0 0 3,10 (4 ) .- 2 4 3～ 2 4 5采用敏筛过敏原检测系统和放射免疫法对 12 0例慢性荨麻疹患者进行血清特异性 Ig E及甲状腺自身抗体的检测 ,并设 4 0例正常对照。结果显示 ,86例患者血清特异性 Ig E阳性 ,其中 2 3例 (2 6 .7% )甲状腺过氧化物酶抗体 (T POA b)阳性 ,18例 (2 0 .9% )促甲状腺受体自身抗体 (TR Ab)阳性 ;34例血清特异性 Ig E阴性 ,其中 10例 (2 9.4 % ) TPO Ab阳性 ,8例 (2 …     

慢性荨麻疹患者自体血清皮肤试验与抗FcεRI抗体的关系分析

目的:了解慢性荨麻疹患者自体血清皮肤试验(ASST)与血清抗FcεRI抗体的关系.方法:对病例组56例慢性荨麻疹患者进行ASST,同时采用酶联免疫吸附试验法(ELISA)检测血清抗FcεRI抗体水平,并与对照组24名正常人比较.结果:病例组ASST阳性率为55 4%,血清抗FcεRI抗体水平为(2 89±2 36) U/L,两者均高于对照组(P<0 01);ASST阳性与阴性慢性荨麻疹患者血清抗FcεRI抗体水平分别为(3 23±2 62) U/L和(2 18±1 84) U/L,两者差异有统计学意义(P<0 05).结论:慢性荨麻疹患者ASST与抗FcεRI抗体水平有关,ASST阳性慢性荨麻疹患者血清抗FcεRI抗体水平较高.     

甲状腺自身抗体检测与慢性荨麻疹的相关性分析

目的通过甲状腺自身抗体检测,探讨其在慢性荨麻疹发病中的作用。方法采用电化学发光法,对215例慢性荨麻疹患者的甲状腺自身抗体及甲状腺功能进行检测,并与72例正常体检人群对照。结果 215例慢性荨麻疹患者血清中抗甲状腺球蛋白抗体(TG-Ab)、促甲状腺素(TSH)、抗甲状腺微粒抗体(TM-Ab)异常的分别为42例(14%)、3例(13%)、37例(13%),其水平显著高于对照组(P均0.05),但两组三碘甲状原氨酸(T3)、甲状腺素(T4)、游离三碘甲状原氨酸(FT3)、游离甲状腺素(FT4)相对比差异无显著性(P均0.05)。结论半数以上慢性荨麻疹的患者血清中存在有TSH、TGA及TMA的异常,提示部分慢性荨麻疹发病机制可能与甲状腺自身抗体的异常有关。     

慢性荨麻疹患者血清特异性IgE及甲状腺自身抗体的检测

目的：探讨自身免疫在特发性慢性荨麻疹和已知特异性过敏原慢性荨麻疹发病机制中的作用。方法：采用敏筛过敏原检测系统和放射免疫法，对120例慢性荨麻疹患进行血清特异性I姬及甲状腺自身抗体的检测。结果：86例血清特异性IgE阳性的慢性荨麻疹患中，23例(26．7％)甲状腺过氧化物酶抗体(TPOAb)阳性；18例(20．9％)促甲状腺受体自身抗体(TRAb)阳性。34例血清特异性IgE阴性的慢性荨麻疹患中，10例(29．4％)TPOAb阳性；8例(23．5％)TRAb阳性。两组慢性荨麻疹的TPOAb及TRAb均显高于正常对照组(P均＜0．01)；但两组之间的TPOAb及TRAb阳性率比较，均无显性差异(P均＞0．05)。结论：部分特发性慢性荨麻疹和已知特异性过敏原慢性荨麻疹的发病均可能有自身免疫机制参与。     

Chronic Idiopathic Urticaria and Thyroid Autoimmunity: Perplexing Association

Background:

Autologous serum skin test (ASST) is the most commonly used laboratory test to differentiate chronic autoimmune urticaria patients from chronic idiopathic urticaria patients without autoantibodies. Thyroid autoimmunity is the original paradigm for autoimmune disease in general and many previous studies show increased prevalence of thyroid autoantibodies and deranged thyroid hormone profile in chronic idiopathic urticaria patients.

Aim:

To find the association between thyroid autoimmunity and chronic autoimmune urticaria, if any.

Materials and Methods:

The chronic idiopathic urticaria patients were divided into two subgroups based on autologous serum skin test. Thyroid autoantibodies were estimated in 40 patients each of ASST positive and ASST negative groups. Further, thyroid hormone profile was done in cases with significant titers of thyroid autoantibodies. Forty patients, who had never suffered from urticaria, represented the control group.

Results:

The prevalence of thyroid autoantibodies did not differ significantly among the ASST positive (20%) and ASST negative patients (15%). The control group had low prevalence of these autoantibodies (5%).

Conclusion:

The almost equal prevalence of thyroid autoantibodies in two subgroups of chronic idiopathic urticaria patients suggests possibly the same etiopathogenesis of the two subgroups. The two subgroups probably form a continuum, or even may be the same entity.     

自身免疫性甲状腺疾病与慢性荨麻疹关系探讨

目的：探讨慢性荨麻疹与自身免疫性甲状腺疾病之间的关系。方法：采用放射免疫法对58例慢性荨麻疹患者及30例正常体检人群的甲状腺功能及抗甲状腺自身抗体进行了检测，结果：58例慢性荨麻疹患者中，有8例（13．8％）血清中存在抗甲状腺球蛋白抗（TGA）；7例（12．1％）存在抗甲状腺微粒体抗体（TMA）；慢性荨麻疹组的TGA和TMA水平均显著高于对照组(t值分别为2．762和2．695，P＜0．01）。但两组的T4、RT3、FT3、TSH值比较差异均无显著性（P＞0．05）。结论：慢性荨麻疹的发病有自身免疫机制参与。     

Association between chronic urticaria and thyroid autoimmunity: a prospective study involving 99 patients

BACKGROUND: The association between chronic urticaria and thyroid autoimmunity has been a subject of debate. However, this link was suggested in studies searching thyroid microsomal antibodies (TMA), which are less sensitive and less specific than anti-thyroperoxidase antibodies, moreover these studies did not measure anti-TSH receptor antibodies, nor did they use a control group. As a consequence, the results of these studies are difficult to interpret. OBJECTIVE: The aim of this study was to determine whether chronic urticaria is statistically associated with thyroid autoimmunity. METHODS: In a prospective case-control study, we compared the frequency of thyroid autoantibodies in 45 patients with chronic urticaria and in 30 healthy adult volunteers; we also compared the frequency of chronic urticaria in 32 patients with thyroid diseases with thyroid autoantibodies and in 22 patients with thyroid diseases without thyroid autoantibodies. Thyroid autoantibodies and thyroid hormones were measured in all the subjects; antinuclear antibodies, rheumatoid factors, complement, IgE were assessed and routine laboratory tests were done in patients with chronic urticaria. Fisher's exact statistics were used to test our hypothesis. RESULTS: The frequency of thyroid autoantibodies was significantly higher in patients with chronic urticaria than in healthy controls (26.7%/3.3%; p < 0.01). All the patients with thyroid autoantibodies had thyroid hormone concentrations within the normal limits. The frequency of chronic urticaria was not significantly different (12.5%/9.1%; p = 0.7) in patients with thyroid diseases with or without thyroid antibodies. The rest of the biological investigations revealed only 1 patient with connective tissue disease. CONCLUSION: This study shows a significant association between chronic urticaria and thyroid autoimmunity, and that tests to detect thyroid autoantibodies are relevant in patients with chronic urticaria, whereas extensive laboratory tests are not.     

慢性荨麻疹患者的甲状腺功能及自身抗体水平分析

目的：检测甲状腺功能和自身抗体与慢性荨麻疹发病及病情严重性的相关性。方法：收集91例慢性荨麻疹患者和78例健康志愿者的临床资料,用直接化学发光法测定血清中慢性荨麻疹患者及健康志愿者甲状腺功能及TGAb、TPOAb自身抗体。结果：慢性荨麻疹患者甲状腺自身抗体阳性率分别为13.19%及15.38%,明显高于健康对照组的2.56%及10.26%,差异有统计学意义（P <0.05）。甲状腺功能异常者较功能正常者风团每日发作频率高（P <0.05）。结论：甲状腺自身免疫的异常可能与慢性荨麻疹的发病有关,甲状腺功能可能与慢性荨麻疹的发作频率相关     

Thyroid autoimmunity in chronic urticaria

BACKGROUND: Chronic urticaria (CU) is an autoimmune process in some patients. An association between CU and autoimmune thyroid disease has also previously been proposed. Our group has identified functionally significant histamine-releasing autoantibodies in one subset of CU patients (subset 1), predicted by positive autologous intradermal serum tests and positive histamine release from donor basophil leucocytes in vitro. Sera from a second subset of patients (subset 2), all of whom had positive autologous intradermal serum tests, failed to release histamine from donor basophils. A final disease subset (subset 3) has no identifiable skin reactivity (negative autologous serum skin test) or in vitro histamine releasing activity. OBJECTIVES: In order to examine further the possible relationships between thyroid autoimmunity, thyroid dysfunction and CU, we have examined thyroid autoantibodies and thyroid-stimulating hormone (TSH) levels (an indirect measure of thyroid dysfunction) in the three CU subsets. PATIENTS/METHODS: We studied 182 patients (69% female), of whom 90 had a positive autologous intradermal serum test. RESULTS: Eighteen skin test-positive and four skin test-negative patients had thyroid microsomal antibodies (TMA). TSH outside the normal range was found in 13 skin test-positive and one skin test-negative patient. These findings represent clustering of TMA positivity [risk ratio (RR) 4.06, 95% confidence interval (CI) 1.56-10.6] and of abnormal thyroid function (RR 15.5, CI 2.07-11.6) among the skin test-positive patients. However, in the overall study group an elevated TSH was present in seven patients (3.8%, CI 1.6-7.8) comparable to the 5% expected prevalence in the community. Thyroglobulin antibodies (TGA) were present in two of 182 patients. CONCLUSIONS: There were significant differences between skin test-positive and skin test-negative patients with regard to autoimmune thyroid disease. Evidence for autoimmune thyroid disease and abnormal thyroid function was largely found among the skin test-positive patients, supporting the theory of an autoimmune aetiology in this group.     

Skin autoreactivity in Hashimoto's thyroiditis patients without urticaria: autologous serum skin test positivity correlation with thyroid antibodies, sonographical volume and grading

Recent studies have shown an association between anti-thyroid antibodies and autologous serum skin test (ASST) positive urticaria patients. However, a connection between thyroid and this reliable skin test for mast cell autoreactivity, ASST, has not been reported yet. We investigated ASST in patients with Hashimoto's thyroiditis (HT) without urticaria and compared the results with laboratory and sonographical findings of HT. 154 HT patients, 100 healthy volunteers without HT as a first control group and 46 patients with multinodular goitre but without autoimmune thyroid disease as a second control group underwent testing with ASST. ASST was applied to these groups according to two criteria, first as ASST(new): autologous serum red wheal response 1.5?mm bigger than negative control; second as ASST(old): serum red wheal response 5?mm bigger than negative control accepted as positive. Free triiodothyronine (fT3), free thyroxine (fT4), thyroid-stimulating hormone (TSH), thyroid peroxidase antibody (anti-TPO) and thyroglobulin antibody (anti-Tg) levels were measured. ASST(old), ASST(new) scored positive in 51.3-60.4% of HT patients, with statistically significant differences. Thyroid volume grades were inversely proportional with ASST(old) and (new) positivity. Moderate (+) titers of anti-Tg in ASST(old) and (new) (+) cases were significantly higher than the same titers of anti-Tg in ASST(old) and (new) (-) cases. The prevalence of ASST positivity in HT patients was not affected by the following factors: gender, age at screening, laboratory measurements of thyroid function tests, anti-TPO antibodies and thyroid ultrasound (US) echogenicity. Positivity of ASST in HT has shown that there is a skin mast cell autoreactivity in HT patients independent of autoreactive chronic urticaria (ACU).     

Lack of correlation between Helicobacter pylori infection and autologous serum skin test in chronic idiopathic urticaria

BACKGROUND: There are controversial reports about the direct role of Helicobacterpylori infection in chronic idiopathic urticaria. The indirect role of H. pylori infection in the induction of pathogenetic antibodies is not fully elucidated either. This study aims to reveal the association of H. pylori infection with autologous serum skin test positivity in chronic idiopathic urticaria (CIU) patients. METHODS: A total of 47 patients (35 women, 12 men, age range 17-65 years) diagnosed as CIU were included in the study. Autologous serum skin test was performed on all patients. The patients were examined with a commercially available ELISA test for H. pylori-specific antibodies. Gastroscopy with mucosal biopsy and rapid urease tests were proposed to verify the presence of H. pylori infection. RESULTS: Helicobacter pylori infection was detected in 33 of the 47 patients (70%). No significant relation was found between the autologous serum skin test positivity and the serological and histopathological presence of H. pylori infection. CONCLUSION: The results of our study suggest that chronic H. pylori infection does not appear to have a role in the induction of autoantibodies in CIU.