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  Authority of Polish Society of Allergology

vol 17. no 1. March 2012  

 Review articles
Etiopathogenesis and diagnosis of chronic urticaria
Alicja Kasperska-Zając, Julia Jagodzińska

Urticaria in its acute form has been recorded among as much as 45%
of the population while the presence of chronic symptoms affect
0.1.3% of people. Acute urticaria is manifested predominantly in
children while its chronic form is mostly the disease of adults. The key
role in urticarial processes is played by mediators released by mast cells
and basophils, among those . mainly by histamine. Moreover, local
and systemic inflammatory responses are developed . the acute-phase
response. Such acute-phase response is manifested by increased circulating
IL-6, which varies along with CRP changes, and may be related
to the disease severity and activity. The etiopathogenesis of chronic
urticaria is complex and has not been yet completely recognized. The
disease creates some remarkable diagnostic and therapeutic difficulties
and significantly reduces the patientsf life quality. Diverse factors,
including the environmental, immunological as well as hormonal
ones, are pointed to as those triggering and sustaining the urticarial
reaction. Despite highly detailed diagnostic procedures, in most cases
the reasons have not been accounted for, and such form of the disease
is referred to as an idiopathic one. The diagnostic panel comprises:
1) the autologous serum skin test . ASST, performed as a screening for
autoreactive/autoimmune urticaria, 2) testing for Hashimoto disease
due to frequent co-occurrence of the disease with urticaria, 3) elimination
of the infection foci, taking into account H. pylori, however
different opinions have been expressed on the role of this bacteria in
etiopathogenesis of urticaria, 4) other tests depending on the clinical
picture as well as the results of the basic tests. Recommendations should
include a pseudoallergen-free diet. Such procedure may bring alleviated
symptoms in 1.4 - 1.3 of patients. As shown by my own experience
such dietary restrictions should be introduced gradually and followed
throughout the demanded time.

keywords: przewlekła pokrzywka, etiopatogeneza, diagnostyka,chronic urticaria, etiopathogenesis, diagnosis

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