Urticaria laboratory findings: Difference between revisions

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__NOTOC__
__NOTOC__
{{Urticaria}}
{{Urticaria}}
{{CMG}}
{{CMG}} ; {{AE}} {{Anahita}}


==Overview==
==Overview==
Laboratory evaluation can be used as a measure to determine [[disease]] severity, responsiveness to [[treatment]] and [[prognosis]], in addition to their role as a [[diagnosis|diagnostic tool]]. Tests such as autologous [[serum]] [[skin]] test (ASST) and [[Basophil granulocyte|basophil]] activation test (BAT) are useful for detection of [[Autoantibody|autoantibodies]] against [[Immunoglobulin E|IgE]]. Moreover elevated levels of [[c-reactive protein]] ([[C-reactive protein|CRP]]), [[erythrocyte sedimentation rate]] ([[Erythrocyte sedimentation rate|ESR]]), certain [[interleukins]] and [[tumor necrosis factor-alpha]] have been reported in [[urticaria]] [[patients]]. Laboratory evaluations that can determine [[disease]] activity are autologous [[serum]] [[skin]] test (ASST), [[c-reactive protein]] ([[C-reactive protein|CRP]]) and [[Interleukin 6|IL-6]].


==Laboratory Findings==
==Laboratory Findings==
*Autologous [[serum]] [[skin]] test (ASST) and [[Basophil granulocyte|basophil]] activation test (BAT) are two tests that are capable of detecting any [[Autoantibody|autoantibodies]] against [[Immunoglobulin E|IgE]] for FcεRI.<ref name="pmid31571935">{{cite journal| author=Puxeddu I, Petrelli F, Angelotti F, Croia C, Migliorini P| title=Biomarkers In Chronic Spontaneous Urticaria: Current Targets And Clinical Implications. | journal=J Asthma Allergy | year= 2019 | volume= 12 | issue=  | pages= 285-295 | pmid=31571935 | doi=10.2147/JAA.S184986 | pmc=6759208 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=31571935  }} </ref><ref name="pmid26739404">{{cite journal| author=Ye YM, Park JW, Kim SH, Ban GY, Kim JH, Shin YS | display-authors=etal| title=Prognostic Factors for Chronic Spontaneous Urticaria: A 6-Month Prospective Observational Study. | journal=Allergy Asthma Immunol Res | year= 2016 | volume= 8 | issue= 2 | pages= 115-23 | pmid=26739404 | doi=10.4168/aair.2016.8.2.115 | pmc=4713874 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26739404  }} </ref>  
*Autologous [[serum]] [[skin]] test (ASST) and [[Basophil granulocyte|basophil]] activation test (BAT) are two tests that are capable of detecting any [[Autoantibody|autoantibodies]] against [[Immunoglobulin E|IgE]] for FcεRI.<ref name="pmid31571935">{{cite journal| author=Puxeddu I, Petrelli F, Angelotti F, Croia C, Migliorini P| title=Biomarkers In Chronic Spontaneous Urticaria: Current Targets And Clinical Implications. | journal=J Asthma Allergy | year= 2019 | volume= 12 | issue=  | pages= 285-295 | pmid=31571935 | doi=10.2147/JAA.S184986 | pmc=6759208 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=31571935  }} </ref><ref name="pmid26739404">{{cite journal| author=Ye YM, Park JW, Kim SH, Ban GY, Kim JH, Shin YS | display-authors=etal| title=Prognostic Factors for Chronic Spontaneous Urticaria: A 6-Month Prospective Observational Study. | journal=Allergy Asthma Immunol Res | year= 2016 | volume= 8 | issue= 2 | pages= 115-23 | pmid=26739404 | doi=10.4168/aair.2016.8.2.115 | pmc=4713874 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26739404  }} </ref>  
**Although ASST is not a [[Specificity (tests)|specific test]], positive results can determine active [[disease]], [[mast cells]] and [[Basophil granulocyte|basophils]] activation and possible reduction in [[Basophil granulocyte|basophils]].  
**Although ASST is not a [[Specificity (tests)|specific test]], positive results can determine active [[disease]], [[mast cells]] and [[Basophil granulocyte|basophils]] activation and possible reduction in [[Basophil granulocyte|basophils]].
**Interestingly positive autologous [[serum]] [[skin]] test (ASST) could be related to better [[prognosis]].  
**Interestingly positive autologous [[serum]] [[skin]] test (ASST) could be related to better [[prognosis]].
**Moreover positive autologous [[serum]] [[skin]] test (ASST) seems to be related to slower response to [[omalizumab]].  
**Moreover positive autologous [[serum]] [[skin]] test (ASST) seems to be related to slower response to [[omalizumab]].
*[[C-reactive protein]] ([[C-reactive protein|CRP]]) is also related to [[disease]] activity and [[treatment]] response in [[urticaria]].<ref name="pmid29130488">{{cite journal| author=Kolkhir P, Altrichter S, Hawro T, Maurer M| title=C-reactive protein is linked to disease activity, impact, and response to treatment in patients with chronic spontaneous urticaria. | journal=Allergy | year= 2018 | volume= 73 | issue= 4 | pages= 940-948 | pmid=29130488 | doi=10.1111/all.13352 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29130488  }} </ref><ref name="pmid21645137">{{cite journal| author=Kasperska-Zajac A, Sztylc J, Machura E, Jop G| title=Plasma IL-6 concentration correlates with clinical disease activity and serum C-reactive protein concentration in chronic urticaria patients. | journal=Clin Exp Allergy | year= 2011 | volume= 41 | issue= 10 | pages= 1386-91 | pmid=21645137 | doi=10.1111/j.1365-2222.2011.03789.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21645137  }} </ref><ref name="pmid20534097">{{cite journal| author=Ohtsuka T| title=Response to oral cyclosporine therapy and high sensitivity-CRP level in chronic idiopathic urticaria. | journal=Int J Dermatol | year= 2010 | volume= 49 | issue= 5 | pages= 579-84 | pmid=20534097 | doi=10.1111/j.1365-4632.2010.04384.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20534097  }} </ref>
*[[C-reactive protein]] ([[C-reactive protein|CRP]]) is also related to [[disease]] activity and [[treatment]] response in [[urticaria]].<ref name="pmid29130488">{{cite journal| author=Kolkhir P, Altrichter S, Hawro T, Maurer M| title=C-reactive protein is linked to disease activity, impact, and response to treatment in patients with chronic spontaneous urticaria. | journal=Allergy | year= 2018 | volume= 73 | issue= 4 | pages= 940-948 | pmid=29130488 | doi=10.1111/all.13352 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29130488  }} </ref><ref name="pmid21645137">{{cite journal| author=Kasperska-Zajac A, Sztylc J, Machura E, Jop G| title=Plasma IL-6 concentration correlates with clinical disease activity and serum C-reactive protein concentration in chronic urticaria patients. | journal=Clin Exp Allergy | year= 2011 | volume= 41 | issue= 10 | pages= 1386-91 | pmid=21645137 | doi=10.1111/j.1365-2222.2011.03789.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21645137  }} </ref><ref name="pmid20534097">{{cite journal| author=Ohtsuka T| title=Response to oral cyclosporine therapy and high sensitivity-CRP level in chronic idiopathic urticaria. | journal=Int J Dermatol | year= 2010 | volume= 49 | issue= 5 | pages= 579-84 | pmid=20534097 | doi=10.1111/j.1365-4632.2010.04384.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20534097  }} </ref>
**It's elevated level is also associated with positive autologous [[serum]] [[skin]] test (ASST) and elevated levels of [[erythrocyte sedimentation rate]] ([[erythrocyte sedimentation rate|ESR]]), [[White blood cells|leukocytes]], [[neutrophils]] and [[Interleukin 6|IL-6]].
**It's elevated level is also associated with positive autologous [[serum]] [[skin]] test (ASST) and elevated levels of [[erythrocyte sedimentation rate]] ([[erythrocyte sedimentation rate|ESR]]), [[White blood cells|leukocytes]], [[neutrophils]] and [[Interleukin 6|IL-6]].
**Elevated [[C-reactive protein|CRP]] is related to better response to [[mouth|oral]] [[cyclosporine]] [[therapy]] and conversely poor response to [[antihistamines]].  
**Elevated [[C-reactive protein|CRP]] is related to better response to [[mouth|oral]] [[cyclosporine]] [[therapy]] and conversely poor response to [[antihistamines]].
**In contrast to other [[inflammation|inflammatory conditions]], [[urticaria]] [[patients]] usually present with lower quantitative level of [[C-reactive protein|CRP]].  
**In contrast to other [[inflammation|inflammatory conditions]], [[urticaria]] [[patients]] usually present with lower quantitative level of [[C-reactive protein|CRP]].
*[[Complete blood count]] ([[Complete blood count|CBC]]) with differential<ref name="pmid28913986">{{cite journal| author=Kaplan AP| title=Chronic Spontaneous Urticaria: Pathogenesis and Treatment Considerations. | journal=Allergy Asthma Immunol Res | year= 2017 | volume= 9 | issue= 6 | pages= 477-482 | pmid=28913986 | doi=10.4168/aair.2017.9.6.477 | pmc=5603475 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28913986  }} </ref>
*[[Erythrocyte sedimentation rate]] ([[Erythrocyte sedimentation rate|ESR]]): Elevated levels might be related to [[autoimmune disease]].<ref name="pmid28913986">{{cite journal| author=Kaplan AP| title=Chronic Spontaneous Urticaria: Pathogenesis and Treatment Considerations. | journal=Allergy Asthma Immunol Res | year= 2017 | volume= 9 | issue= 6 | pages= 477-482 | pmid=28913986 | doi=10.4168/aair.2017.9.6.477 | pmc=5603475 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28913986  }} </ref>
*[[Interleukins]]:
*[[Interleukins]]:
**Elevated level of [[Interleukin 6|IL-6]] is related to [[disease]] activity in [[urticaria]].<ref name="pmid21645137">{{cite journal| author=Kasperska-Zajac A, Sztylc J, Machura E, Jop G| title=Plasma IL-6 concentration correlates with clinical disease activity and serum C-reactive protein concentration in chronic urticaria patients. | journal=Clin Exp Allergy | year= 2011 | volume= 41 | issue= 10 | pages= 1386-91 | pmid=21645137 | doi=10.1111/j.1365-2222.2011.03789.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21645137  }} </ref>
**Elevated level of [[Interleukin 6|IL-6]] is related to [[disease]] activity in [[urticaria]].<ref name="pmid21645137">{{cite journal| author=Kasperska-Zajac A, Sztylc J, Machura E, Jop G| title=Plasma IL-6 concentration correlates with clinical disease activity and serum C-reactive protein concentration in chronic urticaria patients. | journal=Clin Exp Allergy | year= 2011 | volume= 41 | issue= 10 | pages= 1386-91 | pmid=21645137 | doi=10.1111/j.1365-2222.2011.03789.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21645137  }} </ref>
**[[Interleukin 18|IL-18]], one of the [[Interleukin 1|IL-1 family cytokines]], has been present in [[serum]] specimens of nearly all [[patients]] with [[urticaria|chronic spontaneous urticaria]]. Nevertheless more studies required to determine it's exact role in the [[pathogenesis]] of this subtype.<ref name="pmid17509061">{{cite journal| author=Tedeschi A, Lorini M, Suli C, Asero R| title=Serum interleukin-18 in patients with chronic ordinary urticaria: association with disease activity. | journal=Clin Exp Dermatol | year= 2007 | volume= 32 | issue= 5 | pages= 568-70 | pmid=17509061 | doi=10.1111/j.1365-2230.2007.02450.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17509061  }} </ref><ref name="pmid23433789">{{cite journal| author=Puxeddu I, Italiani P, Giungato P, Pratesi F, Panza F, Bartaloni D | display-authors=etal| title=Free IL-18 and IL-33 cytokines in chronic spontaneous urticaria. | journal=Cytokine | year= 2013 | volume= 61 | issue= 3 | pages= 741-3 | pmid=23433789 | doi=10.1016/j.cyto.2013.01.015 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23433789  }} </ref>
**[[Interleukin 18|IL-18]], one of the [[Interleukin 1|IL-1 family cytokines]], has been present in [[serum]] specimens of nearly all [[patients]] with [[urticaria|chronic spontaneous urticaria]]. Nevertheless more studies required to determine it's exact role in the [[pathogenesis]] of this subtype.<ref name="pmid17509061">{{cite journal| author=Tedeschi A, Lorini M, Suli C, Asero R| title=Serum interleukin-18 in patients with chronic ordinary urticaria: association with disease activity. | journal=Clin Exp Dermatol | year= 2007 | volume= 32 | issue= 5 | pages= 568-70 | pmid=17509061 | doi=10.1111/j.1365-2230.2007.02450.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17509061  }} </ref><ref name="pmid23433789">{{cite journal| author=Puxeddu I, Italiani P, Giungato P, Pratesi F, Panza F, Bartaloni D | display-authors=etal| title=Free IL-18 and IL-33 cytokines in chronic spontaneous urticaria. | journal=Cytokine | year= 2013 | volume= 61 | issue= 3 | pages= 741-3 | pmid=23433789 | doi=10.1016/j.cyto.2013.01.015 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23433789  }} </ref>
**The following table is a summary of possible elevated [[interleukins]] in [[urticaria]]:<ref name="pmid23433789">{{cite journal| author=Puxeddu I, Italiani P, Giungato P, Pratesi F, Panza F, Bartaloni D | display-authors=etal| title=Free IL-18 and IL-33 cytokines in chronic spontaneous urticaria. | journal=Cytokine | year= 2013 | volume= 61 | issue= 3 | pages= 741-3 | pmid=23433789 | doi=10.1016/j.cyto.2013.01.015 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23433789  }} </ref><ref name="pmid31571935">{{cite journal| author=Puxeddu I, Petrelli F, Angelotti F, Croia C, Migliorini P| title=Biomarkers In Chronic Spontaneous Urticaria: Current Targets And Clinical Implications. | journal=J Asthma Allergy | year= 2019 | volume= 12 | issue=  | pages= 285-295 | pmid=31571935 | doi=10.2147/JAA.S184986 | pmc=6759208 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=31571935  }} </ref><ref name="pmid27926978">{{cite journal| author=Kolkhir P, André F, Church MK, Maurer M, Metz M| title=Potential blood biomarkers in chronic spontaneous urticaria. | journal=Clin Exp Allergy | year= 2017 | volume= 47 | issue= 1 | pages= 19-36 | pmid=27926978 | doi=10.1111/cea.12870 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27926978  }} </ref>
**The following table is a summary of possible elevated [[interleukins]] in [[urticaria]]:<ref name="pmid23433789">{{cite journal| author=Puxeddu I, Italiani P, Giungato P, Pratesi F, Panza F, Bartaloni D | display-authors=etal| title=Free IL-18 and IL-33 cytokines in chronic spontaneous urticaria. | journal=Cytokine | year= 2013 | volume= 61 | issue= 3 | pages= 741-3 | pmid=23433789 | doi=10.1016/j.cyto.2013.01.015 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23433789  }} </ref><ref name="pmid31571935">{{cite journal| author=Puxeddu I, Petrelli F, Angelotti F, Croia C, Migliorini P| title=Biomarkers In Chronic Spontaneous Urticaria: Current Targets And Clinical Implications. | journal=J Asthma Allergy | year= 2019 | volume= 12 | issue=  | pages= 285-295 | pmid=31571935 | doi=10.2147/JAA.S184986 | pmc=6759208 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=31571935  }} </ref><ref name="pmid27926978">{{cite journal| author=Kolkhir P, André F, Church MK, Maurer M, Metz M| title=Potential blood biomarkers in chronic spontaneous urticaria. | journal=Clin Exp Allergy | year= 2017 | volume= 47 | issue= 1 | pages= 19-36 | pmid=27926978 | doi=10.1111/cea.12870 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27926978  }} </ref>
<br>
<br>
{| style="border: 2px solid #4479BA; align="left"
{| style="border: 2px solid #4479BA; align=" left"
! style="width: 200px; background: #4479BA;" | {{fontcolor|#FFF|[[Interleukins]]}}
! style="width: 200px; background: #4479BA;" |{{fontcolor|#FFF|[[Interleukins]]}}
! style="width: 400px; background: #4479BA;" | {{fontcolor|#FFF|Explanations}}
! style="width: 400px; background: #4479BA;" |{{fontcolor|#FFF|Explanations}}
|-
|-
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" | [[Interleukin 6]]
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" |[[Interleukin 6]]
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" | <br>
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" |<br>
Determines [[disease]] activity
 
* Determines [[disease]] activity.
|-
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" |[[Interleukin 1]]
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" |<br>
 
* Such as [[Interleukin 18]] and [[Interleukin 17]]. More studies are required.
|-
|-
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" | [[Interleukin 1]]
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" |[[Interleukin|Interleukin 23]]
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" | <br>
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" |<br>
Such as [[Interleukin 18]] and [[Interleukin 17]]
 
<br>
* [[Interleukin|Interleukin 23]]/[[Interleukin 17]] axis has been explained in the [[pathogenesis]] of [[urticaria]].
More studies are required.
|-
|-
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" | [[Interleukin|Interleukin 23]]
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" |[[Interleukin 31]]
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" | <br>
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" |
[[Interleukin|Interleukin 23]]/[[Interleukin 17]] axis has been explained in [[pathogenesis]] of [[urticaria]].
* Also elevated in other [[inflammation|chronic skin inflammations]].
* <br>No association to [[disease]] activity.
* <br>[[Omalizumab]] [[treatment]] leads to a remarkable reduction in [[interleukin 31]] response and might be used as a predictor of response to [[omalizumab]].
|-
|-
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" | [[Interleukin 31]]
|}
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" | <br>
Also elevated in other [[inflammation|chronic skin inflammations]].
<br>
<br>
No association to [[disease]] activity.
 
<br>
*Elevated levels of [[tumor necrosis factor-alpha]] has been detected in some [[patients]] with [[urticaria|chronic spontaneous urticaria]].
[[Omalizumab]] [[treatment]] lead to a remarkable reduction in [[interleukin 31]] response and might be used as a predictor of response to [[omalizumab]].
*The following table is a summary of useful markers to determine [[disease]] severity and response to [[treatment]] in [[urticaria]]:<ref name="pmid31571935">{{cite journal| author=Puxeddu I, Petrelli F, Angelotti F, Croia C, Migliorini P| title=Biomarkers In Chronic Spontaneous Urticaria: Current Targets And Clinical Implications. | journal=J Asthma Allergy | year= 2019 | volume= 12 | issue=  | pages= 285-295 | pmid=31571935 | doi=10.2147/JAA.S184986 | pmc=6759208 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=31571935  }} </ref><ref name="pmid11764301">{{cite journal| author=Grattan CE| title=Basophils in chronic urticaria. | journal=J Investig Dermatol Symp Proc | year= 2001 | volume= 6 | issue= 2 | pages= 139-40 | pmid=11764301 | doi=10.1046/j.0022-202x.2001.00027.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11764301  }} </ref><ref name="pmid20214668">{{cite journal| author=Tedeschi A, Asero R, Lorini M, Marzano AV, Cugno M| title=Plasma levels of matrix metalloproteinase-9 in chronic urticaria patients correlate with disease severity and C-reactive protein but not with circulating histamine-releasing factors. | journal=Clin Exp Allergy | year= 2010 | volume= 40 | issue= 6 | pages= 875-81 | pmid=20214668 | doi=10.1111/j.1365-2222.2010.03473.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20214668  }} </ref><ref name="pmid23451767">{{cite journal| author=Atwa MA, Emara AS, Youssef N, Bayoumy NM| title=Serum concentration of IL-17, IL-23 and TNF-α among patients with chronic spontaneous urticaria: association with disease activity and autologous serum skin test. | journal=J Eur Acad Dermatol Venereol | year= 2014 | volume= 28 | issue= 4 | pages= 469-74 | pmid=23451767 | doi=10.1111/jdv.12124 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23451767  }} </ref><ref name="pmid28299827">{{cite journal| author=Sánchez-Borges M, Caballero-Fonseca F, Capriles-Hulett A, González-Aveledo L, Maurer M| title=Factors linked to disease severity and time to remission in patients with chronic spontaneous urticaria. | journal=J Eur Acad Dermatol Venereol | year= 2017 | volume= 31 | issue= 6 | pages= 964-971 | pmid=28299827 | doi=10.1111/jdv.14221 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28299827  }} </ref><ref name="pmid30584542">{{cite journal| author=Folci M, Heffler E, Canonica GW, Furlan R, Brunetta E| title=Cutting Edge: Biomarkers for Chronic Spontaneous Urticaria. | journal=J Immunol Res | year= 2018 | volume= 2018 | issue=  | pages= 5615109 | pmid=30584542 | doi=10.1155/2018/5615109 | pmc=6280255 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30584542  }} </ref>
 
{| style="border: 2px solid #4479BA; align=" left"
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" |Markers to determine [[disease]] severity/[[prognosis]]
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" |<br>
 
*[[Basophil granulocyte|Basophil]] count
*[[Basophil granulocyte|CD203-c basophils]]
*[[C-reactive protein]] ([[C-reactive protein|CRP]])
*[[Interleukin 6]]
*[[Interleukin 17]]
*[[Interleukin 18]]
*[[Interleukin 23]]
*[[Tumor necrosis factor-alpha]]
*[[MMP9]]
*LCN2
*[[Thrombin|Prothrombin fragments]]
*[[D-dimer]]
*Autologous [[serum]] [[skin]] test (ASST)
*[[platelet|Mean platelet volume]]
*[[Vitamin D]]
*[[Glycoprotein 130|Soluble gp130]]
|-
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" |Markers to evaluate response to [[therapy]]
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" |<br>
 
*[[C-reactive protein|CRP]]
*[[Basophil granulocyte|CD203-c basophils]]
*[[Template:Interleukin receptor modulators|Interleukin 31]]
*[[Interleukin 6]]
*LCN2
*[[D-dimer]]
*[[Complement component 5a|C5a]]
*Autologous [[serum]] [[skin]] test (ASST)
*[[Basophil granulocyte|Basophil]] [[histamine]] release assay (BHRA)
*[[Immunoglobulin E]]
*[[Clusterin]]
|-
|-
|}
|}
*Elevated levels of [[tumor necrosis factor-alpha]] has been detected in some [[patients]] with [[urticaria|chronic spontaneous urticaria]].
<br>
 
*High levels of [[vascular endothelial growth factor]] ([[Vascular endothelial growth factor|VEGF]]) has been detected in [[urticaria]] [[patients]], which is probably related to it's effect on [[vascular permeability]].
*It is recommended to search for [[paraproteins]], [[hepatitis B]], [[hepatitis C]], [[systemic lupus erythematosus]] and [[inflammatory bowel disease]] in [[patients]] with confirmed [[diagnosis]] of [[urticaria|urticaria vasculitis]].<ref name="pmid10756214">{{cite journal| author=Greaves M| title=Chronic urticaria. | journal=J Allergy Clin Immunol | year= 2000 | volume= 105 | issue= 4 | pages= 664-72 | pmid=10756214 | doi=10.1067/mai.2000.105706 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10756214  }} </ref>


==References==
==References==
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Latest revision as of 16:10, 4 February 2021

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Anahita Deylamsalehi, M.D.[2]

Overview

Laboratory evaluation can be used as a measure to determine disease severity, responsiveness to treatment and prognosis, in addition to their role as a diagnostic tool. Tests such as autologous serum skin test (ASST) and basophil activation test (BAT) are useful for detection of autoantibodies against IgE. Moreover elevated levels of c-reactive protein (CRP), erythrocyte sedimentation rate (ESR), certain interleukins and tumor necrosis factor-alpha have been reported in urticaria patients. Laboratory evaluations that can determine disease activity are autologous serum skin test (ASST), c-reactive protein (CRP) and IL-6.

Laboratory Findings


Interleukins Explanations
Interleukin 6
Interleukin 1
Interleukin 23
Interleukin 31


Markers to determine disease severity/prognosis
Markers to evaluate response to therapy


References

  1. ↑ 1.0 1.1 1.2 Puxeddu I, Petrelli F, Angelotti F, Croia C, Migliorini P (2019). "Biomarkers In Chronic Spontaneous Urticaria: Current Targets And Clinical Implications". J Asthma Allergy. 12: 285–295. doi:10.2147/JAA.S184986. PMC 6759208 Check |pmc= value (help). PMID 31571935.
  2. ↑ Ye YM, Park JW, Kim SH, Ban GY, Kim JH, Shin YS; et al. (2016). "Prognostic Factors for Chronic Spontaneous Urticaria: A 6-Month Prospective Observational Study". Allergy Asthma Immunol Res. 8 (2): 115–23. doi:10.4168/aair.2016.8.2.115. PMC 4713874. PMID 26739404.
  3. ↑ Kolkhir P, Altrichter S, Hawro T, Maurer M (2018). "C-reactive protein is linked to disease activity, impact, and response to treatment in patients with chronic spontaneous urticaria". Allergy. 73 (4): 940–948. doi:10.1111/all.13352. PMID 29130488.
  4. ↑ 4.0 4.1 Kasperska-Zajac A, Sztylc J, Machura E, Jop G (2011). "Plasma IL-6 concentration correlates with clinical disease activity and serum C-reactive protein concentration in chronic urticaria patients". Clin Exp Allergy. 41 (10): 1386–91. doi:10.1111/j.1365-2222.2011.03789.x. PMID 21645137.
  5. ↑ Ohtsuka T (2010). "Response to oral cyclosporine therapy and high sensitivity-CRP level in chronic idiopathic urticaria". Int J Dermatol. 49 (5): 579–84. doi:10.1111/j.1365-4632.2010.04384.x. PMID 20534097.
  6. ↑ 6.0 6.1 Kaplan AP (2017). "Chronic Spontaneous Urticaria: Pathogenesis and Treatment Considerations". Allergy Asthma Immunol Res. 9 (6): 477–482. doi:10.4168/aair.2017.9.6.477. PMC 5603475. PMID 28913986.
  7. ↑ Tedeschi A, Lorini M, Suli C, Asero R (2007). "Serum interleukin-18 in patients with chronic ordinary urticaria: association with disease activity". Clin Exp Dermatol. 32 (5): 568–70. doi:10.1111/j.1365-2230.2007.02450.x. PMID 17509061.
  8. ↑ 8.0 8.1 Puxeddu I, Italiani P, Giungato P, Pratesi F, Panza F, Bartaloni D; et al. (2013). "Free IL-18 and IL-33 cytokines in chronic spontaneous urticaria". Cytokine. 61 (3): 741–3. doi:10.1016/j.cyto.2013.01.015. PMID 23433789.
  9. ↑ Kolkhir P, André F, Church MK, Maurer M, Metz M (2017). "Potential blood biomarkers in chronic spontaneous urticaria". Clin Exp Allergy. 47 (1): 19–36. doi:10.1111/cea.12870. PMID 27926978.
  10. ↑ Grattan CE (2001). "Basophils in chronic urticaria". J Investig Dermatol Symp Proc. 6 (2): 139–40. doi:10.1046/j.0022-202x.2001.00027.x. PMID 11764301.
  11. ↑ Tedeschi A, Asero R, Lorini M, Marzano AV, Cugno M (2010). "Plasma levels of matrix metalloproteinase-9 in chronic urticaria patients correlate with disease severity and C-reactive protein but not with circulating histamine-releasing factors". Clin Exp Allergy. 40 (6): 875–81. doi:10.1111/j.1365-2222.2010.03473.x. PMID 20214668.
  12. ↑ Atwa MA, Emara AS, Youssef N, Bayoumy NM (2014). "Serum concentration of IL-17, IL-23 and TNF-α among patients with chronic spontaneous urticaria: association with disease activity and autologous serum skin test". J Eur Acad Dermatol Venereol. 28 (4): 469–74. doi:10.1111/jdv.12124. PMID 23451767.
  13. ↑ Sánchez-Borges M, Caballero-Fonseca F, Capriles-Hulett A, González-Aveledo L, Maurer M (2017). "Factors linked to disease severity and time to remission in patients with chronic spontaneous urticaria". J Eur Acad Dermatol Venereol. 31 (6): 964–971. doi:10.1111/jdv.14221. PMID 28299827.
  14. ↑ Folci M, Heffler E, Canonica GW, Furlan R, Brunetta E (2018). "Cutting Edge: Biomarkers for Chronic Spontaneous Urticaria". J Immunol Res. 2018: 5615109. doi:10.1155/2018/5615109. PMC 6280255. PMID 30584542.
  15. ↑ Greaves M (2000). "Chronic urticaria". J Allergy Clin Immunol. 105 (4): 664–72. doi:10.1067/mai.2000.105706. PMID 10756214.

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