Urticaria laboratory findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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 Findings


Interleukins Explanations
Interleukin 6

Determines disease activity

Interleukin 1

Such as Interleukin 18 and Interleukin 17
More studies are required.

Interleukin 23

Interleukin 23/Interleukin 17 axis has been explained in pathogenesis of urticaria.

Interleukin 31

Also elevated in other chronic skin inflammations.
No association to disease activity.
Omalizumab treatment lead to a remarkable reduction in interleukin 31 response and might be used as a predictor of response to omalizumab.


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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