Chronic urticaria and thyroid pathology. Martes 6 de octubre

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 Chronic urticaria and thyroid pathology


Authors: Sandra Nora Gonzalez-Diaz,a Mario Sanchez-Borges,b Diana Maria Rangel-Gonzalez,a,∗ Rosa Ivett Guzman-Avilan,a Jose Ignacio Canseco-Villarreal,a and Alfredo Arias-Cruza


Abstract

Urticaria is defined as the sudden appearance of erythematous, itchy wheals of variable size, with or without angioedema (AE) (swelling of the deeper layers of the skin). Its classification depends on time course of symptoms and the presence of eliciting factors. When it lasts less than 6 weeks it is classified as acute urticaria (AU), and if the symptoms persist for more than 6 weeks, it is classified as chronic urticaria (CU). Current International Guidelines also classify CU as chronic spontaneous urticaria (CSU) and inducible urticarial, according to the absence or presence of environmental triggering factors. CSU is defined as urticaria and/or angioedema in which there is no evidence of a specific eliciting factor. CSU is associated with autoimmunity in 30–45% of the cases, sharing some immunological mechanisms with other autoimmune diseases, and is associated with autoimmune thyroid disease (ATD) in about 4.3%–57.4% patients. Several studies suggest that adequate therapy with anti-thyroid drugs or levothyroxine in early stages of ATD and CSU, may help to remit the latter; but there is still a lack of double-blind, placebo-controlled studies that support this hypothesis in patients without abnormal thyroid hormone levels. The objective of this review is to describe the pathophysiology of chronic spontaneous urticaria and its association with autoimmune thyroid disease.

doi: 10.1016/j.waojou.2020.100101

Comentarios

  1. Jaime Sosa6 de octubre de 2020, 7:38

    La asociación entre UCE y enfermedad autoinmune tiroidea es más común en mujeres adultas, oscilando entre el 4,3% y el 57,4%.

    En el abordaje de ambas enfermedades, se debe tener en cuenta que gran cantidad de pacientes con UCE pueden tener autoanticuerpos antitiroideos, sin esto significar una enfermedad clinica, por lo que se debe individualizar cada caso y no asumir que un paciente con autoanticuerpos positivos, va a ser un paciente con enfermedad tiroidea.

    Aunque existen varios estudios que explican la relación entre ambas patologias, aún faltan estudios doble ciego controlados con placebo que apoyen el uso de fármacos antitiroideos y levotiroxina en pacientes con UCE y autoanticuerpos positivos sin alteraciones en los niveles de hormona tiroidea.

    Definitivamente no hay indicacion para hacer reemplazo de hormona tiroidea en todos los pacientes con UCE

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