Tuesday, December 10, 2013

Sjogren's and Chronic Urticaria

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I've been just itching to share this literature review with y'all. It examines the relationship of chronic urticaria (hives) and autoimmunity. I was surprised to learn that up to 50% of all chronic urticaria is accompanied by an autoimmune disease: autoimmune thyroid disease being the most common but also including Sjogren's syndrome. I was particularly interested since it seems that many sjoggies have bothersome and mysterious skin issues, myself included. *scratch scratch scratch*

The review is entitled "Chronic Urticaria and Autoimmunity" and can be found here. Here's an excerpt:
ABSTRACT     Chronic urticaria is defined as hives, typically occurring daily, for greater than 6 weeks duration. Chronic idiopathic urticaria, which has no discernable external cause, comprises the majority of cases of chronic urticaria. Over half of all cases of chronic idiopathic urticaria are thought to occur by an autoimmune mechanism, primarily autoantibodies against the high affinity immunoglobulin E (IgE) receptor (FcεRI). Chronic urticaria is hypothesized to occur because of a predilection in the patient to develop reactions to self. Supporting this hypothesis, a strong association has been found between chronic urticaria and additional autoimmune diseases, such as thyroid disease, rheumatoid arthritis, systemic lupus erythematosus, Sjögren's syndrome, celiac disease and type 1 diabetes, among others. Herein, we review the associations between chronic urticaria, thyroid disease, and other autoimmune disorders, as well as the implications that these correlations hold for therapeutic intervention in chronic urticaria.
CONCLUSION     CU is defined as hives lasting longer than 6 weeks. Currently, it is thought that up to 50% of CU is caused by autoimmune mechanisms. Autoantibodies to the high affinity IgE receptor are the most commonly identified offender, activating mast cells, basophils, and the complement system, resulting in the wheal and flare reaction. CU is hypothesized to occur because of a predisposition in the patient to develop autoimmune diseases. In concordance with this hypothesis, additional autoimmune diseases are observed in patients with CU. Thyroid disease, particularly hypothyroidism, is the most common additional autoimmune disease diagnosed. Furthermore, thyroid disease may directly exacerbate CU severity by activating the complement system. Other autoimmune diseases that occur more frequently in patients with CU include RA, SLE, vitiligo, pernicious anemia, celiac disease, and Sjögren's syndrome.

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