Allergology International

Allergology International

Volume 67, Issue 1, January 2018, Pages 114-118
Allergology International

Original Article
Histopathological and clinical evaluation of chronic spontaneous urticaria patients with neutrophilic and non-neutrophilic cutaneous infiltrate

https://doi.org/10.1016/j.alit.2017.06.012Get rights and content
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open access

Abstract

Background

Chronic urticaria has an expressive prevalence in general population, especially in adults, and is defined by the presence of intermittent hives for six weeks or longer. Our study aims to characterize the histological patterns of chronic spontaneous urticaria, based on the inflammatory cell infiltrate, and correlate them to laboratory exams.

Methods

It was performed a retrospective analysis of laboratory, histopathology and direct immunofluorescence data of 93 patients with chronic urticaria. For histopathological analysis, cell count was performed in four fields at high magnification (×400) for each specimen. The resulting cell count medians were submitted to statistical analysis and, then, were correlated to laboratorial findings.

Results

We found a female predominance (76.34%) of chronic urticaria cases, and an average age of 42.5 years (SD ± 15). Two histological groups were distinctive: 1) chronic urticaria with predominance of neutrophils or eosinophils – N (%) = 39 (42.4%) – and 2) chronic urticaria with predominance of lymphocytes – N (%) = 53 (57.6%). There was not significant correlation between histological groups and laboratorial tests. Moreover, direct immunofluorescence was positive in 21 (33,87%) from 62 patients.

Conclusions

There is not enough scientific evidence to support neutrophilic urticaria as a solid, separate entity.

Keywords

Eosinophil
Histopathology
Neutrophil
Urticaria
Urticarial subtypes

Abbreviations

CSU
chronic spontaneuous urticaria
IgE
immunoglobulin E
AOSD
adult onset Still disease
CAPS
cryopyrin associated periodic syndromes
X
abnormal tests
N
total test
x/N (%)
relation between abnormal tests (x) and total tests (N) followed by the respective percentage in the specific groups
N/E
neutrophilic/eosinophilic group
Ly
lymphocytic group
RV
reference value
TPO-Ab
thyroid peroxidase antibody
TG-Ab
thyroid globulin antibody
ANA
antinuclear autoantibodies
RF
rheumatoid factor
increased
decreased
CRP
C-reactive protein
ESR
erythrocyte sedimentation rate
TSH
thyroid stimulating hormone
MPV
mean platelet volume
Anti-TBG
anti-tireoglobulin
Anti-TPO
anti-thyroperoxidase
TSH
thyroid stimulating hormone
DIF
direct immunofluorescence
BMZ
basal membrane zone
CB
citoid bodies

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Peer review under responsibility of Japanese Society of Allergology.