Autoimmune Urticaria is a type of chronic hives (urticaria) that occurs when the immune system mistakenly attacks the body's own tissues, leading to the release of histamine and other chemicals that cause hives, itching, and swelling. Unlike common forms of urticaria, which may be triggered by allergens or environmental factors, autoimmune urticaria is primarily driven by an autoimmune response, where the body's immune system targets its own skin cells.
Key Features of Autoimmune Urticaria:
- Cause:
- In autoimmune urticaria, the immune system produces autoantibodies that target and bind to certain receptors in the skin called IgE receptors on mast cells. Mast cells are responsible for releasing histamine, which leads to the symptoms of urticaria (hives).
- The autoantibodies cause mast cells to release histamine and other chemicals, resulting in the inflammation, itching, and swelling characteristic of hives.
- The exact cause of the immune response is often unknown, though some triggers may include infections, stress, or other autoimmune conditions.
- Symptoms:
- Hives: Raised, red, itchy welts on the skin, which can appear anywhere on the body. The hives often change shape and location and may last for several hours before disappearing.
- Itching: Intense itching is a hallmark symptom of autoimmune urticaria.
- Swelling (angioedema): Swelling, particularly around the eyes, lips, or throat, may accompany the hives.
- Chronic: Autoimmune urticaria is typically a chronic condition, with symptoms that can persist for weeks, months, or even longer.
- Flare-ups: Symptoms may worsen at times of stress or illness.
- Diagnosis:
- Clinical examination: A doctor will evaluate the patient's history of symptoms and examine the hives.
- Blood tests: To detect autoantibodies that target the IgE receptor or other proteins involved in the immune response. Tests like the basophil activation test (BAT) or histamine release test can be used to confirm autoimmune involvement.
- Exclusion of other causes: Other potential causes of hives, such as allergies, infections, or other autoimmune conditions, will be ruled out.
- Treatment:
- Antihistamines: The first-line treatment for autoimmune urticaria is usually antihistamines to help control itching and reduce the appearance of hives.
- Corticosteroids: In more severe cases, oral corticosteroids may be prescribed to reduce inflammation and control flare-ups.
- Immunosuppressive therapies: For chronic or severe cases, medications that suppress the immune system, such as cyclosporine, methotrexate, or omalizumab (a monoclonal antibody), may be used to decrease the autoimmune response.
- Biologic therapies: Omalizumab (Xolair), which is commonly used to treat asthma, has been found to be effective in treating chronic autoimmune urticaria, especially in cases that don't respond to antihistamines or steroids.
- Prognosis:
- Chronic condition: Autoimmune urticaria can be a long-term condition, often lasting months or even years. However, some individuals may experience periods of remission where symptoms improve or disappear for a while.
- Quality of life impact: The chronic itching and visible hives can impact a person’s quality of life, causing discomfort, emotional distress, and social embarrassment.
- Treatment success: With appropriate treatment, symptoms can usually be managed effectively, though relapses are possible. Biologic therapies like omalizumab have shown positive results in managing autoimmune urticaria for many patients.
