Antithyroid antibodies in chronic urticaria and angioedema

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To the Editor:

Chronic urticaria (CU) was a cutaneous disease of unknown origin until the past decade, during which a subpopulation comprising approximately 35% to 45% of patients was found to show evidence of an autoimmune disorder. At least 35% of patients with CU have an IgG antibody directed to the α subunit of the IgE receptor,1, 2 whereas an additional 5% to 10% of patients have anti-IgE that is functional.3 These antibodies cross-link the IgE receptor to cause mast cell degranulation. Fixation of

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    It is therefore advisable to assess patients with CSU for CSUaiTI and CSUaiTIIb. Differentiating factors include time since the onset of disease (longer in CSUaiTIIb)1,2 and concomitant autoimmune diseases (more common in CSUaiTIIb).13,15,18-20 Also, results of basic CSU tests (ie, CBC with differential, CRP) can differentiate between type I versus type IIb autoimmune CSU, with CRP more often elevated and eosinophil and basophil levels more often reduced in the latter than the former.21

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