Arquivos de Asma, Alergia e Imunologia
https://www.aaai-asbai.org.br/article/doi/10.5935/2526-5393.20180058
Arquivos de Asma, Alergia e Imunologia
Original Article

Características clínicas e autoimunidade nos pacientes com urticária dermográfica

Clinical features and autoimmunity in patients with dermographic urticaria

Rafaella Amorim Gaia Duarte; Raisa Borges de Castro; Franciane Bruschi Almonfrey; Jorge Kalil; Antônio Abilio Motta; Rosana Câmara Agondi

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Resumo

Introdução: A urticária dermográfica (UD) é a forma de urticária induzida mais comum, com uma prevalência geral de até 5%. Na urticária demográfica, o estímulo físico é decorrente de trauma ou fricção, seja ela por roupa, ou arranhões. A urtica pruriginosa aparece cerca de 10 minutos após o estímulo, e desaparece em 1 a 2 horas. Os anti-histamínicos (AH1) são a primeira opção de tratamento para controle da doença, e não se conhece a etiologia dessa entidade clínica. Objetivo: Avaliar as características clínicas de pacientes com urticária dermográfica ou dermografismo sintomático. Métodos: Estudo retrospectivo de prontuário eletrônico de pacientes com UD, atendidos em um hospital terciário. Foram avaliados o tempo de doença, associação com urticária crônica espontânea (UCE), o tipo de tratamento, e a frequência de doença autoimune e/ou autoanticorpos. Resultados: Foram avaliados 161 pacientes com UD em seguimento há mais de seis meses. Cento e trinta e nove pacientes (85,7%) eram do sexo feminino, com média de idade de 48,6 anos e tempo de doença de 10,1 anos. A maioria respondeu ao AH1. Ao longo do seguimento, o AH1 de segunda geração foi utilizado em 73,5% dos pacientes, e o de primeira geração adicionado ao de segunda geração ou isolado em 50% dos pacientes. Quinze pacientes (9,3%) haviam feito uso de corticoide oral para controle dos sintomas. A associação com UCE estava presente em 44,1% dos pacientes. Alguma doença autoimune estava presente em 6,3% dos pacientes com UD associados à UCE, e em 14,5% naqueles com diagnóstico isolado de UD. Autoanticorpos estavam presentes em 34,9% dos pacientes com UD associada à UCE, e em 32,7% naqueles com UD isolada. Conclusões: A prevalência de autoimunidade e/ou autoanticorpos foi elevada, independentemente da associação da UD com UCE.

Palavras-chave

Urticária, autoanticorpos, autoimunidade, doenças da glândula tireoide.

Abstract

Introduction: Dermographic urticaria (DU) is the most common form of inducible urticaria, with an overall prevalence of up to 5%. In DU, physical stimulation is due to trauma or friction, either by clothing or scratches. Pruritic wheals appear about 10 minutes after the stimulus and disappear within 1 to 2 hours. Antihistamines are the first treatment option to control the disease. The underlying cause is unknown. Objective: To evaluate the clinical features of patients with DU or symptomatic dermographism. Methods: A retrospective study of electronic medical records of patients with DU treated at a tertiary hospital. Disease duration, association with chronic spontaneous urticaria (CSU), type of treatment, and frequency of autoimmune disease and/or autoantibodies were assessed. Results: A total of 161 patients with DU were followed for more than 6 months. One hundred thirty-nine patients (85.7%) were female, with mean age of 48.6 years and mean disease duration of 10.1 years. Most patients responded well to antihistamines. Over the follow-up period, second-generation antihistamines were used by 73.5% of patients, while firstgeneration antihistamines combined with second-generation drugs or alone were used by 50%. Fifteen patients (9.3%) had used oral corticosteroids to control their symptoms. The association with CSU was found in 44.1%. Autoimmune disease was found in 6.3% of patients with DU associated with CSU and in 14.5% of those with diagnosis of isolated DU. Autoantibodies were found in 34.9% of patients with DU associated with CSU and in 32.7% of those with isolated DU. Conclusions: The prevalence of autoimmunity and/or autoantibodies was high, regardless of the association of DU with CSU.

Keywords

Urticaria, autoantibodies, autoimmunity, thyroid diseases.

References

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Submitted date:
10/10/2018

Accepted date:
12/17/2018

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