100514 - Chronic urticaria and eradication of helicobacter pillory-evaluation of treatment results
Case report
Background: A 42-year-old female patient presented to the allergy clinic with complaints of urticaria. She has been suffering from it for several years. She has been experiencing periodic urticaria with pronounced swelling of the face, tongue, and around the eyes. The last exacerbation began about two weeks ago. It manifested as generalized urticaria in all parts of the body, as well as pronounced swelling around the eyes, lips, and tongue. Complaints were also expressed: periodic feeling of choking, pain, heartburn, and discomfort in the epigastrium. According to the patient, for the past few days she has been eating specific foods rich in spices. She takes antihistamine pills. She took a steroid pill once with a positive result. He went to an allergy clinic for further diagnosis and treatment.Initial examination diagnosed the condition as chronic urticaria. Diagnostic methods and treatment goals were planned. In the first stage of treatment, a steroid drug in pill form was prescribed - methylprednisolone - 16 mg - after breakfast - for 5 days.The patient underwent the following examinations: study of total and specific immunoglobulins in blood serum. Also, determination of the amount of vitamin D in blood serum.
A gastroenterologist consultation was conducted and appropriate examinations were scheduled. The gastroscopy confirmed the presence of Helicobacter pylori in the gastric epithelium. Serum Total IgE level was within normal limits. Specific panel data were also within normal limits. Serum vitamin D levels were critically low at 8 ng/mL. Treatment was planned: First, treatment by a gastroenterologist was prescribed to eradicate Helicobacter pylori. Treatment was also prescribed to regulate vitamin D levels.
The treatment showed positive dynamics. The urticarial rash decreased, and the swelling in the facial area also disappeared. The patient's condition was assessed after four weeks of treatment - during examination: the skin was clean, without pronounced urticarial rash. The facial area was also free of swelling. The pain in the epigastric region decreased, and heartburn and discomfort also became less frequent.A further treatment plan was developed in consultation with the gastroenterologist, with emphasis on Helicobacter pylori eradication.
The patient was called for a repeat consultation three months later. During the examination, there were no complaints. According to the patient, the condition was stable during the three months and no exacerbations were detected.
Result: Based on the history, diagnosis, and treatment results, the patient's condition was assessed as chronic idiopathic urticaria induced by Helicobacter pylori. Properly conducted and planned measures resulted in a positive outcome.
Conclusion: Helicobacter pylori may be a provoking factor in chronic idiopathic urticaria, and with proper diagnosis and treatment, a stable and long-lasting remission can be achieved.
