D2.20 - Chronic Idiopathic Urticaria with the presence of Helicobacter pylori infection-clinical and laboratory data correlation

Chronic Urticaria is the condition that last for more than six weeks and return often over months or years.  Chronic Urticaria (CU) is a disturbing allergic condition of the skin. Although frequently benign, it may sometimes be a red flag sign of a serious internal disease. The welts often start as itchy patches that turn into swollen welts that vary in size. These welts appear and fade at random as the reaction runs its course. Each individual welt typically lasts less than 24 hours. CU can be very uncomfortable and interfere with sleep and daily activities. A multitude of etiologies have been implicated in the causation of CU, including physical, infective, vasculitis, psychological and idiopathic, but the etiology for most cases remains unknown and therapy is largely directed at symptomatic care.  Autoantibodies directed against either IgE or α-chain of the high-affinity IgE receptor (FcεRIα) can be detected in 30–50% of subjects with Urticaria, suggesting that autoimmune mechanisms are involved in the pathogenesis of CU. 

Helicobacter pylori is a type of bacteria that infects your stomach. It can cause sores and inflammation in the lining of your stomach or the upper part of your small intestine (the duodenum). Infection with H. pylori is common. For most people, it never causes any symptoms. About two-thirds of the world’s population has it in their bodies. But it's the most common cause of peptic ulcers, which are painful open sores in your digestive tract. In rare cases, it could even lead to stomach cancer. Some studies have reported an association between CU and Helicobacter pylori (H. pylori) infection.

The study was performed in adult aged 18 -60 years old, including patients with chronic Urticaria (n=80), who referred to Allergy department for a visit. control group persons aged 18-60 were also include in this survey. The patients underwent several laboratory tests: Total and specific IgE level (respiratory allergens-grass and tree pollen) in a serum, also helicobacter pylori diagnostic test- in a stool and exhaled air.

The aim of the study was to detect the correlation between the presence of Helicopter infection and Chronic Idiopathic Urticaria. 

Using the multivariate logistic regression analysis, the presence of chronic urticarial was associated with the presence of helicobacter pylori in a stool and exhaled air (OR=1.34, 96% CI (1,14-1.58) P=0.011; X2=6.78; F-0.022)

35% of the patients in control group persons (n=7) had positive helicobacter pylori test. In the group –chronic Urtikaria - 75% of the patients

(n=60) had positive test on helicobacter pylori.

According the results, presence of helicobacter pylori (p-0.039; x2-3.12) is strongly associated with chronic Urticaria, but neither serum total

IgE level (p-0.54; x2-10.9), nor specific IgE level tests (respiratory allergens-grass and tree pollen) results (p-0.50, x2-5.12) were correlations with this disease.

The presence of helicobacter pylori infection predict increased risk of Chronic Urticaria. Therefore, by eradication of helicobacter infection maybe improve Chronic Urticaria management.