D1.261 - Phenotypic and Immunological Profiles of Chronic Urticaria: A Cross- Sectional Study From South India

Chronic spontaneous urticaria (CSU) and chronic inducible urticaria (CIndU) are heterogeneous in presentation and may be associated with atopic or autoimmune comorbidities. Understanding demographic, clinical, and immunological patterns can help refine management strategies.

A cross- sectional analysis of clinical data of 133 patients seen in an Allergy- Immunology specialty clinic in South Kerala from April 2024 to December 2025 with CSU/CIndU was performed assessing demographics, clinical phenotype (wheals, angioedema, or both), inducible triggers, allergic comorbidities, and autoimmune markers (ANA, anti-TPO). Statistical analyses included chi-square and binary logistic regression.

Of 133 patients, 43 (32.3%) were males and 90 (67.7%) females and mean age at diagnosis was 37.29 ± 13.47 years (range 14–71). Mean disease duration was 35.98 months and 28 patients (21%) had history of relapses. 45.9% of patients presented with wheals alone, 39.8% presented with wheals and angioedema while 10.5% presented with angioedema alone. Dermographism was noted in 43 patients (32.3%) and 24 patients (18%) had CIndU other than dermographism. Allergic rhinitis was present in 46 (34.6%) patients and asthma in 44 patients (33.1%). 60 patients (45.1%) had at least one allergic disorder. ANA was positive in 58 (43.6%), anti-TPO in 25 patients (18.8%), and either marker in 65 (48.9%) patients. ANA positivity was significantly more frequent in females (p = 0.002, OR 3.73, 1.63- 8.57). 90 patients (75.6%) were found to have elevated IgE levels and 16 (13.4%) had high CRP.

This cohort shows distinct gender-related differences in autoimmune marker prevalence, with a high burden of allergic comorbidities. These findings underscore the importance of phenotyping and comorbidity screening in CSU management.