D2.54 - Correlation Between IgE Anti-Thyroid Peroxidase And Chronic Spontaneous Urticaria

Chronic Spontaneous Urticaria (CSU) is immune-mediated condition with auto-allergic: Immunoglobulin E (IgE) anti-Thyroid Peroxidase (IgE anti-TPO) or autoimmune basis: Immunoglobulin G (IgG) against IgE or its receptor (FcεR) on mast cells, leading to activation.

A case-control study of 45 patients with age-/sex-matched healthy individuals, was conducted at Ain Shams University Hospital over the period of 12 months.

Demographics showed mean age (years) 33.9±10.4 and 34.4±9.6 with female predominance 82% and 80%, and high body mass index (BMI kg/m2) 27.4±3.6 and 25.9±3.4 in patients and controls, respectively. Family history of atopy was positive 22.2% in patients, whilst 4% among controls. The mean age of onset (years) was 27.9±10.6 and duration of disease (years) was 6.1±6.7. Weekly Urticaria Activity Score (UAS7 0-42) revealed 11.1% well-controlled (1-6), 22.2% mild (7-15), 31.1% moderate (16-27), 35.6% severe (28-42) urticaria. Laboratory findings among patients showed: Eosinophil count (cells/µL) 359±156.6, IgE (IU/mL) 201.2±248.7, and TSH (ml/L) 2.9±2.3. The mean level of IgE anti-TPO (IU/mL) 0.42±0.36 (highest in females, p=0.004) and 0.14±0.20 in patients and controls, respectively (p<0.001). There was statistical significance between the mean level of IgE anti-TPO (IU/mL) and UAS7: 0.70±0.40, 0.30±0.24, 0.29±0.27, and 0.16±0.04 in severe, moderate, mild, and well-controlled urticaria, respectively (p<0.001). UAS7 correlated positively with duration of the disease, eosinophil count, and IgE anti-TPO level (highest in females, p=0.004) (p=0.046, p=0.049, p=0.013, respectively) and negatively with BMI (p=0.049). There was no statistical significance between UAS7 subgroups and demographic data, clinical characteristics, and laboratory work-up.

Understanding the role of IgE anti-TPO could have an important effect on both diagnosis and management.