D2.242 - Chronic Urticaria and Thyroid Disease: Analysis of Clinical, Laboratory Data and Therapeutic Response in the Mediterranean Area of Tarragona

Chronic spontaneous urticaria (CSU) is associated with autoimmunity (30–45%), particularly autoimmune thyroid disease (AITD) (4.3%–57.4%), and treatment of AITD may favor CSU remission.

The present study aims to determine whether the treatment of autoimmune thyroid disease in patients with chronic spontaneous urticaria (CSU) allows for control or resolution of the condition, as well as to describe the response to the different treatments used to control CSU.

A retrospective descriptive study of adult patients with CSU between 2022 and 2024.They were classified into two groups: 1) CSU and AITD, with and without thyroid hormone alteration (THA), 2) CSU without AITD. We collected clinical, analytical, and therapeutic data and performed statistical analysis.

A cohort of 63 patients with CSU was recorded. 53 had AITD, with 11 of them presenting thyroid hormone alterations. 58 (92%) were women, with a mean age of 47.2 (17–82) and 53.6 (38–82) years for total CSU and CSU-AITD with THA, respectively.

In the CSU-AITD group:

• Those with THA had higher Anti-TPO levels, p=0.030;
• 23 (43.39%) received treatment for AITD: 19 (35.8%) levothyroxine, 3 (5.6%) thiamazole (methimazole), 1 (1.8%) I-131, and 2 (3.7%) total/partial thyroidectomy;
• 22 (41.5%) improved CSU with AITD treatment, p=0.018.

Anti-TPO presence was higher than Anti-TG, 88.6% and 41%, respectively.Basophil count, 39 (±25)/μL, was higher in those who improved CSU, p=0.047, and eosinophil count, 126 (±89), was lower in those who improved CSU with thyroid treatment, p=0.016.

Specific treatment of AITD in patients with CSU improves CSU, so we recommend its indication in patients with CSU-AITD with thyroid dysfunction.

Analytically, we highlight:

• A lower eosinophil count is associated with CSU improvement in patients treated for AITD, and a higher basophil count with better therapeutic response in overall CSU;
• The importance of Anti-TPO determination for the diagnosis of CSU-AITD.