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Kronik Ürtikerli Hastalarda Basamak Tedavisine Yanıt ve Prognostik Faktörler: Retrospektif Çalışma

Yıl 2020, Cilt: 3 Sayı: 2, 94 - 104, 31.08.2020

Öz

Giriş: Kronik ürtikerli hastaların; genel özelliklerinin değerlendirilmesi ve tedavilerine göre 2 gruba ayırarak; 1.ve 2. basamak tedavi ile rahatlayan ve anti histamin ilaç tedavisine dirençli olup 3. Basamak tedavi almak durumunda kalan hastaların karşılaştırılması, prognostik faktörlerin araştırılması planlandı.
Materyal ve Metot: Bu çalışmada 27 Haziran 2016-27 Haziran 2017 tarihleri arasında Adana Numune Eğitim Araştırma Hastanesi Alerji ve İmmünoloji Kliniği’ne başvuran 182 kronik ürtiker hastalarının dosyalarından retrospektif olarak dermografik özellikler, labaratuar değerleri, deri prik test sonucu, otolog serum deri testi sonucu, tedavi başlangıcında yapılan ürtiker kontrol testi, önerilen tedaviler ve yanıtları değerlendirilerek kayıt altına alındı. Kronik ürtikerli hastalar antihistamin direnci pozitif ve negatif olarak iki gruba ayrılarak gruplar arasında farklılık olup-olmadığı araştırıldı
Bulgular: 18-72 yaş arası ortalama yaş 40.56±13.02 olan 128 kadın 54 erkek hasta alındı. Kadınlarda hastalık süresi 25.72±29.85 ay, erkeklerde hastalık süresi 23.26±29.56 aydır. 99 (70K, 29E) hastada antihistamin ilaç tedavisine direnç saptanmazken, 83 (58K,25E) 3. basamak tedavi uygulandı. Dermografik özellikler, atopi ve dermografizm varlığı, deri testi sonucunda; gruplar arasında istatistiksel olarak anlamlı fark saptanmadı. Hastalık süresi yüksek erkek olgularda antihistamin grubu ilaçlara karşı direnç pozitifliği istatistiksel olarak anlamlı bulundu (p=0.031) Hastalık süresi ile dermografizim ve OST arasında ilişki bulunmadı. (sırasıyla p=0.640, p=0.075).
Sonuç: Kronik ürtikerde antihistamin ilaç tedavisine direnci önceden anlamamızı sağlayacak klinik bulgular ve laboratuvar parametrelerinin saptanması tedavi seçiminde önemlidir. Çalışmamızda OST pozitifliği, kronik ürtikere eşlik eden anjioödem varlığı ve soy geçmişte alerjik hastalık olması total Ig E nin<1 IU/ml ile hastalık süresi fazla olan erkek olgularda antihistamin ilaç tedavisine direnç ile ilişkili bulundu.

Kaynakça

  • Saini SS. Urticaria and anjiodema.In: AdkinsonNF, Bochner BS, Burks AV, Middleton,s Allergy Principles and Practise.Vol.1,Ch.36 8 th edition. Elsevier Inc Philedelphia, USA, 2014.p575-587
  • Kaplan AP, Horakova Z, Katz SI. Assessment of tissue fluid histamine levels in patients with urticaria. J Allergy Clin Immunol. 1978;61(6):350-4.
  • Zuberbier T, Aberer W, Asero R, Abdul Latiff AH, Baker D, Ballmer-Weber B, et al. The EAACI/GA(2)LEN/EDF/WAO guideline for the definition, classification, diagnosis and management of urticaria. Allergy. 2018;73(7):1393-414.
  • Kocaturk GE, Aktan Ş, Atakan N, Bulbul BE, Erdem T, Koca R. Türkiye Ürtiker Tanı ve Tedavi Klavuzu-2016. Turkderm Arch Turk Dermatol Venerology 2016;50:82-98.
  • Johansson SG, Hourihane JO, Bousquet J, Bruijnzeel-Koomen C, Dreborg S, Haahtela T, et al. A revised nomenclature for allergy. An EAACI position statement from the EAACI nomenclature task force. Allergy. 2001;56(9):813-24.
  • Merrett J, Merrett TG. Phadiatop--a novel IgE antibody screening test. Clin Allergy. 1987;17(5):409-16.
  • Pepys J. Skin tests for immediate, type I, allergic reactions. Proc R Soc Med. 1972;65(3):271-2.
  • Konstantinou GN, Asero R, Maurer M, Sabroe RA, Schmid-Grendelmeier P, Grattan CE. EAACI/GA(2)LEN task force consensus report: the autologous serum skin test in urticaria. Allergy. 2009;64(9):1256-68.
  • Weller K, Groffik A, Church MK, Hawro T, Krause K, Metz M, et al. Development and validation of the Urticaria Control Test: a patient-reported outcome instrument for assessing urticaria control. J Allergy Clin Immunol. 2014;133(5):1365-72, 72 e1-6.
  • Marrouche N, Grattan C. Update and insights into treatment options for chronic spontaneous urticaria. Expert Rev Clin Immunol. 2014;10(3):397-403.
  • Karakonstantis S, Kalemaki D, Tzagkarakis E, Lydakis C. Pitfalls in studies of eosinopenia and neutrophil-to-lymphocyte count ratio. Infect Dis (Lond). 2018;50(3):163-74.
  • Shah AD, Denaxas S, Nicholas O, Hingorani AD, Hemingway H. Low eosinophil and low lymphocyte counts and the incidence of 12 cardiovascular diseases: a CALIBER cohort study. Open Heart. 2016;3(2):e000477.
  • Sanchez-Borges M, Caballero-Fonseca F, Capriles-Hulett A, Gonzalez-Aveledo L, Maurer M. Factors linked to disease severity and time to remission in patients with chronic spontaneous urticaria. J Eur Acad Dermatol Venereol. 2017;31(6):964-71.
  • Gregoriou S, Rigopoulos D, Katsambas A, Katsarou A, Papaioannou D, Gkouvi A, et al. Etiologic aspects and prognostic factors of patients with chronic urticaria: nonrandomized, prospective, descriptive study. J Cutan Med Surg. 2009;13(4):198-203.
  • Marin-Cabanas I, Berbegal-de Gracia L, de Leon-Marrero F, Hispan P, Silvestre JF. Management of Chronic Spontaneous Urticaria in Routine Clinical Practice Following the EAACI/GA(2)LEN/EDF/WAO Guidelines. Actas Dermosifiliogr. 2017;108(4):346-53.
  • Curto-Barredo L, Archilla LR, Vives GR, Pujol RM, Gimenez-Arnau AM. Clinical Features of Chronic Spontaneous Urticaria that Predict Disease Prognosis and Refractoriness to Standard Treatment. Acta Derm Venereol. 2018;98(7):641-7.
  • Woo YR, Jung KE, Koo DW, Lee JS. Vitamin D as a Marker for Disease Severity in Chronic Urticaria and Its Possible Role in Pathogenesis. Ann Dermatol. 2015;27(4):423-30.
  • Rasool R, Masoodi KZ, Shera IA, Yosuf Q, Bhat IA, Qasim I, et al. Chronic urticaria merits serum vitamin D evaluation and supplementation; a randomized case control study. World Allergy Organ J. 2015;8(1):15.
  • Movahedi M, Tavakol M, Hirbod-Mobarakeh A, Gharagozlou M, Aghamohammadi A, Tavakol Z, et al. Vitamin D deficiency in chronic idiopathic urticaria. Iran J Allergy Asthma Immunol. 2015;14(2):222-7.
  • Kozel MM, Mekkes JR, Bossuyt PM, Bos JD. Natural course of physical and chronic urticaria and angioedema in 220 patients. J Am Acad Dermatol. 2001;45(3):387-91.
  • Kumar YH, Bhaskar S, Shankar K. Comparative Study of Positive Versus Negative Autologous Serum Skin Test in Chronic Spontaneous Urticaria and its Treatment Outcome. N Am J Med Sci. 2016;8(1):25-30.
  • Huilan Z, Bihua L, Runxiang L, Jiayan L, Luyang L, Zhenjie L. Features of Antihistamine-Resistant Chronic Urticaria and Chronic Urticaria During Exacerbation. Indian J Dermatol. 2015;60(3):323.
  • Staubach P, Onnen K, Vonend A, Metz M, Siebenhaar F, Tschentscher I, et al. Autologous whole blood injections to patients with chronic urticaria and a positive autologous serum skin test: a placebo-controlled trial. Dermatology. 2006;212(2):150-9.
  • Kolkhir P, Church MK, Altrichter S, Skov PS, Hawro T, Frischbutter S, et al. Eosinopenia, in Chronic Spontaneous Urticaria, Is Associated with High Disease Activity, Autoimmunity, and Poor Response to Treatment. J Allergy Clin Immunol Pract. 2020;8(1):318-25 e5.
  • Kessel A, Helou W, Bamberger E, Sabo E, Nusem D, Panassof J, et al. Elevated serum total IgE--a potential marker for severe chronic urticaria. Int Arch Allergy Immunol. 2010;153(3):288-93.
  • de Montjoye L, Darrigade AS, Gimenez-Arnau A, Herman A, Dumoutier L, Baeck M. Correlations between disease activity, autoimmunity and biological parameters in patients with chronic spontaneous urticaria. Eur Ann Allergy Clin Immunol. 2020.

RESPONSE TO LINE TREATMENT FOR CHRONIC URTICARIA AND PROGNOSTIC FACTORS: RETROSPECTIVE STUDY

Yıl 2020, Cilt: 3 Sayı: 2, 94 - 104, 31.08.2020

Öz

Kaynakça

  • Saini SS. Urticaria and anjiodema.In: AdkinsonNF, Bochner BS, Burks AV, Middleton,s Allergy Principles and Practise.Vol.1,Ch.36 8 th edition. Elsevier Inc Philedelphia, USA, 2014.p575-587
  • Kaplan AP, Horakova Z, Katz SI. Assessment of tissue fluid histamine levels in patients with urticaria. J Allergy Clin Immunol. 1978;61(6):350-4.
  • Zuberbier T, Aberer W, Asero R, Abdul Latiff AH, Baker D, Ballmer-Weber B, et al. The EAACI/GA(2)LEN/EDF/WAO guideline for the definition, classification, diagnosis and management of urticaria. Allergy. 2018;73(7):1393-414.
  • Kocaturk GE, Aktan Ş, Atakan N, Bulbul BE, Erdem T, Koca R. Türkiye Ürtiker Tanı ve Tedavi Klavuzu-2016. Turkderm Arch Turk Dermatol Venerology 2016;50:82-98.
  • Johansson SG, Hourihane JO, Bousquet J, Bruijnzeel-Koomen C, Dreborg S, Haahtela T, et al. A revised nomenclature for allergy. An EAACI position statement from the EAACI nomenclature task force. Allergy. 2001;56(9):813-24.
  • Merrett J, Merrett TG. Phadiatop--a novel IgE antibody screening test. Clin Allergy. 1987;17(5):409-16.
  • Pepys J. Skin tests for immediate, type I, allergic reactions. Proc R Soc Med. 1972;65(3):271-2.
  • Konstantinou GN, Asero R, Maurer M, Sabroe RA, Schmid-Grendelmeier P, Grattan CE. EAACI/GA(2)LEN task force consensus report: the autologous serum skin test in urticaria. Allergy. 2009;64(9):1256-68.
  • Weller K, Groffik A, Church MK, Hawro T, Krause K, Metz M, et al. Development and validation of the Urticaria Control Test: a patient-reported outcome instrument for assessing urticaria control. J Allergy Clin Immunol. 2014;133(5):1365-72, 72 e1-6.
  • Marrouche N, Grattan C. Update and insights into treatment options for chronic spontaneous urticaria. Expert Rev Clin Immunol. 2014;10(3):397-403.
  • Karakonstantis S, Kalemaki D, Tzagkarakis E, Lydakis C. Pitfalls in studies of eosinopenia and neutrophil-to-lymphocyte count ratio. Infect Dis (Lond). 2018;50(3):163-74.
  • Shah AD, Denaxas S, Nicholas O, Hingorani AD, Hemingway H. Low eosinophil and low lymphocyte counts and the incidence of 12 cardiovascular diseases: a CALIBER cohort study. Open Heart. 2016;3(2):e000477.
  • Sanchez-Borges M, Caballero-Fonseca F, Capriles-Hulett A, Gonzalez-Aveledo L, Maurer M. Factors linked to disease severity and time to remission in patients with chronic spontaneous urticaria. J Eur Acad Dermatol Venereol. 2017;31(6):964-71.
  • Gregoriou S, Rigopoulos D, Katsambas A, Katsarou A, Papaioannou D, Gkouvi A, et al. Etiologic aspects and prognostic factors of patients with chronic urticaria: nonrandomized, prospective, descriptive study. J Cutan Med Surg. 2009;13(4):198-203.
  • Marin-Cabanas I, Berbegal-de Gracia L, de Leon-Marrero F, Hispan P, Silvestre JF. Management of Chronic Spontaneous Urticaria in Routine Clinical Practice Following the EAACI/GA(2)LEN/EDF/WAO Guidelines. Actas Dermosifiliogr. 2017;108(4):346-53.
  • Curto-Barredo L, Archilla LR, Vives GR, Pujol RM, Gimenez-Arnau AM. Clinical Features of Chronic Spontaneous Urticaria that Predict Disease Prognosis and Refractoriness to Standard Treatment. Acta Derm Venereol. 2018;98(7):641-7.
  • Woo YR, Jung KE, Koo DW, Lee JS. Vitamin D as a Marker for Disease Severity in Chronic Urticaria and Its Possible Role in Pathogenesis. Ann Dermatol. 2015;27(4):423-30.
  • Rasool R, Masoodi KZ, Shera IA, Yosuf Q, Bhat IA, Qasim I, et al. Chronic urticaria merits serum vitamin D evaluation and supplementation; a randomized case control study. World Allergy Organ J. 2015;8(1):15.
  • Movahedi M, Tavakol M, Hirbod-Mobarakeh A, Gharagozlou M, Aghamohammadi A, Tavakol Z, et al. Vitamin D deficiency in chronic idiopathic urticaria. Iran J Allergy Asthma Immunol. 2015;14(2):222-7.
  • Kozel MM, Mekkes JR, Bossuyt PM, Bos JD. Natural course of physical and chronic urticaria and angioedema in 220 patients. J Am Acad Dermatol. 2001;45(3):387-91.
  • Kumar YH, Bhaskar S, Shankar K. Comparative Study of Positive Versus Negative Autologous Serum Skin Test in Chronic Spontaneous Urticaria and its Treatment Outcome. N Am J Med Sci. 2016;8(1):25-30.
  • Huilan Z, Bihua L, Runxiang L, Jiayan L, Luyang L, Zhenjie L. Features of Antihistamine-Resistant Chronic Urticaria and Chronic Urticaria During Exacerbation. Indian J Dermatol. 2015;60(3):323.
  • Staubach P, Onnen K, Vonend A, Metz M, Siebenhaar F, Tschentscher I, et al. Autologous whole blood injections to patients with chronic urticaria and a positive autologous serum skin test: a placebo-controlled trial. Dermatology. 2006;212(2):150-9.
  • Kolkhir P, Church MK, Altrichter S, Skov PS, Hawro T, Frischbutter S, et al. Eosinopenia, in Chronic Spontaneous Urticaria, Is Associated with High Disease Activity, Autoimmunity, and Poor Response to Treatment. J Allergy Clin Immunol Pract. 2020;8(1):318-25 e5.
  • Kessel A, Helou W, Bamberger E, Sabo E, Nusem D, Panassof J, et al. Elevated serum total IgE--a potential marker for severe chronic urticaria. Int Arch Allergy Immunol. 2010;153(3):288-93.
  • de Montjoye L, Darrigade AS, Gimenez-Arnau A, Herman A, Dumoutier L, Baeck M. Correlations between disease activity, autoimmunity and biological parameters in patients with chronic spontaneous urticaria. Eur Ann Allergy Clin Immunol. 2020.
Toplam 26 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Klinik Tıp Bilimleri
Bölüm Makaleler
Yazarlar

Güzin Özden 0000-0003-4856-2267

Deniz Çetinkünar Bu kişi benim 0000-0002-2212-9214

Ayşe Turan 0000-0002-0745-4975

Yayımlanma Tarihi 31 Ağustos 2020
Kabul Tarihi 30 Ağustos 2020
Yayımlandığı Sayı Yıl 2020 Cilt: 3 Sayı: 2

Kaynak Göster

APA Özden, G., Çetinkünar, D., & Turan, A. (2020). Kronik Ürtikerli Hastalarda Basamak Tedavisine Yanıt ve Prognostik Faktörler: Retrospektif Çalışma. Journal of Cukurova Anesthesia and Surgical Sciences, 3(2), 94-104.
https://dergipark.org.tr/tr/download/journal-file/11303