Current features of diagnosing the autoimmune type of chronic spontaneous urticaria in clinical practice

Burygina EV, Kozlova YI, Frolova EV, et al. . Current features of diagnosing the autoimmune type of chronic spontaneous urticaria in clinical practice. Russian Journal of Clinical Dermatology and Venereology. 2023;22(2):186‑191. (In Russ.)
https://doi.org/10.17116/klinderma202322021186

Подписка 2025-2 (Russian Journal of Clinical Dermatology and Venereology)

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BACKGROUND

Chronic spontaneous urticaria (CSU) is a condition with heterogeneous immunopathogenic mechanisms. Identifying the autoimmune type of CSU is necessary for choosing proper therapeutic tactics.

OBJECTIVE

To evaluate the use of basophil activation test in clinical practice to diagnose the autoimmune type of CSU.

MATERIALS AND METHODS

The study included 125 patients with CSU aged 18 to 75 years (median 42 years); 72.8% were females. All patients were evaluated for urticaria activity using the UAS7 score and thyroid function; eosinophil and basophil counts and total IgE were determined in peripheral blood, an intradermal test with autologous serum test and an indirect basophil activation test (BAT) was performed using flow cytometry.

RESULTS

A positive BAT result was obtained in 43 (34.4%) patients with CSU. There was a higher activity of urticaria in BAT(+) patients vs. BAT(–) ones (p=0.031), angioedema (p=0.012), and hypothyroidism (p=0.002) were also more common in BAT(+) patients. There were lower eosinophil (p=0.027) and basophil (p=0.026) counts and total blood IgE (p<0.001), and a higher level of antibodies to thyroid peroxidase (p=0.004).

CONCLUSION

The inclusion of indirect BAT in the algorithm of examination of patients with CSU enables identifying cases with an autoimmune type of disease in clinical practice.

Keywords:

chronic spontaneous urticaria

autoimmune urticaria

basophil activation test

autologous serum test

flow cytometry

Authors:

Burygina E.V.

North-Western State Medical University named after I.I. Mechnikov

ORCID: 0000-0002-9307-4927

Kozlova Y.I.

North-Western State Medical University named after I.I. Mechnikov

ORCID: 0000-0002-4602-2438

Frolova E.V.

Mechnikov North-Western State Medical University

SPIN RSCI: 1212-0030
Scopus AuthorID: 37037140300
ResearcherID: O-4134-2014
ORCID: 0000-0002-5569-5175

Uchevatkina A.E.

North-Western State Medical University named after I.I. Mechnikov

ORCID: 0000-0001-6688-7781

Aak O.V.

North-Western State Medical University named after I.I. Mechnikov

ORCID: 0000-0001-8130-7503

Filippova L.V.

North-Western State Medical University named after I.I. Mechnikov

ORCID: 0000-0003-4167-7440

Melnikova A.V.

North-Western State Medical University named after I.I. Mechnikov

Raznatovsky K.I.

North-Western State Medical University named after I.I. Mechnikov

ORCID: 0000-0003-1022-7463

Vasilyeva N.V.

Mechnikov North-Western State Medical University

ORCID: 0000-0002-3700-6743

Klimko N.N.

North-Western State Medical University named after I.I. Mechnikov

ORCID: 0000-0001-6095-7531

Received:

18.06.2022

Accepted:

16.03.2023

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