Frequency and Characteristics of Systemic Complaints Among Chronic Idiopathic/Spontaneous Urticaria Patients
Monday, March 7, 2016
South Exhibit Hall H (Convention Center)
Judy Doong, BS, Eric Oliver, MD, Sarbjit S. Saini, MD FAAAAI
Rationale: Chronic idiopathic/spontaneous urticaria (CIU/CSU) patients can report systemic complaints (SC) that are also seen in primary mast cell disorders. We sought to determine the frequency and characteristics of SC among CIU/CSU patients and their association with other disease measures, basophil histamine release profiles, and serum tryptase.

Methods: CIU/CSU patients were recruited from allergy clinics. Subjects completed a disease symptom survey and venipuncture. Blood basophils were isolated and histamine release was measured after polyclonal goat anti-human IgE stimulation. In addition, a serum sample was stored for later tryptase analysis.

Results: A total of 155 CIU/CSU subjects were surveyed, with 103 reporting SC with concomitant hives as follows: joints pain or swelling (36.8%), headache/fatigue (31.6%), flushing (28.4%), wheezing (20%), gastrointestinal complaints (17.4%), and palpitations (6.5%). Three or more SC were noted by 30.1% of SC subjects. Subjects with SC were compared with subjects lacking systemic complaints (NSC). Both groups had similar demographic profile (average age in 40s, majority female, and Caucasian), use of anti-histamines, and basophil histamine release profiles. The SC group, compared to NSC group, had significantly greater disease duration (53% SC vs 30.8% NSC had >4 years duration), emergency department visits (16.5% vs 0% >3 visits in the last year), CIU-related work absences (23% vs 3.9% >7 days), use of oral corticosteroids (84.5% vs 59.6%), and quality-of-life (QoL) impairment (76 vs 59 SkinDex Score).

Conclusions: Despite similar demographics with NSC subjects, CIU/CSU patients with SC have features consistent with greater disease burden (work absences, ER visits, and corticosteroid use), and QoL impairment.