Clinical evolution of patients with chronic spontaneous urticaria steroid-dependent.

RATIONALE: According to international consensus, exacerbations of chronic spontaneous urticaria (CSU) can be treated with oral corticosteroids (CS)during a short period of time. However, some patients with CSU use systemic CScontinuously for long periods. Continuous use of this drug is associated with more difficult clinical control of the disease and to CS-induced side effects.The aim of this study was to evaluate the clinical outcome of patients with CSUsteroid-dependent

METHODS: Retrospective analysis of electronic medical records of adult CSUsteroid-dependent patients referred to a tertiary service. Patients that were on systemic CS use for more than 6 months were included in this study.The time of CS use, CS-induced side effects and laboratory parameters (d-dimer and serum cortisol) were assessed

RESULTS: A total of 31 patients were included, with mean age of 45.6 years, of which 83.9% were female. The mean duration of CSU was 8.3 years, while the mean time of CS use was 5.1 years. Four patients (12.9%) developedhypogammaglobulinemia; 7 patients (22.6%), obesity; 3 patients (9.7%) presented ophthalmologic alterations (one patient, cataract and two, glaucoma) and two patients (6.5%) developed diabetes. Two patients presented two concomitant CS-induced side effects. The mean serum cortisol was 6.2 μg/dLand d-dimer, 1207.1 ng/mL

CONCLUSIONS: More than 40% of the patients with CSU do not respond to antihistamines and frequently long-term CS was prescribed inadequately to control the disease. CS-induced side effects were not uncommon, some of these were severe complications and this drug must be avoided for patients with CSU