Publications

Background and objective: Numerous autoimmune diseases (AIDs) have been linked to chronic spontaneous ur- ticaria (CSU). Here, we provide the first extensive and comprehensive evaluation of the prevalence of AIDs in pa- tients with CSU and vice versa.

Methods: A Pubmed and Google Scholar search was performed to identify studies reporting the prevalence of var- ious AIDs in CSU and vice versa published before April 2017.

Results: The prevalence of individual AIDs in CSU is increased (≥1% in most studies vs ≤1% in the general popula- tion). AIDs with relatively high prevalence in the general population are also quite common in CSU patients, whereas those with low prevalence remain a rare finding in CSU. The rates of comorbidity in most studies were ≥1% for insulin-dependent diabetes mellitus, rheumatoid arthritis (RA), psoriasis and celiac disease (CD), ≥ 2% for Graves’ disease, ≥ 3% for vitiligo, and ≥ 5% for pernicious anemia and Hashimoto’s thyroiditis. Organ-spe- cific AIDs are more prevalent in CSU than systemic (multiorgan or non organ-specific) AIDs. N 2% of CSU patients have autoimmune polyglandular syndromes encompassing autoimmune thyroid disease (ATD) and vitiligo or pernicious anemia. Antithyroid and antinuclear antibodies are the most prevalent AID-associated autoantibodies in CSU. N15% of CSU patients have a positive family history for AIDs. The prevalence of urticarial rash in AID pa- tients is N1% in most studies. This rash is more prevalent in eosinophilic granulomatosis with polyangiitis, ATD, systemic lupus erythematosus, RA and CD.

Conclusions: CSU patients have an increased risk of AIDs, especially adult female patients and those with a posi- tive family history and a genetic predisposition for AIDs, who should be screened for signs and symptoms of AIDs.