Effect of Levothyroxine Treatment on Clinical Symptoms in Hypothyroid Patients with Chronic Urticaria and Thyroid Autoimmunity
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Background: Thyroid autoimmunity has been increasingly reported to be associated with chronic urticaria (CU), and the possible clinical benefit of thyroid hormone or anti-thyroid drugs in some CU patients with autoimmune thyroid disease has been studied. However, the effect of thyroid hormone or anti-thyroid drugs on clinical symptoms of CU remains unclear. Objective: We investigated the clinical response of urticaria to the treatment of thyroid dysfunction. Methods: Medical records of patients with CU evaluated for thyroid autoimmunity and thyroid function were collected and reviewed. Results: Of 184 patients with CU, 43 patients (23.4%) had thyroid autoantibodies and 26 patients (14.1%) had thyroid dysfunction. While none of the five patients with Graves’ disease showed any improvement of urticaria after treatment with anti-thyroid drugs, two of the 10 patients with Hashimoto’s thyroiditis showed improved urticaria after being treated with levothyroxine. Conclusion: Although levothyroxine treatment was effective in a minority of patients with CU, there may be a causal relationship between CU and thyroid autoimmunity.
Abstract
Background: Thyroid autoimmunity has been increasingly reported to be associated with chronic urticaria (CU), and the possible clinical benefit of thyroid hormone or anti-thyroid drugs in some CU patients with autoimmune thyroid disease has been studied. However, the effect of thyroid hormone or anti-thyroid drugs on clinical symptoms of CU remains unclear. Objective: We investigated the clinical response of urticaria to the treatment of thyroid dysfunction. Methods: Medical records of patients with CU evaluated for thyroid autoimmunity and thyroid function were collected and reviewed. Results: Of 184 patients with CU, 43 patients (23.4%) had thyroid autoantibodies and 26 patients (14.1%) had thyroid dysfunction. While none of the five patients with Graves’ disease showed any improvement of urticaria after treatment with anti-thyroid drugs, two of the 10 patients with Hashimoto’s thyroiditis showed improved urticaria after being treated with levothyroxine. Conclusion: Although levothyroxine treatment was effective in a minority of patients with CU, there may be a causal relationship between CU and thyroid autoimmunity.
참고문헌 (35)
- Champion RH., "Urticaria and angio-oedema. A review of 554 patients", Br J Dermatol, 81, pp.588~597 (1969)
- Öykü Marasoğlu Çelen, "Usefulness of the Autologous Serum Test for the Diagnosis of Chronic Idiopathic Urticaria", Annals of Dermatology, 26(5), pp.592~597 (2014), 대한피부과학회
- Grattan CE., "A serological mediator in chronic idiopathic urticaria--a clinical, immunological and histological evaluation", Br J Dermatol, 114, pp.583~590 (1986)
- Gruber BL., "Prevalence and functional role of anti-IgE autoantibodies in urticarial syndromes", J Invest Dermatol, 90, pp.213~217 (1988)
- Hide M., "Autoantibodies against the high-affinity IgE receptor as a cause of histamine release in chronic urticaria", N Engl J Med, 328, pp.1599~1604 (1993)
- Grattan CE., "Preliminary identification of a low molecular weight serological mediator in chronic idiopathic urticaria", Br J Dermatol, 119, pp.179~183 (1988)
- Ferrer M., "Comparative studies of functional and binding assays for IgG anti-Fc(epsilon)RIalpha(alpha-subunit)in chronic urticaria", J Allergy Clin Immunol, 101, pp.672~676 (1998)
- Stitt JM., "Urticaria and autoimmunity : where are we now?", Curr Allergy Asthma Rep, 13, pp.555~562 (2013)
- Fraser K., "Chronic urticaria and autoimmunity", Skin Therapy Lett, 18, pp.5~9 (2013)
- Feibelmann TC., "Assessment of association between autoimmune thyroid disease and chronic urticaria", Arq Bras Endocrinol Metabol, 51, pp.1077~1083 (2007)
- Palma-Carlos AG., "Chronic urticaria and thyroid auto-immunity", Eur Ann Allergy Clin Immunol, 37, pp.143~146 (2005)
- Kaplan AP., "Pathogenesis of chronic urticaria", Clin Exp Allergy, 39, pp.777~787 (2009)
- Mozena JD., "Lack of a role for cross-reacting anti-thyroid antibodies in chronic idiopathic urticaria", J Invest Dermatol, 130, pp.1860~1865 (2010)
- Rumbyrt JS., "Resolution of chronic urticaria in patients with thyroid autoimmunity", J Allergy Clin Immunol, 96, pp.901~905 (1995)
- Leznoff A., "Syndrome of idiopathic chronic urticaria and angioedema with thyroid autoimmunity : a study of 90 patients", J Allergy Clin Immunol, 84, pp.66~71 (1989)
- Gaig P., "Successful treatment of chronic idiopathic urticaria associated with thyroid autoimmunity", J Investig Allergol Clin Immunol, 10, pp.342~345 (2000)
- Cebeci F., "Association between chronic urticaria and thyroid autoimmunity", Eur J Dermatol, 16, pp.402~405 (2006)
- McLeod DS., "The incidence and prevalence of thyroid autoimmunity", Endocrine, 42, pp.252~265 (2012)
- Lee MS., "The prevalence of antithyroid autoantibodies in normal Korean population", Korean J Intern Med, 28, pp.491~498 (1985)
- Turktas I., "The association of chronic urticaria and angioedema with autoimmune thyroiditis", Int J Dermatol, 36, pp.187~190 (1997)
- Zauli D., "Thyroid autoimmunity in chronic idiopathic urticaria : implications for therapy", Am J Clin Dermatol, 3, pp.525~528 (2002)
- Kikuchi Y., "Antithyroid antibodies in chronic urticaria and angioedema", J Allergy Clin Immunol, 112, pp.218~ (2003)
- Verneuil L., "Association between chronic urticaria and thyroid autoimmunity : a prospective study involving 99 patients", Dermatology, 208, pp.98~103 (2004)
- 김재환, "두드러기 환자의 예후 인자로서 갑상선 자가항체의 효용성에 대한 연구", 대한피부과학회지, 49(10), pp.872~876 (2011), 대한피부과학회
- 이서영, "갑상선 자가항체와 만성 특발성 두드러기의 예후", Allergy Asthma & Respiratory Diseases, 1(2), pp.151~156 (2013), 대한 소아알레르기 호흡기학회
- Confino-Cohen R., "Chronic urticaria and autoimmunity : associations found in a large population study", J Allergy Clin Immunol, 129, pp.1307~1313 (2012)
- Chung JH., "Prevalence of thyrotoxicosis and hypothyroidism in the subjects for health check-up", J Korean Soc Endocrinol, 14, pp.301~313 (1999)
- Leznoff A., "Association of chronic urticaria and angioedema with thyroid autoimmunity", Arch Dermatol, 119, pp.636~640 (1983)
- Asero R., "Association of chronic urticaria with thyroid autoimmunity and Raynaud phenomenon with anticentromere antibodies", J Allergy Clin Immunol, 111, pp.1129~1130 (2003)
- Kandeel AA., "Evaluation of chronic urticaria in patients with Hashimoto thyroiditis", J Clin Immunol, 21, pp.335~347 (2001)
- Levy Y., "Chronic urticaria : association with thyroid autoimmunity", Arch Dis Child, 88, pp.517~519 (2003)
- Aversano M., "Improvement of chronic idiopathic urticaria with L-thyroxine : a new TSH role in immune response?", Allergy, 60, pp.489~493 (2005)
- Nuzzo V., "Idiopathic chronic urticaria and thyroid autoimmunity : Experience of a single center", Dermatoendocrinol, 3, pp.255~258 (2011)
- Gulec M., "Chronic urticaria in patients with autoimmune thyroiditis : significance of severity of thyroid gland inflammation", Indian J Dermatol Venereol Leprol, 77, pp.477~482 (2011)
- Bagnasco M., "Urticaria and thyroid autoimmunity", Thyroid, 21, pp.401~410 (2011)