Resumo

GALASSI, N. et al. Chronic urticaria: Follow up, autologous serum skin test, basophil count and activation. Medicina (B. Aires) [online]. 2003, vol.63, n.1, pp.15-20. ISSN 0025-7680.

Recent advances on the pathogenesis of chronic urticaria have defined a group of patients with autoantibodies directed to the IgE or to the alpha chain of the Fc high affinity receptor of IgE, FceRIa. These antibodies are detected in vivo through the autologous serum test (AST) and in vitro with a variety of techniques. We here describe 37 patients with chronic urticaria, 28 female and 9 male, with a  f/m ratio of 3.1. Mean age at onset was 36.5 years (range 16-78). AST was positive in 25 (68%) of 37 patients. Serum induced a wheal significantly larger than plasma (122 ± 78 mm² vs 57 ± 66 mm², p<0.05). Median persistence of the chronic urticaria, estimated by Kaplan-Meyer analysis, was 437 days, with no difference between AST(+) and AST(-) patients (437 vs. 369, p=0.18). Mean IgE concentration was 157 ± 173 IU/mL, as expected in an unselected population.  Basophil count was lower in patients compared with controls (17 ± 12 cel/mL vs. 43 ± 27 cel/mL, p< 0.008). Only sera from 2/7(28.6%) patients AST (+) and very low basophil count consistently induced expression of CD63. This effect was abrogated in non-releasing basophils, confirming the presence of antibodies directed to the FceRIa-IgE . We conclude that functional antibodies are present in only a minority of patients and that their identification does not predict the outcome.

Palavras-chave : Chronic urticaria; Autoantibodies; Follow up.

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