Factores pronóstico asociados a la duración de la urticaria espontánea crónica en población colombiana

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Artículo de investigación
Rev Asoc Colomb Dermatol. 2013; 21: 2 (Abril-Junio), 124-132

Factores pronóstico asociados a la duración de la urticaria espontánea crónica en población colombiana

Prognostic factors associated with the duration of chronic spontaneous urticaria in a Colombian population
Autor(es): 
Sara Elizabeth Sus
sara.sus.carrizosa@hotmail.com
Médica, residente de Alergología Clínica, Universidad de Antioquia, Medellín, Colombia
María Nelly Restrepo
Médica, residente de Alergología Clínica, Universidad de Antioquia, Medellín, Colombia
Liliana María Tamayo
Médica dermatóloga, alergóloga clínica; docente de posgrado de Alergología Clínica, Universidad de Antioquia; docente de posgrado de Dermatología, Universidad Pontificia Bolivariana, Medellín, Colombia
Ricardo Cardona
. Médico, magíster en Inmunología, alergólogo clínico; docente de posgrado de Alergología, Universidad de Antioquia, Medellín, Colombia
Resumen: 

Introducción. No existen, hasta la fecha, marcadores clínicos o de laboratorio que permitan predecir la duración de la urticaria, con resultados reproducibles en los diferentes estudios realizados.

Objetivo. Explorar la asociación entre los factores de pronóstico y la duración de la urticaria espontánea crónica. Metodología. Es un estudio retrospectivo en el que se exploran los factores asociados a la duración de la urticaria espontánea crónica en la población remitida al Servicio de Alergología Clínica de la IPS universitaria de la Universidad de Antioquia.

Resultados. Se incluyeron 99 casos (67 mujeres y 32 hombres), con un promedio de edad de 40,3 años. El 71,7 % presentó prueba positiva de plasma y suero autólogo. El 17,2 % presentaba alteración tiroidea determinada por alteración de la tirotropina (TSH), presencia de anticuerpos antitiroideos o ambos. El 65,7 % recibía tratamiento con antihistamínicos H1, el 17,2 %, antihistamínico H1 más antagonista del receptor de leucotrienos, el 11,1 %, antihistamínicos H1 más antihistamínicos H2, y solo el 2 % recibió tratamiento con medicamento inmunomodulador. La duración de la enfermedad mayor de 60 meses se asoció con angioedema, otros tipos de urticaria, enfermedades alérgicas cutáneas y sexo femenino.

Conclusiones. En la exploración de los factores asociados a la duración, aunque las variables estudiadas no fueron estadísticamente significativas, se observaron diferencias mayores del 10 % que marcan una tendencia que pudiera ser significativa con un mayor tamaño de muestra, para las variables sexo femenino, presencia de angioedema, presencia de alergias en piel y la asociación con otros tipos de urticaria, lo cual concuerda con lo descrito en la literatura científica. La prueba de plasma y suero autólogo en nuestra cohorte no mostró tener ninguna asociación con la duración de la enfermedad.

Palabras clave: 
: urticaria, Angioedema, prueba cutánea, pronóstico, urticaria/tratamiento, enfermedades tiroideas.

Summary: 

Background: To date there are no clinical or laboratory markers to predict the duration of urticaria, with reproducible results among the different populations
studied.

Objective: To explore the association between prognostic factors and duration of spontaneous chronic urticaria.

Methodology: We performed a retrospective study that explored factors associated with the duration of spontaneous chronic urticaria, at the Servicio de
Alergología Clínica of the Universidad de Antioquia.

Results: Ninety nine cases (67 women, 32 men) were studied, with a mean age of 40.3 years. Seventy one percent of patients tested positive for autologous
serum-plasma skin test; 17.2% had thyroid impairment determined by TSH and/ or the presence of antithyroid antibodies; 65,7% received treatment with H1-
antihistamines, 17.2% H1-antihistamine and a leukotriene receptor antagonist, 11.1% H1-antihistamines plus H2-antihistamines, and only 2% were treated
with immunomodulatory drugs. The duration of the disease over 60 months was associated with angioedema, other types of urticaria, allergic skin diseases
and female gender.

Conclusions: After exploring the factors associated with the persistence of spontaneous chronic urticaria, although the variables studied showed no statistically significant differences, there were differences in percentages greater than 10% for the variables sex, presence of angioedema, presence of skin allergies and association with other types of urticaria, marking a trend that could be significant with a larger sample size. Our findings are consistent with those described in the literature. The autologous serum-plasma skin test did not have any association with the duration of spontaneous chronic urticaria in our cohort.

Key words: 
Urticaria, angioedema, skin test, prognosis, urticaria/ treatment, thyroid diseases.
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