SELECTED ARTICLES FROM THE RECENT LITERATURE 2006

12/18/06

Chronic urticaria in celiac disease

Summary
Background – There is a continuing investigation for possible association of chronic idiopathic urticaria (CIU) with systemic disorders, including putative autoimmune diseases.

Findings – Haussman and Sekar of the Ottawa Hospital described a 24 hour woman with CIU and G-I complaints compatible with a diagnosis of celiac disease (CD). An intestinal biopsy showed findings compatible with a diagnosis of CD. Both the G-I symptoms and CIU remitted on gluten-free diet.

Reference
Can J Gastroenterol 2006;20:291-3

Editor's Comments
Although I did not see evidence of investigation to be sure the patient did not have allergy to wheat or other grains she restricted from her diet, the clinical picture is compatible with CD-associated urticaria. Such an association has been reported recently in children with CD.

CD is now recognized to likely be an autoimmune disease with the presence of anti-endomysial antibodies (not mentioned in this report). In about 50% of CIU patients there is evidence of serum antibodies which bind to and activate skin mast cells. In 10-25% of CIU patients there are increased serum levels of anti-thyroid antibodies. Thus, autoimmunity may be playing a pathogenic role in a sizable percentage of cases of CD and CIU.

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