Published: August 25, 2020
Chronic spontaneous urticaria (CSU) is a chronic disease characterized by wheals and pruritus and/or angioedema. CSU causes reduced quality of life (QoL), and many patients with CSU frequently suffer psychological problems such as depression, anxiety, and other psychosomatic conditions during the disease. Fatigue is a common and disabling symptom in chronic, and/or autoimmune, and/or allergic diseases including diabetes, rheumatoid arthritis, asthma, atopic dermatitis, and so on, and often ignored in daily practice. Although CSU is a chronic disease, fatigue has not yet been thoroughly evaluated in CSU.
In a recently published study in The Journal of Allergy and Clinical Immunology: In Practice, Erol et al. investigated fatigue and its drivers in patients with CSU. They evaluated patients with generic outcome measures such as Hospital Anxiety and Depression Scale and disease specific outcome measures such as Urticaria Activity Score, Urticaria Control Test, Chronic Urticaria- Quality of Life Questionnaire (CU-QoL) and evaluated fatigue with the Fatigue Severity Scale (FSS). They compared the results with healthy control group participants.
Erol et al., found nearly half of patients with CSU suffer from fatigue. This ratio is below one quarter in healthy subjects. Average FSS scores were higher in patients with CSU which indicates more severe fatigue than in healthy participants. The FSS scores were higher in female patients than in male ones, in obese patients than in normal weight patients, and in those who had anxiety and/or depression than those without. Another important result was that patients who had disturbed sleep because of nocturnal pruritus had more severe fatigue than those with normal sleep cycles. There were no significant associations between disease activity, disease control scores, and FSS in patients with CSU. A significant correlation was noted between total FSS scores and both Chronic Urticaria-QoL and Dermatology Life Quality Index in patients with CSU which indicate that fatigue is associated with impaired QoL.
Physicians who treat patients with CSU should talk about fatigue with their patients, especially females and/or patients with nocturnal pruritus.
The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.