10 research outputs found
Acquired Cold Urticaria: Clinical Features, Particular Phenotypes, and Disease Course in a Tertiary Care Center Cohort
BACKGROUND: Data about special phenotypes, natural course, and prognostic variables of patients with acquired cold urticaria (ACU) are scarce.
OBJECTIVES: We sought to describe the clinical features and disease course of patients with ACU, with special attention paid to particular phenotypes, and to examine possible parameters that could predict the evolution of the disease.
METHODS: This study was a retrospective chart review of 74 patients with ACU who visited a tertiary referral center of urticaria between 2005 and 2015.
RESULTS: Fourteen patients (18.9%) presented with life-threatening reactions after cold exposure, and 21 (28.4%) showed negative results after cold stimulation tests (classified as atypical ACU). Nineteen patients (25.7%) achieved complete symptoms resolution at the end of the surveillance period and had no subsequent recurrences. Higher rates of atypical ACU along with a lower likelihood of achieving complete symptom resolution was observed in patients who had an onset of symptoms during childhood (P < .05). In patients with atypical ACU, shorter disease duration and lower doses of antihistamines required for achieving disease control were detected (P < .05). Age at disease onset, symptom severity, and cold urticaria threshold values were found to be related to disease evolution (P < .05).
LIMITATIONS: This study was limited by its retrospective nature.
CONCLUSIONS: The knowledge of the clinical predictors of the disease evolution along with the clinical features of ACU phenotypes would allow for the establishment of an early and proper therapeutic strategy
Temperature Thresholds in Assessment of the Clinical Course of Acquired Cold Contact Urticaria: A Prospective Observational One-year Study
Rupatadine 20 mg and 40 mg are Effective in Reducing the Symptoms of Chronic Cold Urticaria
Chronic cold urticaria (ColdU) is a rare disease characterized by mast cell-
mediated wheals and angioedema following cold exposure. Second-generation
H1-antihistamines, such as rupatadine, are the recommended first-line therapy.
As of yet, the effects of rupatadine up-dosing on development of ColdU symptom
have only been partially characterized. Two-centre, randomized, double-blind,
3-way crossover, placebo-controlled study in patients with a confirmed ColdU
was designed to assess the effects of up-dosing of rupatadine. A total of 23
patients were randomized to receive placebo, rupatadine 20 mg/day, and
rupatadine 40 mg/day for 1 week. The primary outcome was change in critical
temperature thresholds and critical stimulation time thresholds after
treatment. Secondary endpoints included assessment of safety and tolerability
of rupatadine. Both 20 and 40 mg rupatadine were highly effective in reducing
critical temperature thresholds (pâ<â0.001) and critical stimulation time
thresholds (pâ<â0.001). In conclusion, rupatadine 20 and 40 mg significantly
reduced the development of chronic cold urticaria symptom without an increase
in adverse effects
Doxepin in difficultâtoâtreat chronic urticaria: A retrospective, crossâsectional study from Turkey
Rituximab treatment of pemphigus foliaceus: A retrospective study of 12 patients
Pemphigus foliaceus (PF) is a
chronic autoimmune blistering disease caused
by pathogenic serum autoantibodies against
desmoglein 1. Initial treatments for PF include
systemic corticosteroids, immunosuppressants, and
dapsone.1 Rituximab, a chimeric monoclonal
antibody specific to the CD20 molecule on B cells,
was shown to be effective for severe and refractory
cases of pemphigus in a meta-analysis.2 The
researchers also tried to analyze the efficacy of this
treatment for PF, but the results were based on
heterogeneous case series and reports. Our aim
was to evaluate the clinical response to rituximab
in a series of patients with PF. This study has been
approved by our Institutional Review Board