Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0042109 (urticaria)
 6,569 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Paroxystic vasomotor skin manifestations are provoked by various etiologies. Widespread or generalized vasomotor skin manifestations may be induced by a physiological reaction (emotinal flushing), by a drug (vasodilator drugs, antabuse, antidiabetic, sulfonamides), by a discharge of histamine (urticaria, mastocytosis) or by an hypersecretion of serotonin (dumping-syndrome, carcinoid syndrome). They may be caused by an endocrinopathy (menopause, hyperthyroidism, hypoglycaemia, medullary thyroid carcinoma, pheochromocytoma, endocrine pancreas, carcinoma). More rarely vasomotor troubles happen in homocystinuria, inhalation of a toxic (trichlorethylen, calcic cyanamid) and exceptionally in some immunohaematologic diseases. Main localized vasomotor skin manifestations observed are dermographism, facial flushing (Sluder's syndrome, cluster headaches, Frey's syndrome, Riley-Day's syndrome) and acral syndromes (Raynaud's phenomenon, erythromelalgia).
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PMID:[Paroxystic vasomotor skin manifestations (author's transl)]. 8 21

The presenting features of 236 thyrotoxic patients seen in the thyroid clinic were reviewed. 18.65% of these patterns had one or more dermatological complaints at presentation. There was no specific difference in this group of patients when compared with the general hyperthyroid population with regard to age, race, sex, duration of hyperthyroidism or biochemical indices of thyrotoxicosis. The two major complaints were itching and alopecia. The prevalence of pruritus at 6.4% in our series was identical to that of other workers, but we had a much lower occurrence of alopecia at 2.6%. The diagnosis of thyrotoxicosis was delayed in two patients in whom the only major complaint was pruritus. These symptoms cleared quickly when these patients became euthyroid. However there were other patients who noted hair loss with anti-thyroid medications. The incidence of vitiligo, eczema, onycholysis in our series was much lower those quoted in the Western literature The occurrence of pretibial myoxoedema in our series is similar to that of other workers from this region. The other miscellaneous manifestations include urticaria, xanthelasma and systemic lupus erythematosis. In conclusion we feel the cutaneous manifestations of hyperthyroidism are common in our patients.
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PMID:The prevalence of skin manifestations in thyrotoxicosis--a retrospective study. 252 42

Hyperactivity of the sympathetic nervous system produces many of the skin changes of hyperthyroidism, while the hypometabolic state and the accumulation of mucopolysaccharides in the dermis are responsible for hypothyroid cutaneous manifestations. Acropachy, atopic eczema, localized myxedema and nail changes are associated with thyrotoxicosis. Vitiligo may be seen in all three thyroid diseases of autoimmune origin. Hyperpigmentation, pruritus and urticaria are associated with hyperthyroidism.
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PMID:Cutaneous signs of thyroid disease. 376 64

Hormones of the thyroid gland (thyroxine, tri-iodothyronine) control the metabolism of cells and tissue of the body, while parathormone and calcitonine are balancing the intra- and extracellular levels of calcium and phosphorus by governing some metabolic functions of bones, kidney and small intestine. Growth, maturation and metabolic homeostasis of the organism depend, among other intrinsic factors, on a normal production and secretory rate of both thyroidal and parathyroidal hormones. Clinical conditions of hyperthyroidism induce 1. increased metabolic turnover of the body with transcutaneous heat loss, 2. disordered growth of hairs and nails, 3. hyperpigmentation of skin, 4. pruritus with or without urticaria. Pretibial (usually symmetrical) myxedema may be associated with conditions of either hyper- or hypothyroidism (e.g., Hashimoto's thyroiditis); if combined with bilateral exophthalmus and acropachyderma of fingers and toes, it is called Diamond syndrome, or E.M.O. syndrome. In hypothyroidism, the skin feels chilly and dry, looks pale, and may present follicular keratoses with or without secondary eczema. The hair appears dull and sparse due to disordered anagen phase. Skin wounds heal with delay. Diffuse myxedema originates in the papillary and periadnexal connective tissue and eventually extends to the dermis as a whole. Clinical conditions of hyperparathyroidism rarely cause secondary calcification of the skin; they may induce severe pruritus, particularly in secondary hyperparathyroidism due to renal failure. Impetigo herpetiformis or generalized pustular psoriasis, resp., may be set off by excessive surgical removal of the goiter. Congenital maldevelopment of both thymus and parathyroid gland leads to cellular immune deficiency with secondary chronic muco-cutaneous candidosis.
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PMID:[The thyroid gland, the parathyroid gland and the skin]. 648 58

The prevalence of thyroid autoimmunity is high in patients with chronic idiopathic urticaria (CIU), but in few selected patients the possible clinical benefit of levothyroxine sodium or antithyroid drugs has been studied. The objective of the present study was to confirm the prevalence of antithyroid antibodies in patients with CIU and to investigate the clinical response to levothyroxine sodium or methimazole. Antithyroglobulin and antiperoxidase antibodies were measured in 170 consecutive patients with CIU. Twenty-five (14.7%) had an antithyroglobulin or antiperoxidase antibody levels > 180 lU/ml and all but three were women. Twenty patients with CIU and thyroid autoimmunity were treated with levothyroxine sodium if hypothyroidism or normal thyroid function were present (18 patients) and with methimazole if hyperthyroidism was detected (two patients). Clinical response was evaluated by a clinical score. Autologous serum skin test before treatment was performed in 18 patients with thyroid autoantibodies. Urticaria resolved rapidly in two patients with Graves' disease. The clinical response of urticaria to levothyroxine sodium treatment was good in 15 patients and partial in two, whereas only one patient showed no improvement in clinical score (p < 0.0005). No changes in the antithyroglobulin or antiperoxidase levels were detected. Five patients reported adverse effects. The autologous serum skin test was positive in 10 patients and negative in eight. After successful treatment the test was repeated in six patients, proving negative in four and significantly diminished in two. We concluded that patients with CIU and thyroid autoimmunity benefit from treatment with levothyroxine sodium or antithyroid drugs. Antithyroid antibodies and positive autologous serum skin test in these patients could be markers of autoimmune disease with several target organs.
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PMID:Successful treatment of chronic idiopathic urticaria associated with thyroid autoimmunity. 1120 34

That a subset of patients with chronic idiopathic urticaria possesses functional autoantibodies against the high affinity IgE receptor, or less commonly, IgE, is widely accepted. That these same autoantibodies are causative of chronic urticaria is highly probable, but not entirely proven, since no animal model of chronic urticaria has been devised using these autoantibodies. However we know that intradermal injection of anti-FceR1 IgG in healthy volunteers does cause an urticarial reaction. The concept of chronic urticaria as a disease caused by autoantibodies activating the normal function of target cells (mast cells) by combination with a receptor epitope is intriguing, although not entirely unique, since a similar mechanism appears to underlie some types of autoimmune hyperthyroidism. The detection of patients with these antibodies is usually not possible by clinical assessment alone. Unfortunately no convenient or reliable immunoassays have been developed to detect the autoantibodies, and the gold standard remains the basophil mediator release assay, using normal human donor basophils or a basophil leukemia cell line. The autologous serum skin test has proved to be a useful screening test for autoimmune urticaria. Identification of patients with autoimmune urticaria is of some importance because, apart from obviating the necessity for irrelevant tests, immunotherapy, using cyclosporin, intravenous immunoglobulin or even plasmapheresis can be contemplated in severely affected treatment-resistant patients.
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PMID:Autoimmune urticaria. 1222 62

The association between thyroid autoimmunity and chronic idiopathic urticaria has long been recognized, although prevalence rates differ in the studies reported to date (from 12 to 29%). There is, therefore, a strong indication to screen patients affected by chronic urticaria of unknown origin for thyroid antibodies (antithyroperoxidase and antithyroglobulin) and, when positive, for serum thyrotropin to assess thyroid functional status. Less clear is the implication of thyroid autoimmunity for therapy, as most patients with urticaria who have associated thyroid autoimmunity are euthyroid. There is no doubt that cases with clinical or subclinical thyroid dysfunction should undergo treatment with either levothyroxine or antithyroid drugs for hypo- or hyper-function, respectively. Although the best remission rates for symptoms of urticaria have so far been obtained with levothyroxine in patients who are euthyroid, monitoring of thyroid function through serum thyrotropin determination is highly recommended because of the risk of hyperthyroidism, especially in the elderly.
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PMID:Thyroid autoimmunity in chronic idiopathic urticaria: implications for therapy. 1235 53

One hundred Thai patients with chronic idiopathic urticaria (CIU) were studied to determine the prevalence of thyroid antibodies in comparison to 100 age- and sex-matched healthy volunteers. It was found that 21 patients (21%) with CIU were positive for thyroid antibodies. Among normal volunteers, only nine cases (9%) had elevated titers of thyroid antibodies. The frequency of thyroid antibodies in the chronic urticaria group was significantly more common than the control group (chi-square = 4.75, p=0.03). Among 21 patients with CIU who were positive for thyroid antibodies, 9 cases were negative for thyroid antibodies when repeating the tests after 3 months. Only 12 patients still had persistent elevation of antibodies after 3 months and thyroid function test was performed in these 12 patients. It was found that 9 cases had autoimmune thyroiditis with euthyroidism. One case had subclinical hyperthyroidism. One case had autoimmune hyperthyroidism, One case had subclinical hypothyroidism.
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PMID:Prevalence of thyroid antibodies in Thai patients with chronic idiopathic urticaria. 1240 11

Methimazole, carbimazole, and propylthiouracil (PTU) are the mainstays of antithyroid drug therapy. Adverse effects of these drugs have been documented in less than 15% of patients undergoing treatment for hyperthyroidism. Common problems include fever, skin rash, urticaria, arthralgias, and arthritis. Vasculitis associated with antineutrophil anticytoplasmic antibodies (ANCA) has been reported on several occasions following treatment with PTU. However, vasculitis rarely appears to be associated with carbimazole. We report the clinical history of a woman with a necrotizing glomerulonephritis and pulmonary hemorrhage associated with carbimazole therapy.
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PMID:Necrotizing glomerulonephritis and pulmonary hemorrhage associated with carbimazole therapy. 1642 41

Propylthiouracil (PTU) is usually the first choice for the treatment of hyperthyroidism, but it has serious side effects such as hepatitis, cholestatic jaundice, splenomegaly and lupus-like syndrome, in addition to mild and common side effects like granulocytopenia, pruritus, urticaria and maculopapular or papular eruption. Antineutrophil cytoplasmic antibody (ANCA)-positive vasculitis is another serious side effect. A 14-year-old female receiving PTU treatment for hyperthyroidism was referred to our clinic with fever, cough and dyspnea. The PTU dosage was first decreased but pericardial, dermal and joint involvement ascribed to PTU developed later and the drug was discontinued. ANCA-positive vasculitis due to PTU was considered when tests revealed an ANCA-positive state. We suggest that severe multisystemic vasculitis due to PTU should be considered during PTU usage.
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PMID:Propylthiouracil-induced hypersensitivity syndrome. 1684 20


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