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)

In many countries, increasing rates of skin eruptions are attributed to non-steroidal anti-inflammatory drugs (NSAIDs). They are usually mild, and life-threatening reactions such as Stevens-Johnson Syndrome (SJS) or toxic epidermal necrolysis (TEN) are rare. The commonest reactions are pruritus, morbilliform rashes, urticaria and photosensitivity. Urticaria is most frequent in salicylate-sensitive patients, and photosensitivity--a real clinical problem with benoxaprofen--is mainly a phototoxic reaction, predictable from preclinical studies. Other skin reactions are unusual although purpura and cutaneous vasculitis have been attributed to NSAIDs. The main concern is bullous drug reactions--erythema multiforme (EM), SJS and TEN. Whilst EM and SJS have many other causes besides drugs, most cases of TEN are drug-induced. NSAIDs have played an increasing role in the aetiology of TEN and it may be that drugs with a longer serum half-life carry higher risk, especially when administered to patients for infectious complaints who have a predisposing genetic background (HLA-B12). In pre- and post-marketing studies of a new drug, careful attention must be paid to the nature of side-effects, as a high rate of mild reactions belonging to the EM spectrum may be indicative of higher risks of SJS and TEN.
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PMID:Clinical aspects of skin reactions to NSAIDs. 296 Oct 55

Recent studies suggest that autoimmune mechanisms may be involved in the etiology of chronic idiopathic urticaria (CIU). There is a higher prevalence of B12 deficiency in autoimmune diseases and possibly in gastric Helicobacter pylori (H. pylori) infection. The frequency of B12 deficiency in CIU is unknown. Our objective in this study was to determine the prevalence of B12 deficiency in patients with CIU and also its relationship to gastric H. pylori infection and serologic markers of autoimmunity in these groups. Thirty-three patients with CIU and 27 healthy controls were included in the study. Serum vitamin B12 levels, H. pylori infection and serological markers of autoimmunity (anti-thyroglobulin, thyroid microsomal, gastric parietal cell and antinuclear autoantibodies) were investigated. H. pylori infection was determined according to serology and gastric biopsy in 19 patients, serology and urea breath test in 4 patients and serology alone in the remaining 10 patients. Serum B12 levels were below the normal reference range in 11/33 (33.3%) patients with CIU. The mean serum B12 levels among patients with CIU and the controls were 281+/-127.5 pg/ml and 465.1+/-140.3 pg/ml (p=0.0001), respectively. Anti-thyroid antibodies were positive in 6 of 11 patients (54.5%) with low B12 levels, but only in 4 of 27 (14.8%) healthy controls (p=0.019). Anti-GPC antibodies were positive in 4 of 11 (36.4%) patients with CIU and low B12 levels, but only in 2 of 27 (7.4%) healthy controls (p=0.047). In CIU patients, there was no difference in the frequency of IgG H. pylori antibodies between those with low B12 levels and normal B12 levels. Among the 19 patients who had been performed gastric endoscopy, 15 patients (78.9%) had chronic antral gastritis, 2 patients (10.5%) had atrophic gastritis and there were normal findings in 2 patients (10.5%). In conclusion, serum B12 levels were found to be below the normal reference range in 33% of the patients with CIU. An association between low B12 levels and H. pylori could not be shown. The higher frequency of antithyroid and anti-GPC antibodies in patients with low B12 levels suggest that low B12 levels in CIU may be autoimmune in nature.
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PMID:Low B12 levels in chronic idiopathic urticaria. 1573 14

Celiac disease, or gluten-sensitive enteropathy, is an immune-mediated disease of the small bowel that results in malabsorption. It classically presents with gastrointestinal symptoms including chronic diarrhea, weight loss, abdominal bloating and anorexia. It is becoming more frequently identified in asymptomatic patients with a diagnosis of deficiencies related to malabsorption of iron, folic acid, vitamin B12 and vitamin D. It is increasingly identified as a cause for early or refractory osteoporosis. Occasionally, celiac disease presents with cutaneous manifestations alone. Dermatitis herpetiformis is a well-recognized cutaneous manifestation of celiac disease. Other cutaneous manifestations include alopecia, angular stomatitis and aphthous ulcerations. Described here is a case of a 24-year-old woman who presented with intermittent urticaria and gastrointestinal complaints. She was found to have celiac disease on small-bowel biopsy. Both her gastrointestinal symptoms and urticaria resolved when she was put on a gluten-free diet, suggesting that her urticaria was a cutaneous manifestation of celiac disease.
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PMID:Chronic urticaria: a cutaneous manifestation of celiac disease. 1660 61

Previous reports have suggested a possible role for vitamin D in the etiology of chronic spontaneous urticaria (CSU); however, little information is available regarding the role of other micronutrients. We, therefore, analyzed vitamin D, vitamin B12, and ferritin levels in CSU patients (n = 282) from a preexisting database at Southampton General Hospital. Data were compared against mean micronutrient levels of the general population of the UK, obtained from the National Diet and Nutrition Survey. Vitamin D levels of CSU patients were found to be higher than those of the general UK population (P = 0.001). B12 levels were lower in patients with CSU (P < 0.001) than in the general population. Ferritin levels were found to be lower in male CSU patients than in the general male population (P = 0.009). This association between low B12 and iron levels and CSU might indicate a causal link, with micronutrient replacement as a potential therapeutic option.
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PMID:Association between Micronutrient Levels and Chronic Spontaneous Urticaria. 2657 42