Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0848237 (acute stress)
 4,619 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Studies report that urticarial dermographism is exacerbated by "life events" and emotions. The aim of this study was to determine what aspects of life quality are affected by symptomatic dermographism and whether acute stress is a potential triggering factor. A total of 21 adult patients with urticarial dermographism completed a questionnaire on symptoms and quality of life. Twelve patients agreed to enrol in the study, which involved provocation by prick test and dermographism before and after a standardized psychosocial stress test (Trier Social Stress Test). Seventeen age-matched controls underwent corresponding tests. Of the patients answering the questionnaire, 43% reported that their disease had an impact on their quality of life and 33% that psychosocial stress precipitated the symptoms. However, the dermographic reaction in patients with urticaria factitia was not significantly intensified after the stress test. We conclude that the acute psychosocial stress test does not alter the magnitude of the dermographic reactions.
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PMID:Urticarial dermographism: clinical features and response to psychosocial stress. 1798 86

A 45-year-old woman with marital and working troubles, a personal history positive for malignant melanoma, and a family history of vitiligo presented with adrenergic urticaria (AU), which at first responded to propranolol, but later became unresponsive to both ?-blockers and antihistamines. Meanwhile, rheumatoid arthritis became apparent. Treatment with corticosteroids and methotrexate led to remission of neither the rheumatologic nor the dermatologic condition. Attempts to taper the immunosuppressive treatment were invariably followed by recurrence of adrenergic urticaria, which still proved unresponsive to propranolol, as did the rheumatoid arthritis. The courses of the diseases strictly paralleled each other. Rheumatoid arthritis could have triggered adrenergic urticaria by simply adding a supplemental stress, but also by systemically activating mast cells, which are known to be involved in the pathogenesis of chronic inflammatory diseases. A brief discussion of either the dermatological manifestations of, or treatments for rheumatoid arthritis is provided, in order to illustrate the kind of clinical difficulties that such atypical patients pose to physicians. Adrenergic urticaria is an uncommon yet probably under-diagnosed form of urticaria, which is considered a form of neurogenic acute reaction mainly triggered by acute stress. The author presents a case of AU, however, that is only partially explained by a stress setting, though it is strongly associated with the course of an autoimmune disease.
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PMID:Adrenergic urticaria and rheumatoid arthritis in a patient with melanoma: an intricate medical management. 2239 95