Chronic Spontaneous Urticaria in Patients with Common Variable Immunodeficiency

Common variable immunodeficiency (CVID) is a predominantly antibody deficiency and is one of the most common primary immunodeficiencies in adulthood. Replacement therapy with Ig has significantly reduced infectious complications; however, malignant, autoimmune, and inflammatory diseases are still cu...

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Main Authors: Barbara Frossi, Riccardo De Carli, Marco De Carli
Format: Article
Language:English
Published: European Medical Journal 2018-12-01
Series:European Medical Journal
Subjects:
Online Access:https://www.emjreviews.com/dermatology/article/chronic-spontaneous-urticaria-in-patients-with-common-variable-immunodeficiency/
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author Barbara Frossi
Riccardo De Carli
Marco De Carli
author_facet Barbara Frossi
Riccardo De Carli
Marco De Carli
author_sort Barbara Frossi
collection DOAJ
description Common variable immunodeficiency (CVID) is a predominantly antibody deficiency and is one of the most common primary immunodeficiencies in adulthood. Replacement therapy with Ig has significantly reduced infectious complications; however, malignant, autoimmune, and inflammatory diseases are still current major causes of morbidity and mortality. In recent years, interest has increased regarding allergic manifestations that may be associated with primary immunodeficiencies; however, no data are currently available on chronic spontaneous urticaria (CSU). In this report, the authors describe CSU in patients with CVID attending their centre. Three CVID patients were affected by CSU and were unresponsive to antihistamines. Patients were screened for the presence of serum autoreactivity by an autologous serum skin test; only one patient was positive for serum autoreactivity. The serum of this patient was found to induce CD63 upregulation on basophils and degranulation of LAD2 mast cells. All patients were treated with omalizumab therapy at the standard dose of 300 mg every 4 weeks. The patient with autoreactive serum was the best responder to omalizumab therapy, whereas the other two patients experienced urticaria flares related to intercurrent infections. In this article, the authors describe the presence of CSU in patients with CVID for the first time. Although autoimmunity is a feature of CVID, autoreactivity was documented in one patient only, thus showing that CSU in patients with CVID reflects the heterogeneity of this immune defect.
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spelling doaj.art-83d91ff49d8c45a2a8a7016ec77845e92022-12-22T01:22:24ZengEuropean Medical JournalEuropean Medical Journal2397-67642018-12-013495102Chronic Spontaneous Urticaria in Patients with Common Variable Immunodeficiency Barbara Frossi0Riccardo De Carli1Marco De Carli2Department of Medicine, University of Udine, Udine, ItalyTumor Immunology Unit, Department of Health Sciences, University of Palermo, Palermo, ItalySecond Unit of Internal Medicine, Azienda Sanitaria Universitaria Integrata di Udine, Udine, ItalyCommon variable immunodeficiency (CVID) is a predominantly antibody deficiency and is one of the most common primary immunodeficiencies in adulthood. Replacement therapy with Ig has significantly reduced infectious complications; however, malignant, autoimmune, and inflammatory diseases are still current major causes of morbidity and mortality. In recent years, interest has increased regarding allergic manifestations that may be associated with primary immunodeficiencies; however, no data are currently available on chronic spontaneous urticaria (CSU). In this report, the authors describe CSU in patients with CVID attending their centre. Three CVID patients were affected by CSU and were unresponsive to antihistamines. Patients were screened for the presence of serum autoreactivity by an autologous serum skin test; only one patient was positive for serum autoreactivity. The serum of this patient was found to induce CD63 upregulation on basophils and degranulation of LAD2 mast cells. All patients were treated with omalizumab therapy at the standard dose of 300 mg every 4 weeks. The patient with autoreactive serum was the best responder to omalizumab therapy, whereas the other two patients experienced urticaria flares related to intercurrent infections. In this article, the authors describe the presence of CSU in patients with CVID for the first time. Although autoimmunity is a feature of CVID, autoreactivity was documented in one patient only, thus showing that CSU in patients with CVID reflects the heterogeneity of this immune defect.https://www.emjreviews.com/dermatology/article/chronic-spontaneous-urticaria-in-patients-with-common-variable-immunodeficiency/autoimmunityautologous serum skin test (asst)chronic spontaneous urticaria (csu)common variable immunodeficiency (cvid)cyclosporinemast cell (mc)omalizumabpredominantly antibody deficiencyprimary immunodeficiency (pid)
spellingShingle Barbara Frossi
Riccardo De Carli
Marco De Carli
Chronic Spontaneous Urticaria in Patients with Common Variable Immunodeficiency
European Medical Journal
autoimmunity
autologous serum skin test (asst)
chronic spontaneous urticaria (csu)
common variable immunodeficiency (cvid)
cyclosporine
mast cell (mc)
omalizumab
predominantly antibody deficiency
primary immunodeficiency (pid)
title Chronic Spontaneous Urticaria in Patients with Common Variable Immunodeficiency
title_full Chronic Spontaneous Urticaria in Patients with Common Variable Immunodeficiency
title_fullStr Chronic Spontaneous Urticaria in Patients with Common Variable Immunodeficiency
title_full_unstemmed Chronic Spontaneous Urticaria in Patients with Common Variable Immunodeficiency
title_short Chronic Spontaneous Urticaria in Patients with Common Variable Immunodeficiency
title_sort chronic spontaneous urticaria in patients with common variable immunodeficiency
topic autoimmunity
autologous serum skin test (asst)
chronic spontaneous urticaria (csu)
common variable immunodeficiency (cvid)
cyclosporine
mast cell (mc)
omalizumab
predominantly antibody deficiency
primary immunodeficiency (pid)
url https://www.emjreviews.com/dermatology/article/chronic-spontaneous-urticaria-in-patients-with-common-variable-immunodeficiency/
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