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Allergy. 2016 Mar;71(3):308-22. doi: 10.1111/all.12818. Epub 2015 Dec 28.

Chronic spontaneous urticaria and internal parasites - a systematic review.

Author information

  • 1Department of Dermatology and Venereology, Sechenov First Moscow State Medical University, Moscow, Russia.
  • 2Department of Dermatology and Allergology, University Hospital of Aachen, Aachen, Germany.
  • 3Department of Dermatology and Allergy, Charit√©-Universit√§tsmedizin Berlin, Berlin, Germany.

Abstract

Chronic spontaneous urticaria (CSU) is defined as persistent wheals, angioedema, or both lasting for >6 weeks due to known or unknown causes. Some epidemiological studies and case reports suggest that internal parasite infections (PI) can cause CSU. Here, we provide a systematic overview of published findings on the prevalence and relevance of PI in CSU and we discuss possible pathomechanisms. The prevalence of PI in CSU was investigated by 39 independent studies and comorbidity reportedly ranged from 0 to 75.4% (two-thirds of these studies reported infection rates of 10% or less). The prevalence of PI in adult and pediatric CSU patients ranged from 0% to 75.4% and from 0% to 37.8%, respectively. CSU patients were more often diagnosed with protozoa and had a significantly higher risk of toxocariasis seropositivity and Anisakis simplex sensitization when compared to healthy controls. Patients with chronic urticaria more frequently had seropositivity of fasciolosis, Anisakis simplex sensitization, and the presence of Blastocystis hominis allele 34 (ST3) as compared with control subjects. In 21 studies, efficacy of treatment with antiparasitic drugs ranged from 0 to 100% (35.7% of 269 CSU patients benefitted). In 9 (42.8%) of 21 studies, more than 50% of efficacy was observed. The reported rate of urticaria comorbidity in PI patients in 18 independent studies is 1-66.7%. Urticaria including CSU might be a quite common symptom of strongyloidiasis and blastocystosis. Pathogenic mechanisms in CSU due to PI may include specific IgE, Th2 cytokine skewing, eosinophils, activation of the complement, and the coagulation systems.

© 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

KEYWORDS:

chronic spontaneous urticaria; parasites; pathogenesis; prevalence

PMID:
26648083
[PubMed - in process]

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