A site dedicated to support and research to those with Chronic Urticaria (hives)and their families.
Tuesday, January 13, 2009
What testing is available?
Please post in the COMMENTS AREA any new testing that becomes available and be specific on the "type" of urticaria you have. If there is a broken link to the information I have posted please let me know.
ESR test: Elevated eosinophil count or ESR may suggest allergic causes. Antinuclear antibodies and thyroid studies, including thyroid autoantibodies, may be obtained if clinically indicated. Testing for low serum C4 is a sensitive but nonspecific screen for C1 esterase inhibitor deficiency. Skin biopsy should be done if there is any uncertainty as to the diagnosis or if wheals persist > 24 h (to rule out urticarial vasculitis). Skin testing for allergy may be considered.
TSH levels for Thyroid? Allergy test? See an Allergist or Immunologist The Autologous Serum Skin Test Lupus? You should ask your doctor to check your blood (lab tests)for the levels and function of specific blood cells and proteins.
Mastocytosis testing and diagnosis: Blood tests Bone marrow biopsies with aspirate flow cytometry Bone scans Careful evaluation of response to treatment Radiologic scans Skin biopsies
Food skin testing, if required. Stop all concomitant medications that can be stopped safely; Measure thyroid functions, including the presence of antithyroid peroxidase and thyroglobulin antibody titers (22% of CIUs are associated with Hashimoto's thyroiditis);
Obtain a complete blood cell count (CBC) and erythrocyte sedimentation rate (ESR);
India uses less expensive patch testing for diagnosing chronic urticaria and article on this type of testing is: http://www.ijdvl.com/article.asp?issn=0378-6323;year=2008;volume=74;issue=2;spage=114;epage=117;aulast=Sharma
KEYSTONE, COLO. -- A new in vitro diagnostic assay that detects antibodies responsible for about 40% of chronic idiopathic urticaria is now available, Dr. Mark Boguniewicz said at a meeting on allergy/clinical immunology, asthma, and pulmonary medicine.
The test detects upregulation of CD203c, an ectoenzyme expressed only on basophils, mast cells, and CD34-positive progenitor cells in peripheral blood as a marker of cell activation, said Dr. Boguniewicz, a pediatric allergist and immunologist at National Jewish Medical and Research Center, Denver, which sponsored the meeting. Quote from article titled New Assay takes the sting out of chronic urticaria. Website where article is located is: http://www.highbeam.com/doc/1G1-162510720.html
TESTING AUTOIMMUNE DISEASE USING FLOW CYTOMETRY TO MEASURE CD63 AND MOST RECENTLY CD203C. The association between chronic urticaria (CU) and autoimmune disease has been recognized for some time, especially with autoimmune thyroid disease. More recently, functional IgG autoantibodies against FcepsilonRIalpha and less commonly against IgE have been reported in a subset of patients with CU. These patients have been described as having more severe and difficult-to-control urticaria. The autologous serum skin test has been proposed as a surrogate test to define presence of these autoantibodies, although it identifies presence of histamine releasing factor, not necessarily antibody. Basophil histamine release and basophil activation assays using flow cytometry to measure CD63 and, more recently, CD203c expression have been used to identify patients with autoimmune urticaria. New research suggests that in some patients with CU, the activation of the extrinsic coagulation pathway with thrombin generation might play an important role in their CU.
Lyme disease and urticaria. Abstract no: 990500354
Urticarial vasculitis and Lyme disease source: Journal of the American Academy of Dermatology vol. 22 Number 6, Part 1, June 1990, page 1114-1116 author: Judyann Olson M.D., Nancy B. Esterly
"Erythema chronicum migrans (ECM) is the classic skin lesion of Lyme disease, a multisystem disease caused by the spirochete Borrelia burgdorferi. Other cutaneous manifestations of Lyme disease include localized and generalized urticaria, generalized macular eruptions, malar erythema in febrile patients, and septal panniculitis. We describe a child with urticarial vasculitis as the presenting feature of Lyme disease.........in endemic areas a diagnosis of Lyme disease should be considered in patients with a clinical or histologic urticarial vasculitis, because it is a potentially treatable condition." ____________________
from: Lyme Disease and Its Neurological Complications author Michael F. Finkle, MD source: Archives of Neurol--Vol. 45, Jan 1986 Lyme Disease and Urticaria
St Johns Institute of Dermatology, St Thomas' Hospital, London, UK. mwatsong@hotmail.com
Chronic urticaria is an umbrella term, which encompasses physical urticarias, chronic "idiopathic" urticaria and urticarial vasculitis. It is important to recognize patients with physical urticarias as the investigation and treatment differs in important ways from patients with idiopathic chronic urticaria or urticarial vasculitis. Although relatively uncommon, urticarial vasculitis is an important diagnosis to make and requires histological confirmation by biopsy. Underlying systemic disease and systemic involvement, especially of the kidneys, should be sought. It is now recognized that chronic "idiopathic" urticaria includes a subset with an autoimmune basis caused by circulating autoantibodies against the high affinity IgE receptor (FceR1) and less commonly against IgE. Although the autologous serum skin test has been proven useful in prompting search for and characterization of circulating wheal-producing factors in chronic urticaria, its specificity as a screening test for presence of functional anti-FceR1 is low, and confirmation by demonstration of histamine-releasing activity in the patient's serum must be the benchmark test in establishing this diagnosis. Improved screening tests are being sought; for example, ability of the chronic urticaria patient's serum to evoke expression of CD 203c on donor human basophils is showing some promise. The strong association between autoimmune thyroid disease and autoimmune urticaria is also an area of ongoing research. Drug treatment continues to be centered on the H1 antihistamines, and the newer second-generation compounds appear to be safe and effective even in off-label dosage. Use of systemic steroids should be confined to special circumstances such as tapering regimens for acute flare-ups. Use of leukotriene antagonists is becoming popular, but the evidence for efficacy is conflicting. Cyclosporin is also effective and can be used in selected cases of autoimmune urticaria, and it is also effective in non-autoimmune cases, although less so.
See survey below! But to see the full list of all chronic urticaria go back to the main page. http://urticariaresearch.blogspot.com/ to post or comment in areas like: your health history,Things we should know about your urticaria, diet and other information.
What type of Urticaria have you been diagnosed with?
How Often ?
How are you feeling about your condition?
Have you been sucessful in finding treatment for your Urticaria?
What type of doctor have you seen?
What lab tests have you had?
Previous history of being diagnosed with Nephritis (kidney ) infection?
Have you been hospitalized for an infection in the past?
Muscle/Joint/Jaw/Neck Pain?
Dental problems/abcess/root canals?
NEW QUESTION Contact lens developing crystals?
Digestive issues?
Any issues after receiving childhood immunizations?
Food sensitivity/?
Had a significant vision change through the years?
MRI Brain/Angioma?
Don't forget to post "your" information!!
This site is dedicated to my husband who has battled chronic urticaria for over 29 years. For more information on your type of urticaria please click on this link http://urticariaresearch.blogspot.com/ to go back to the main page and review areas DOWN THE PAGE which include: WE NEED YOUR IMPUT TO LEARN MORE ABOUT THIS CONDITION! *Your Medical history before and after chronic urticaria *Things we should know about your urticaria *Need prayer *Does location play a part? *Do you have a question? *What are your symptoms and triggers? Together we can find a cure!
ESR test:
ReplyDeleteElevated eosinophil count or ESR may suggest allergic causes. Antinuclear antibodies and thyroid studies, including thyroid autoantibodies, may be obtained if clinically indicated. Testing for low serum C4 is a sensitive but nonspecific screen for C1 esterase inhibitor deficiency. Skin biopsy should be done if there is any uncertainty as to the diagnosis or if wheals persist > 24 h (to rule out urticarial vasculitis). Skin testing for allergy may be considered.
TSH levels for Thyroid?
ReplyDeleteAllergy test? See an Allergist or Immunologist
The Autologous Serum Skin Test
Lupus?
You should ask your doctor to check your blood (lab tests)for the levels and function of specific blood cells and proteins.
If anyone has knowledge of what type of testing is required to determine a deficiency of the C1 inhibitor protein?
ReplyDeleteMastocytosis testing and diagnosis:
ReplyDeleteBlood tests
Bone marrow biopsies with aspirate flow cytometry
Bone scans
Careful evaluation of response to treatment
Radiologic scans
Skin biopsies
Idiopathic Urticaria Testing:
ReplyDeleteFood skin testing, if required.
Stop all concomitant medications that can be stopped safely;
Measure thyroid functions, including the presence of antithyroid peroxidase and thyroglobulin antibody titers (22% of CIUs are associated with Hashimoto's thyroiditis);
Obtain a complete blood cell count (CBC) and erythrocyte sedimentation rate (ESR);
chest x-ray if appropriate
India uses less expensive patch testing for diagnosing chronic urticaria and article on this type of testing is: http://www.ijdvl.com/article.asp?issn=0378-6323;year=2008;volume=74;issue=2;spage=114;epage=117;aulast=Sharma
ReplyDeleteKEYSTONE, COLO. -- A new in vitro diagnostic assay that detects antibodies responsible for about 40% of chronic idiopathic urticaria is now available, Dr. Mark Boguniewicz said at a meeting on allergy/clinical immunology, asthma, and pulmonary medicine.
ReplyDeleteThe test detects upregulation of CD203c, an ectoenzyme expressed only on basophils, mast cells, and CD34-positive progenitor cells in peripheral blood as a marker of cell activation, said Dr. Boguniewicz, a pediatric allergist and immunologist at National Jewish Medical and Research Center, Denver, which sponsored the meeting. Quote from article titled New Assay takes the sting out of chronic urticaria. Website where article is located is: http://www.highbeam.com/doc/1G1-162510720.html
TESTING AUTOIMMUNE DISEASE USING FLOW CYTOMETRY TO MEASURE CD63 AND MOST RECENTLY CD203C.
ReplyDeleteThe association between chronic urticaria (CU) and autoimmune disease has been recognized for some time, especially with autoimmune thyroid disease. More recently, functional IgG autoantibodies against FcepsilonRIalpha and less commonly against IgE have been reported in a subset of patients with CU. These patients have been described as having more severe and difficult-to-control urticaria. The autologous serum skin test has been proposed as a surrogate test to define presence of these autoantibodies, although it identifies presence of histamine releasing factor, not necessarily antibody. Basophil histamine release and basophil activation assays using flow cytometry to measure CD63 and, more recently, CD203c expression have been used to identify patients with autoimmune urticaria. New research suggests that in some patients with CU, the activation of the extrinsic coagulation pathway with thrombin generation might play an important role in their CU.
Chronic Hives, Rashes Associated with Bacteria, Autoimmunity: Antibiotics or Thyroid Drugs May Be an Effective Treatment for Urticaria by Mary J. Shomon
ReplyDeleteBACK TO CHRONIC URTICARIA RESEARCH MAIN PAGE
ReplyDeleteLyme disease and urticaria.
ReplyDeleteAbstract no: 990500354
Urticarial vasculitis and Lyme disease
source: Journal of the American Academy of Dermatology vol. 22 Number 6,
Part
1, June 1990, page 1114-1116
author: Judyann Olson M.D., Nancy B. Esterly
"Erythema chronicum migrans (ECM) is the classic skin lesion of Lyme
disease, a multisystem disease caused by the spirochete Borrelia burgdorferi.
Other cutaneous manifestations of Lyme disease include localized and
generalized urticaria, generalized macular eruptions, malar erythema in
febrile
patients, and septal panniculitis. We describe a child with urticarial
vasculitis as the presenting feature of Lyme disease.........in endemic areas
a
diagnosis of Lyme disease should be considered in patients with a clinical or
histologic urticarial vasculitis, because it is a potentially treatable
condition."
____________________
from: Lyme Disease and Its Neurological Complications
author Michael F. Finkle, MD
source: Archives of Neurol--Vol. 45, Jan 1986
Lyme Disease and Urticaria
St Johns Institute of Dermatology, St Thomas' Hospital, London, UK. mwatsong@hotmail.com
ReplyDeleteChronic urticaria is an umbrella term, which encompasses physical urticarias, chronic "idiopathic" urticaria and urticarial vasculitis. It is important to recognize patients with physical urticarias as the investigation and treatment differs in important ways from patients with idiopathic chronic urticaria or urticarial vasculitis. Although relatively uncommon, urticarial vasculitis is an important diagnosis to make and requires histological confirmation by biopsy. Underlying systemic disease and systemic involvement, especially of the kidneys, should be sought. It is now recognized that chronic "idiopathic" urticaria includes a subset with an autoimmune basis caused by circulating autoantibodies against the high affinity IgE receptor (FceR1) and less commonly against IgE. Although the autologous serum skin test has been proven useful in prompting search for and characterization of circulating wheal-producing factors in chronic urticaria, its specificity as a screening test for presence of functional anti-FceR1 is low, and confirmation by demonstration of histamine-releasing activity in the patient's serum must be the benchmark test in establishing this diagnosis. Improved screening tests are being sought; for example, ability of the chronic urticaria patient's serum to evoke expression of CD 203c on donor human basophils is showing some promise. The strong association between autoimmune thyroid disease and autoimmune urticaria is also an area of ongoing research. Drug treatment continues to be centered on the H1 antihistamines, and the newer second-generation compounds appear to be safe and effective even in off-label dosage. Use of systemic steroids should be confined to special circumstances such as tapering regimens for acute flare-ups. Use of leukotriene antagonists is becoming popular, but the evidence for efficacy is conflicting. Cyclosporin is also effective and can be used in selected cases of autoimmune urticaria, and it is also effective in non-autoimmune cases, although less so.