Urticaria (Hives) and Angioedema

Mitchell R. Lester
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Testing in Chronic Urticaria and Angioedema
Because most CU are idiopathic, most patients require no laboratory investigation. If the history or review of systems suggest any of the conditions in Table 1, an underlying systemic disease, or the hives and angioedema have atypical features testing should be directed towards the suspected condition. Of great importance, without a suggestive history of IgE-mediated trigger, testing for specific IgE is not indicated. Despite the lack of sensitivity of routine testing in CU without atypical features, many patients are not satisfied unless some testing is done. In those instances, many experts recommend screening with a CBC, ESR, LFTs, and TSH with any abnormal results being followed up as clinically indicated.

As noted above, about 1/3 of CIU patients have IgG autoantibodies to the a-subunit of FceR1. The utility of detecting the antibody has not been established because it does not affect treatment or outcome. Therefore, use of autologous serum skin tests or in vitro tests for basophil histamine release, basophil activation markers, or for the antibody itself are not currently recommended.


References
Urticaria (Hives) and Angioedema Urticaria (Hives) and Angioedema 4/4/2016
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