Doi
https://doi.org/10.23822/EurAnnACI.1764-1489.58
Summary
A subset of patients with angioedema (AE) and urticaria has histamine releasing autoantibodies. The histamine release test (HR-test) has been used as a tool in chronic urticaria to define the autoimmune subgroup and may possibly guide the clinician to a more personalized therapy, like omalizumab and cyclosporine. The prevalence and value of positive hista-mine releasing autoantibodies in monosymptomatic AE is sparsely described in the literature. The purpose of this study was to report the prevalence of positive histamine releasing autoantibodies in a cohort of patients with recurrent AE and evaluate the usefulness of this test in AE patients. We performed a retrospective cohort study of 612 patients referred due to AE between 1995 and 2013. HR-test results were available in 404 patients. In the sub-group of patients with AE and urticaria, 17.3% had a positive HR-test but only 4.3% of patients with mono-symptomatic AE had a positive HR-test. No statistically significant treatment benefits of anti-histamines, corticosteroids or adrenaline were found comparing patients with angioedema +/- urticaria based on the result of the HR-test (negative / positive). Thus, the HR-test result cannot be used as predictor of the efficacy of anti-allergic treatment.
Key words
monosymptomatic angioedema; histamine-release test; urticaria; antihistamines; corticosteroids; adrenaline