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European Annals of Allergy and Clinical Immunology ISSN 1764-1489

© 2024

Contents »

Histamine-release test in angioedema patients without urticaria - a retrospective cohort study of 404 patients


G. Authried1 georg.authried@rsyd.dk, S.C. Prasad1, E. Rye Rasmussen2, A. Bygum3

Show more: Authors information and Publication history

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