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Severe CSU and activation of the coagulation/fibrinolysis system: clinical aspects


R. Asero r.asero@libero.it

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Doi
https://doi.org/10.23822/EurAnnACI.1764-1489.109

Abstract
Background. About 50% of patients with severe chronic spontaneous urticaria (CSU) show signs of activation of the coagulation/fibrinolysis system, but the clinical significance of this phenomenon is unclear. Objective. The present study compared patients with severe CSU showing and not showing elevated D-dimer plasma levels. Methods. 132 adult patients (m/f 44/88; mean age 51, 5 years; range 14 - 89 years) with severe CSU (UAS-7 > 30) were included in a cross-sectional, real life study. The study group was divided based on baseline D-dimer plasma levels, and compared for age, sex, disease duration, disease activity, CRP, thyroid autoimmunity, total IgE, and atopic status. Results. Identical numbers of patients showed elevated and normal D-dimer plasma levels (50% and 50%, respectively). Patients showing elevated D-dimer levels were slightly older (p < 0.05), were more frequently females (p < 0.05), had a longer disease duration (p < 0.01), and had a significantly higher prevalence of elevated PCR (26/66 vs 4/66; p < 0.001). Conclusions. Only 50% of patients with severe CSU show elevated D-dimer plasma levels. The activation of the coagulation/fibrinolysis system is associated with a systemic inflammatory milieu, suggesting the existence of a specific phenotype. Whether this reflects the existence of different endotypes in patients showing and not showing the activation of the coagulation cascade has still to be established.

Key words
chronic urticaria; D-dimer; coagulation

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