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Table 2 Supporting references by body system

From: Is chronic urticaria more than skin deep?

Body system

Reference number

Type of report

Key content

Respiratory

[11]

Prospective study

Pulmonary function tests revealed that 22/26 of CSU patients had asthma or abnormal bronchial reactivity

[12]

Prospective study

Bronchial hyperreactivity was present in 13/30 of cholinergic urticaria patients which was higher than CSU patients and healthy controls

[13]

Prospective study

Dermographism patients exhibited increase in airway resistance and a decrease in specific airway conductance

[10]

Case report

Authors reported two CU patients in whom urticaria onset was associated with the simultaneous appearance of asthmatic symptoms

Gastrointestinal system

[14]

Prospective study

Forty-four percent of 330 CU patients described abdominal problems mainly gastritis

[16]

Prospective study

After duodenal histamine challenge, 5 of 7 CU patients showed systemic symptoms including diarrhoea and in 6 of 7 histopathological examination revealed ultrastructural changes in the duodenal tissue

[17]

Prospective study

Mast cell numbers were significantly increased in the stomach and duodenum of CU patients even if they did not have GIS symptoms

[21]

Prospective study

Gastroduodenal and intestinal permeability were significantly increased in patients with CU

[22]

Case report

A patient with cholinergic urticaria and erythematous pangastritis, whose severe dyspeptic complaints did not resolve with proton pump inhibitors but did with omalizumab

[23]

Case report

Transient hepatocellular injury including elevation of liver enzymes and hepatosplenomegaly during cholinergic urticaria attacks

Cardiovascular system

[39]

Prospective study

Hypertension is associated with extended duration of CIU

[38]

Retrospective study

CIU patients had a 1.37-fold greater risk of developing hypertension than the non-CIU cohort

[33,34,35,36,37]

Case report

The authors described Kounis syndrome resulting from acute urticaria, chronic urticaria, autoimmune urticaria and cold urticaria

Central nervous system

[42]

Prospective study

By using multiple-modality brain imaging tools, the authors demonstrated dysfunction of the striatum in CSU patients

[43]

Prospective study

Authors demonstrated the altered cerebellar activity and cerebellum-reward-sensorimotor loops in CSU

[40]

Case report

Authors described a patient with cholinergic urticaria associated with epileptic seizures and abnormalities on the encephalogram

[41]

Case report

Authors reported a patient with an unusual form of migraine with urticarial lesions appearing at the end of each migraine attack

Musculoskeletal system

[47]

Retrospective study

1035 (8.7%) patients with CU were diagnosed with osteoporosis compared with 4046 (6.8%) controls. The adjusted multivariate analysis demonstrated that CU was significantly associated with a higher risk for osteoporosis (HR = 1.23, 95% CI 1.10–1.37, P < 0.001)

[44]

Case series

Authors reported four cases with urticaria, angioedema, articular manifestations and HLA-B51 positivity

[45]

Case series

Authors described 9 patients with angioedema, hives and arthritis which they referred as AHA syndrome

[46]

Case report

Authors described a patient whose CU was associated with autoimmune thyroid disease and both CU and arthralgia responded to treatment with l-thyroxine

  1. The references are ranked according to evidence quality
  2. CU chronic urticaria, CIU chronic idiopathic urticaria, CSU chronic spontaneous urticaria