Clinicopathologic findings in (anti‐FcepsilonR1alpha) autoimmune‐related chronic urticaria. (27th March 2015) - Rojanapremsuk, Theera
Abstract Background One cause of chronic urticaria is autoreactivity which is diagnosed by detecting autoantibodies against the IgE receptor alpha subunit (anti‐Fc R1alpha). Objective To compare the histopathologic features of chronic urticaria patients testing positive for anti‐IgE receptor antibody (Ab) to those testing negative. Methods Totally, 438 patients with a clinical presentation of chronic urticaria (2011–2013) had anti‐IgE receptor Ab tested and 37 of those patients had skin biopsy. We evaluated microscopic features including: spongiosis, dermal edema, presence of mast cells, density of lymphocytic infiltration, predomination of eosinophils/neutrophils; intravascular neutrophils and presence of vasculitis. The aforementioned features were compared between negative and positive anti‐IgE receptor Ab groups. Results Of 37 patients, 69% were women and 31% were men. 49% had positive anti‐IgE receptor Ab and 51% had negative anti‐IgE receptor Ab. In the positive anti‐IgE receptor Ab group, 83% showed intravascular neutrophils. Eosinophil predominance was identified in 72% and neutrophil predominance was identified in 28%. In the negative anti‐IgE receptor Ab group, 89% showed intravascular neutrophils. Eosinophil predominance was identified in 53% and neutrophil predominance was identified in 47%. There was no evidence of vasculitis in either group. Conclusion There were no significant histopathologic differences between the anti‐IgE receptor Ab positive and negative cases. Therefore, serum testing for anti‐IgE receptor Ab is required to identify this subgroup of chronic urticaria patients.