Refractory chronic spontaneous urticaria and permanent atrial fibrillation associated with dental infection: Mere coincidence or something more to it?. (March 2016)

• Record Type: Journal Article
• Authors: Kasperska-Zajac, Alicja; Grzanka, Alicja; Kowalczyk, Jacek; Wyszyńska-Chłap, Magdalena; Lisowska, Grażyna; Kasperski, Jacek; Jarząb, Jerzy; Misiołek, Maciej; Kalarus, Zbigniew
• Is Part Of: International journal of immunopathology and pharmacology. Volume 29:Number 1(2016)
• Page Start: 112
• Page End: 120
• Publication Date: 2016-03
• Subjects: atrial fibrillation -- chronic spontaneous urticaria -- C-reactive protein -- acute phase response -- dental infection -- inflammation of oral cavity; Immunopathology -- Periodicals; Pharmacology -- Periodicals; Inflammation -- Periodicals; 615.1
• DOI: 10.1177/0394632015617770
• Languages: English
• ISSNs: 0394-6320

Abstract

Controversy surrounds the role of dental infection/inflammation in the oral cavity in chronic spontaneous urticaria (CSU) and atrial fibrillation (AF), which is mainly due to scarce literature in this area. Therefore, this case report and review of literature illustrate a possible association between the acute-phase response (APR) and clinical conditions, such as CSU and dental infection/inflammation of oral cavity and AF. We describe a 36-year-old man with an 8-year history of difficult-to-treat, uncontrolled CSU, co-existent with dental infection/inflammatory processes of oral cavity and permanent atrial fibrillation (AF). In the presented case, the most likely triggering or aggravating/maintaining factor of the symptoms was the inflammation/dental infection of the oral cavity because of rapid reduction of the urticarial symptoms, drug doses, and serum CRP levels after the dental therapy. Dental treatment may have a beneficial effect on the systemic inflammatory response, reducing/normalizing the circulating levels of APR markers. APR activation appears to worsen CSU course, early identification and treatment of infectious/inflammatory foci in the oral cavity would form the mainstay of supportive therapy for CU probably through reduction of the systemic inflammatory burden. APR associated with infectious/inflammatory foci in the oral cavity could be taken into account as a predisposing agents to AF.