Urticaria causes
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Anahita Deylamsalehi, M.D.[2]
Overview
Urticaria may be caused idiopathically or due to immunological disorders such as autoimmune diseases, food allergies, medications and specific infections. There are also some non-immunological causes for urticaria development, such as physical triggers, dietary pseudo-allergen and hereditary urticaria.
Causes
Common Causes
Common causes of urticaria may include:[1][2][3][4]
- Idiopathic
- Unknown etiology
- Immunological:
- Autoimmune: IgG autoantibodies to IgE receptor or IgE on mast cells could be the responsible mechanism.
- IgE/contact urticaria:
- Contact with allergen cross-links specific IgE (SIgE) on mast cells.
- Could be due to food protein antigens (such a mold or storage mite), insect venoms, animal dander's and/or saliva, penicillin, protease enzymes in biological detergents and latex proteins.
- In patients with urticaria due to latex allergy, there is a higher chance of a wide variety of food allergy due to cross-reactivity between the latex protein antigens and food antigens. The following list is a summary of foods capable of cross-reactivity with latex proteins:
The items: ❑ High frequency of cross-reactivity, such as avocado, banana and chestnut | |||||||||||||||||||||
- Food allergy:[1] [5]
- Studies suggest that foods such as nuts, seafood (such as shellfish), eggs (especially egg white), fish, meat, chocolate, cow’s milk, fruits (such as citrus fruits, plums, pineapples, grapes, apples, bananas, and strawberries), vegetables (such as tomatoes, peas, garlic, onion, beans, and carrot), mushrooms, fermented foods, spirits and spices are capable of causing urticaria.
- Although food allergy is known as a less common cause of adult urticaria, it is a common cause of urticaria in children. In a study done on adults with urticaria, 63% of patients suspected foods to be the reason of their symptoms, however food allergy was responsible for urticaria development in only 0.9% of them.
- medications:
- Sensitivity to Cyclo-oxygenase (COX)-inhibitors (aspirin, NSAIDs)
- Penicillin
- Thiazide diuretics
- Oral contraceptives
- Angiotensin-converting enzyme inhibitors
- Sulfonamides
- Vitamins
- Codeine and morphine
- Curare and its derivatives
- Synthetic adrenocorticotropic hormone
- Radiocontrast substances
- Acetylcysteine
- Aminohippurate
- Antimalarial drugs, such as atovaquone and proguanil hydrochloride or artemether and lumefantrin
- Aztreonam
- Benzphetamine
- Boceprevir
- Penciclovir
- Polidocanol
- Probenecid
- Carbinoxamine
- Cephalosporins, such as Cefoxitin sodium and Cefotaxime sodium
- Clobazam
- Dexamethasone and Prednisone
- Doxorubicin hydrochloride
- Lamivudine
- Dextran
- Caspofungin
- Oxaprozin
- Dapsone
- Idursulfase
- Tetracycline
- Tiagabine
- Tolbutamide
- Ferric Carboxymaltose
- Flavoxate
- Rifampin
- Pegademase
- Pegaspargase
- Streptomycin
- Indinavir and ritonavir
- Ivermectin
- Sulfamethoxazole/Trimethoprim (oral)
- Spironolactone
- Lidocaine (ointment)
- Lincomycin Hydrochloride
- Meropenem
- Niacin
- Nizatidine
- Von Willebrand factor
- Hepatitis B immunoglobulin
- Infections[4][6][7][8]
- Viral infections are the most common cause of acute urticaria, mainly upper respiratory tract infections, such as tonsillitis and rhinosinusitis. Prevalence of upper respiratory tract infections in acute urticaria has been estimated between 28 to 62%, based on reports of five studies.
- Urinary tract infections
- Parasitism
- Hepatitis
- Infectious mononucleosis
- Dental abscesses
- Helicobacter pylori infection
- Syphilis
- Lyme disease
- Varicella
- HIV infection
- Urticarial vasculitis[9]
- Food allergy:[1] [5]
- Non-immunological:
- Physical urticaria: Physical factors trigger histamine release from mast cells.
- Dietary pseudo-allergen:[1][10][11][4][9][12]
- Sensitivity to natural salicylates, colorings (both azo dyes and non-azo dyes), preservatives (such as sulphites, nitrates and nitrites), anti-oxidants (such as butylated hydroxyanisole (BHA) and butylated hydroxytoluene (BHT)) and aspartame (an artificial sweetener).
- Histamine poisoning is one of the non-IgE-mediated food-related urticaria, which occur when foods have high histamine content, such as improperly stored scombroid fish (such as mackerel, tuna and swordfish), with high level of decarboxylated histidine due to bacterial activities. Decarboxylated histidine then produces histamine. Although spoiled non-scombroid fish, such as herring, sardines and anchovies can also be responsible, due to high histamine content.
- Mold spores, pollen, mites, animal hair and dandruff and other respiratory allergens might cause urticaria through respiration. Furthermore, smoking is related to urticaria development.[4]
- Hereditary urticaria
- Medical conditions:
- Urticaria pigmentosa: Increased mast cell load
- Cryopyrin-associated periodic syndrome (CAPS): Due to a mutation in CIAS1 gene.
- Familial form of cold-induced urticaria[13]
- Mental disorders[14][4]
References
- ↑ 1.0 1.1 1.2 Deacock SJ (2008). "An approach to the patient with urticaria". Clin Exp Immunol. 153 (2): 151–61. doi:10.1111/j.1365-2249.2008.03693.x. PMC 2492902. PMID 18713139.
- ↑ Erben AM, Rodriguez JL, McCullough J, Ownby DR (1993). "Anaphylaxis after ingestion of beignets contaminated with Dermatophagoides farinae". J Allergy Clin Immunol. 92 (6): 846–9. doi:10.1016/0091-6749(93)90062-k. PMID 8258619.
- ↑ Beezhold DH, Sussman GL, Liss GM, Chang NS (1996). "Latex allergy can induce clinical reactions to specific foods". Clin Exp Allergy. 26 (4): 416–22. PMID 8732238.
- ↑ 4.0 4.1 4.2 4.3 4.4 Kayiran MA, Akdeniz N (2019). "Diagnosis and treatment of urticaria in primary care". North Clin Istanb. 6 (1): 93–99. doi:10.14744/nci.2018.75010. PMC 6526977 Check
|pmc=value (help). PMID 31180381. - ↑ Rajan JP, Simon RA, Bosso JV (2014). "Prevalence of sensitivity to food and drug additives in patients with chronic idiopathic urticaria". J Allergy Clin Immunol Pract. 2 (2): 168–71. doi:10.1016/j.jaip.2013.10.002. PMID 24607044.
- ↑ Wedi B, Kapp A (1999). "Helicobacter pylori infection and skin diseases". J Physiol Pharmacol. 50 (5): 753–76. PMID 10695557.
- ↑ Akashi R, Ishiguro N, Shimizu S, Kawashima M (2011). "Clinical study of the relationship between Helicobacter pylori and chronic urticaria and prurigo chronica multiformis: effectiveness of eradication therapy for Helicobacter pylori". J Dermatol. 38 (8): 761–6. doi:10.1111/j.1346-8138.2010.01106.x. PMID 21352335.
- ↑ Karaman U, Sener S, Calık S, Saşmaz S (2011). "[Investigation of microsporidia in patients with acute and chronic urticaria]". Mikrobiyol Bul. 45 (1): 168–73. PMID 21341171.
- ↑ 9.0 9.1 Zuberbier T (2003). "Urticaria". Allergy. 58 (12): 1224–34. doi:10.1046/j.1398-9995.2003.00327.x. PMID 14616095.
- ↑ Ros AM, Juhlin L, Michaëlsson G (1976). "A follow-up study of patients with recurrent urticaria and hypersensitivity to aspirin, benzoates and azo dyes". Br J Dermatol. 95 (1): 19–24. doi:10.1111/j.1365-2133.1976.tb15532.x. PMID 952737.
- ↑ Morrow JD, Margolies GR, Rowland J, Roberts LJ (1991). "Evidence that histamine is the causative toxin of scombroid-fish poisoning". N Engl J Med. 324 (11): 716–20. doi:10.1056/NEJM199103143241102. PMID 1997836.
- ↑ Zuberbier T, Iffländer J, Semmler C, Henz BM (1996). "Acute urticaria: clinical aspects and therapeutic responsiveness". Acta Derm Venereol. 76 (4): 295–7. doi:10.2340/0001555576295297. PMID 8869688.
- ↑ Soter NA, Joshi NP, Twarog FJ, Zeiger RS, Rothman PM, Colten HR (1977). "Delayed cold-induced urticaria: a dominantly inherited disorder". J Allergy Clin Immunol. 59 (4): 294–7. doi:10.1016/0091-6749(77)90050-1. PMID 66242.
- ↑ Staubach P, Dechene M, Metz M, Magerl M, Siebenhaar F, Weller K; et al. (2011). "High prevalence of mental disorders and emotional distress in patients with chronic spontaneous urticaria". Acta Derm Venereol. 91 (5): 557–61. doi:10.2340/00015555-1109. PMID 21597672.