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C‐reactive protein is linked to disease activity, impact, and response to treatment in patients with chronic spontaneous urticaria
Author(s) -
Kolkhir P.,
Altrichter S.,
Hawro T.,
Maurer M.
Publication year - 2018
Publication title -
allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.363
H-Index - 173
eISSN - 1398-9995
pISSN - 0105-4538
DOI - 10.1111/all.13352
Subject(s) - medicine , c reactive protein , angioedema , gastroenterology , fibrinogen , acute phase protein , inflammation , immunology
Background Elevated levels of C‐reactive protein ( CRP ), a sensitive marker of inflammation, have been consistently reported in chronic spontaneous urticaria (CSU). Here, we retrospectively analyzed data from 1253 CSU patients from 2 centers to answer the following questions: (i) What is the prevalence of elevated levels of CRP in CSU ? (ii) Why do CSU patients show elevated levels of CRP ? (iii) Are elevated CRP levels relevant? Methods Serum levels of CRP were measured by the nephelometric method. We collected information regarding various laboratory tests including ESR , CBC with differential, D‐dimer, fibrinogen, C3, C4, IL ‐6, etc. For most patients, we also collected data on age, gender, duration of CSU , presence of angioedema, activity ( UAS at the time of blood sampling and for 7 days), quality of life ( CU ‐Q2oL and/or DLQI ), comorbidities and possible causes of CSU , and autologous serum skin test ( ASST ) response. The efficacy of second‐generation antihistamines was evaluated on the day of blood collecting. Results One‐third of CSU patients had elevated levels of CRP . Higher levels of CRP were associated with ASST positivity ( P = .009) and arterial hypertension ( P = .005), but not with other possible causes or comorbidities of CSU . C‐reactive protein correlated with urticaria activity ( P < .001), quality of life impairment ( P = .026), and inflammatory and coagulation markers ( P < .001). C‐reactive protein levels were significantly higher in nonresponders to antihistamines as compared to responders ( P < .001). Conclusion Elevated levels of CRP are common and relevant in CSU patients. The assessment of CRP levels may help to optimize the management of patients with CSU .