RESOLUTION OF CHRONIC URTICARIA IN PATIENTS WITH THYROID AUTOIMMUNITY

Background: Autoimmune disease has been implicated as a cause of chron ic urticaria, and anti-thyroid antibodies have been found in patients with chronic urticaria. Because some patients with chronic urticaria a nd autoimmune hypothyroidism have had clinical resolution with thyroid hormone replacement, we investigated the effect of thyroid hormone in euthyroid patients with chronic urticaria and thyroid autoimmunity. M ethods: Ten euthyroid patients with refractory hives were treated with thyroxine. Seven patients had elevated anti-thyroid antibodies at bas eline. Thyroid function anti-microsomal and anti-thyroglobulin antibod y levels were monitored during treatment. If a clinical response was a chieved, thyroxine was discontinued and restarted if symptoms recurred . Results: Seven patients with elevated anti-thyroid antibodies report ed resolution of symptoms within 4 weeks. Three patients without eleva ted anti-thyroid antibodies did not respond. Five patients had a recur rence of symptoms after treatment was stopped, which resolved after tr eatment was restarted. Thyroid-stimulating hormone levels decreased in all patients with a clinical response. No correlation between clinica l resolution and anti-thyroid antibody levels was seen. Conclusion: Th yroid autoimmunity in euthyroid patients may be associated with chroni c urticaria, and treatment with thyroid suppression can result in clin ical remission.