Autologous Serum Skin Test and Autologous Whole Blood Injections to Patients with Chronic Urticaria: A Retrospective Analysis

探討自體血清注射試驗及自體全血注射治療於慢性蕁麻疹病患中所扮演的角色：一個回顧性分析

曾德朋(Jonathan Te-Peng Tseng) ； 李婉若(Woan-Ruoh Lee) ； 林聖山(Sehng-Shan Lin) ； 許浚翃(Chun-Hung Hsu) ； 楊弘旭(Hung-Hsu Yang) ； 王國憲(Kuo-Hsien Wang) ； 蔡秀欣(Hsiou-Hsin Tsai) ； 蔡宗憲(Tsung-Hsien Tsai)

《中華皮膚科醫學雜誌》 27卷1期 (2009/03) Pp. 27-36

https://doi.org/10.29784/DS.200903.0003

摘要

Background: Chronic urticaria (CU) is defined as widespread short-lived (＜24 h) itching maculopapular skin lesions with or without angioedema for more than 6 weeks for which a predominant physical cause must be excluded. The autologous serum skin test (ASST) has been shown to result in immediate hypersensitivity-type skin reactions in a subpopulation of CU patients and autologous whole blood (AWB) injection has been used as one of treatment modalities.
Objective: To evaluate the relationship of a panel of laboratory examinations to the positivity of ASST and to evaluate the efficacy of AWB injection in the treatment of ASST (+) and ASST (-) CU patients.
Methods: A retrospective chart review was performed on CU patients who were subjected to ASST and received AWB injection therapy. We assessed the therapeutic effects of 8 weekly AWB injections in ASST (+) and ASST (-) CU patients by using urticaria activity score (UAS).
Results: Thiry-seven patients were analysed. There was no significant differences in number of patients, sex distribution, age, smoking vs. non-smoking, exacerbation of uricarial symptoms due to stress, and UAS between ASST (+) and ASST (-) CU patients at baseline. All patients presented normal complete blood count/differential count, and ANA. Anti-microsomal antibody was positive in 3/15 (20.0%) ASST (+) patients and in 2/22 (9.0%) ASST (-) patients (P=0.6). The 8-week course of AWB injection was well tolerated. ASST (+) patients, but not ASST (-) patients, showed significantly reduced CU activity.
Conclusion: 8 of the 9 ASST (+) patients with CU responded to treatment with AWB injection. Only 2 of the 8 ASST (-) patients showed response to the treatment. Others were having no effects or exacerbation of the urticarial symptoms. Further studies utilizing larger number of patients, longer follow-up periods, and different amount of autologous serum injection may better define the clinical efficacy of autologous serum injection for the treatment of chronic urticaria with positive ASST.

並列摘要

Background: Chronic urticaria (CU) is defined as widespread short-lived (＜24 h) itching maculopapular skin lesions with or without angioedema for more than 6 weeks for which a predominant physical cause must be excluded. The autologous serum skin test (ASST) has been shown to result in immediate hypersensitivity-type skin reactions in a subpopulation of CU patients and autologous whole blood (AWB) injection has been used as one of treatment modalities.
Objective: To evaluate the relationship of a panel of laboratory examinations to the positivity of ASST and to evaluate the efficacy of AWB injection in the treatment of ASST (+) and ASST (-) CU patients.
Methods: A retrospective chart review was performed on CU patients who were subjected to ASST and received AWB injection therapy. We assessed the therapeutic effects of 8 weekly AWB injections in ASST (+) and ASST (-) CU patients by using urticaria activity score (UAS).
Results: Thiry-seven patients were analysed. There was no significant differences in number of patients, sex distribution, age, smoking vs. non-smoking, exacerbation of uricarial symptoms due to stress, and UAS between ASST (+) and ASST (-) CU patients at baseline. All patients presented normal complete blood count/differential count, and ANA. Anti-microsomal antibody was positive in 3/15 (20.0%) ASST (+) patients and in 2/22 (9.0%) ASST (-) patients (P=0.6). The 8-week course of AWB injection was well tolerated. ASST (+) patients, but not ASST (-) patients, showed significantly reduced CU activity.
Conclusion: 8 of the 9 ASST (+) patients with CU responded to treatment with AWB injection. Only 2 of the 8 ASST (-) patients showed response to the treatment. Others were having no effects or exacerbation of the urticarial symptoms. Further studies utilizing larger number of patients, longer follow-up periods, and different amount of autologous serum injection may better define the clinical efficacy of autologous serum injection for the treatment of chronic urticaria with positive ASST.

並列關鍵字

Chronic urticaria ； Autologous serum skin test ； Autologous whole blood injection