Severe chronic urticaria is associated with elevated plasma levels of D‐dimer
- 4 January 2008
- Vol. 63 (2), 176-180
- https://doi.org/10.1111/j.1398-9995.2007.01514.x
Abstract
Background: Patients with chronic urticaria (CU) frequently show signs of thrombin generation as a result of the activation of the extrinsic pathway of coagulation and signs of fibrinolysis as shown by slightly increased mean D‐dimer plasma levels. Here, we studied patients with severe CU to see whether the activation of coagulation and fibrinolysis parallels the severity of the disease. Methods: Eight consecutive patients with severe exacerbations of CU and 13 with slight CU were studied. Plasma prothrombin fragment F1+2 as well as D‐dimer were measured by ELISA. Serum histamine‐releasing activity was assessed by basophil histamine release assay. Seventy‐four normal subjects were used as controls. Results: In patients with severe CU, median levels of both D‐dimer (11.20 nmol/l) and F1+2 (592 pmol/l) largely exceeded those found in patients with slight CU [D‐dimer: 2.66 nmol/l (P = 0.001) and F1+2: 228 pmol/l (P = 0.003)] and in normal subjects [D‐dimer: 1.41 nmol/l (P = 0.0001) and F1+2: 159 pmol/l (P = 0.0001)]. Sera from 25% of patients with severe CU and 31% of those with slight CU, but from none of normal subjects, showed in vitro histamine‐releasing activity. D‐dimer and F1+2 levels were significantly correlated each other (r = 0.64, P = 0.002) and with CU severity score (r = 0.80–0.90, P = 0.0001), but no correlation was observed between serum histamine‐releasing activity and coagulation parameters or severity score. Conclusions: Severe exacerbations of CU are associated with a strong activation of coagulation cascade and fibrinolysis. Whether this activation is the cause of CU or acts as an amplification system is still a matter of debate.Keywords
This publication has 18 references indexed in Scilit:
- Activation of the tissue factor pathway of blood coagulation in patients with chronic urticariaJournal of Allergy and Clinical Immunology, 2007
- Generation of C5a in the absence of C3: a new complement activation pathwayNature Medicine, 2006
- Plasma of patients with chronic urticaria shows signs of thrombin generation, and its intradermal injection causes wheal-and-flare reactions much more frequently than autologous serumJournal of Allergy and Clinical Immunology, 2006
- Chronic urticaria responding to subcutaneous heparin sodiumBritish Journal of Dermatology, 2005
- Thrombin-Induced Force Development in Vascular Endothelial Cells: Contribution to Alteration of Permeability Mediated by Calcium-Dependent and -Independent PathwaysJournal of Pharmacological Sciences, 2005
- The autologous serum skin test: a screening test for autoantibodies in chronic idiopathic urticariaBritish Journal of Dermatology, 1999
- Thrombin functions as an inflammatory mediator through activation of its receptor.The Journal of Experimental Medicine, 1996
- Autoantibodies against the High-Affinity IgE Receptor as a Cause of Histamine Release in Chronic UrticariaNew England Journal of Medicine, 1993
- Detection of circulating histamine releasing autoantibodies with functional properties of anti‐IgE in chronic urticariaClinical and Experimental Allergy, 1991
- Continuous Automatic Fluorometric Evaluation of Total Blood HistamineNature, 1967