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Coagulation, fibrinolysis may play role in chronic urticaria pathogenesis

Evidence suggests that coagulation, fibrinolysis and accompanying systems have a role in chronic urticaria pathogenesis and that evaluating their biomarkers may aid in disease management, according to a review article published in Allergy.

“In particular, the level of D-dimer in plasma correlates with disease severity, and, although studies have been carried out only on few patients, it has been found that it returns to normal values during remission,” Alberto Tedeschi, MD, of the Unità Operativa di Allergologia e Immunologia Clinica, Fondazione IRCCS, Cá Granda, Ospedale Maggiore Policlinico, in Milan, Italy, and colleagues wrote. “Despite its relative nonspecificity (as it may be elevated in a number of inflammatory processes), measurement of D-dimer can be proposed for assessing the severity of disease and possibly predicting the response to treatment with antihistamines in patients with [chronic urticaria].”

In their literature review spanning 1950 to 2013, the researchers reported that hypercoagulation in patients with urticaria may add to inflammation and tissue damage, thus increasing the risk for thrombosis. They also observed that hypercoagulation that occurred in patients with chronic urticaria and angioedema were unlikely to be linked to an increased risk for thrombosis, compared with patients with acute urticaria alone.

“The mechanism and cause of urticaria remain unclear in many patients with [chronic urticaria],” the researchers wrote.

Disclosure: The researchers report no relevant financial disclosures.