{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:35:21Z","timestamp":1787841321304,"version":"build-2784847793"},"reference-count":42,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2009,7]]},"abstract":"<jats:p>It is well-recognized that 30-40% of chronic idiopathic urticaria is autoimmune in nature. Chronic autoimmune urticaria is caused by anti-Fc\u03b5RI and less frequently, by anti-IgE autoantibodies that lead to mast cell and basophil activation, thereby giving rise to the release of histamine and other proinflammatory mediators. Activation of the classical complement pathway and formation of C5a are important in dermal mast cell activation. C5a is also a neutrophil and eosinophil chemoattractant. Chronic autoimmune urticaria has been found to be associated with autoimmune thyroid disease. The autologous serum skin test is used as a screening test for chronic autoimmune urticaria and has a sensitivity and specificity of about 70 and 80%, respectively. The current gold standard diagnostic test is the basophil histamine release assay. The treatment of chronic autoimmune urticaria, as in chronic idiopathic urticaria, is with H1 antihistamines. Oral corticosteroids may be used during acute flares. Refractory cases have been shown to respond to cyclosporine and other immunomodulators. The prevalence of chronic autoimmune urticaria in Singapore is similar to that reported in Western countries at about 42%. The presence of thyroid autoimmunity appears to be higher than reported, with 22.5% of patients with chronic idiopathic urticaria here, exhibiting presence of thyroid autoantibodies.<\/jats:p>","DOI":"10.4103\/0019-5154.55640","type":"journal-article","created":{"date-parts":[[2009,9,10]],"date-time":"2009-09-10T06:30:03Z","timestamp":1252564203000},"page":"269-274","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":24,"title":["CHRONIC AUTOIMMUNE URTICARIA: WHERE WE STAND?"],"prefix":"10.4103","volume":"54","author":[{"given":"C L","family":"Goh","sequence":"first","affiliation":[{"name":"Department of Dermatology, National Skin Center, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K T","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Dermatology, National Skin Center, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-20250920","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1046\/j.1365-2133.1997.d01-1168.x","article-title":"The impact of chronic urticaria on quality of life","volume":"136","author":"O'Donnell","year":"1997","journal-title":"Br J Dermatol"},{"key":"R2-20250920","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1111\/j.1365-2222.2009.03256.x","article-title":"Pathogenesis of chronic urticaria","volume":"39","author":"Kaplan","year":"2009","journal-title":"Clin Exp Allergy"},{"key":"R3-20250920","first-page":"65","article-title":"Chronic autoimmune urticaria in children","volume":"16","author":"Dodig","year":"2008","journal-title":"Acta Dermatovenerol Croat"},{"key":"R4-20250920","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1111\/j.1398-9995.1962.tb02937.x","article-title":"Basophilic leucopenia in different forms of urticaria","volume":"17","author":"Rorsman","year":"1962","journal-title":"Acta Allergologica"},{"key":"R5-20250920","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/0091-6749(89)90180-2","article-title":"Syndrome of idiopathic chronic urticaria and angioedema with thyroid autoimmunity: A study of 90 patients","volume":"84","author":"Leznoff","year":"1989","journal-title":"J Allergy Clin Immunol"},{"key":"R6-20250920","doi-asserted-by":"crossref","first-page":"1599","DOI":"10.1056\/NEJM199306033282204","article-title":"Autoantibodies against the high affinity IgE receptor as a cause for histamine release in chronic urticaria","volume":"328","author":"Hide","year":"1993","journal-title":"N Engl J Med"},{"key":"R7-20250920","doi-asserted-by":"crossref","first-page":"1001","DOI":"10.1111\/1523-1747.ep12338544","article-title":"Dermal mast cell activation by autoantibody against the high affinity IgE receptor in chronic urticaria","volume":"106","author":"Nimii","year":"1996","journal-title":"J Invest Dermatol"},{"key":"R8-20250920","doi-asserted-by":"crossref","first-page":"2606","DOI":"10.1172\/JCI118325","article-title":"Autoantibodies directed against the \u00e1-chain of Fcepsilon R1; A selective marker and pathogenetic factor for a distinct subset of chronic urticaria patients","volume":"96","author":"Fiebiger","year":"1995","journal-title":"J Clin Invest"},{"key":"R9-20250920","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1016\/S0091-6749(97)70071-X","article-title":"Assessment of autoimmunity in patients with chronic urticaria","volume":"99","author":"Tong","year":"1997","journal-title":"J Allergy Clin Immunol"},{"key":"R10-20250920","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1159\/000235301","article-title":"The pathology of the autologous serum skin test response in chronic urticaria resembles IgE-mediated late phase reactions","volume":"93","author":"Grattan","year":"1990","journal-title":"Int Arch Allergy Immunol"},{"key":"R11-20250920","doi-asserted-by":"crossref","first-page":"844","DOI":"10.1002\/(SICI)1521-4141(199803)28:03<844::AID-IMMU844>3.0.CO;2-4","article-title":"IL-4 mRNA transcription is induced in mouse bone marrow-derived mast cells through an MHC class II- dependent signaling pathway","volume":"28","author":"Frandji","year":"1998","journal-title":"Eur J Immunol"},{"key":"R12-20250920","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1016\/j.jaci.2004.12.1120","article-title":"Functional assessment of pathogenic IgG subclasses in chronic autoimmune urticaria","volume":"115","author":"Soundararajan","year":"2005","journal-title":"J Allergy Clin Immunol"},{"key":"R13-20250920","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1172\/JCI511","article-title":"Anti-Fcepsilon R1 autoantibodies in autoimmune-mediated disorders: Identification of a structure function relationship","volume":"101","author":"Fiebiger","year":"1998","journal-title":"J Clin Invest"},{"key":"R14-20250920","doi-asserted-by":"crossref","first-page":"1599","DOI":"10.1056\/NEJM199306033282204","article-title":"Autoantibodies against the high affinity IgE receptor as a cause for histamine release in chronic urticaria","volume":"328","author":"Hide","year":"1993","journal-title":"N Engl J Med"},{"key":"R15-20250920","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1172\/JCI511","article-title":"Anti-FcepsilonRI alpha autoantibodies in autoimmune-mediated disorders. Identification of a structure function relationship","volume":"101","author":"Fiebiger","year":"1998","journal-title":"J Clin Invest"},{"key":"R16-20250920","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1067\/mai.2002.120954","article-title":"A role for C5a in augmenting IgG dependent histamine release from basophils in chronic urticaria","volume":"109","author":"Kikuchi","year":"2002","journal-title":"J Allergy Clin Immunol"},{"key":"R17-20250920","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1016\/S0091-6749(98)70283-0","article-title":"Anti-Fcepsilon R1 autoantibodies and basophil histamine releasability in chronic idiopathic urticaria","volume":"102","author":"Sabroe","year":"1998","journal-title":"J Allergy Clin Immunol"},{"key":"R18-20250920","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1111\/j.1365-2133.1986.tb04065.x","article-title":"A serological mediator in chronic idiopathic urticaria: A clinical Immunologicalal and histological evaluation","volume":"114","author":"Grattan","year":"1986","journal-title":"Br J Dermatol"},{"key":"R19-20250920","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1046\/j.1365-2133.1999.02707.x","article-title":"The autologous serum skin test: A screening test for autoantibodies in chronic idiopathic urticaria","volume":"140","author":"Sabroe","year":"1999","journal-title":"Br J Dermatol"},{"key":"R20-20250920","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1067\/mai.2002.126782","article-title":"Classification of anti-FceR1 and anti-IgE autoantibodies in chronic urticaria and correlation with disease activity","volume":"40","author":"Sabroe","year":"2002","journal-title":"J Allergy Clin Immunol"},{"key":"R21-20250920","doi-asserted-by":"crossref","first-page":"1105","DOI":"10.1046\/j.1365-2222.2001.01131.x","article-title":"Chronic urticaria: Novel clinical and serological aspects","volume":"31","author":"Asero","year":"2001","journal-title":"Clin Exp Allergy"},{"key":"R22-20250920","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1067\/mjd.2002.122759","article-title":"Chronic urticaria","volume":"46","author":"Grattan","year":"2002","journal-title":"J Am Acad Dermatol"},{"key":"R23-20250920","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1111\/j.1398-9995.2005.00673.x","article-title":"The autologous serum skin test in the follow-up of patients with chronic urticaria","volume":"60","author":"Fusari","year":"2005","journal-title":"Allergy"},{"key":"R24-20250920","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1111\/j.1346-8138.2004.tb00688.x","article-title":"Multiple NSAID intolerance in chronic idiopathic urticaria is correlated with delayed, pronounced and prolonged autoreactivity","volume":"31","author":"Erbagci","year":"2004","journal-title":"J Dermatol"},{"key":"R25-20250920","first-page":"23","article-title":"Chronic idiopathic urticaria (CIU) and Helicobacter pylori - not directly causative, but could there be a link?","volume":"13","author":"Greaves","year":"2001","journal-title":"ACI Int"},{"key":"R26-20250920","doi-asserted-by":"crossref","first-page":"1056","DOI":"10.1067\/mai.2001.115484","article-title":"Mechanisms of autoimmune activation of basophils in chronic urticaria","volume":"107","author":"Kikuchi","year":"2001","journal-title":"J Allergy Clin Immunol"},{"key":"R27-20250920","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1016\/S0190-9622(99)70495-0","article-title":"Chronic idiopathic urticaria: Comparison of clinical features of patients with and without anti-FceR1 or anti-IgE autoantibodies","volume":"40","author":"Sabroe","year":"1999","journal-title":"J Am Acad Dermatol"},{"key":"R28-20250920","doi-asserted-by":"crossref","first-page":"A22","DOI":"10.1016\/S0091-6749(02)81365-3","article-title":"Basophil infiltration of weals in chronic idiopathic urticaria","volume":"109","author":"Hoskin","year":"2002","journal-title":"J Allergy Clin Immunol"},{"key":"R29-20250920","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1111\/j.1365-2133.2004.06042.x","article-title":"Basophil CD63 expression assay on highly sensitized atopic donor leucocytes: A useful method in chronic autoimmune urticaria","volume":"151","author":"Gyimesi","year":"2004","journal-title":"Br J Dermatol"},{"key":"R30-20250920","doi-asserted-by":"crossref","first-page":"1430","DOI":"10.1016\/j.jaci.2006.02.016","article-title":"Chronic urticaria sera increase basophil CD203c surface expression","volume":"117","author":"Yasnowsky","year":"2006","journal-title":"J Allergy Clin Immunol"},{"key":"R31-20250920","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1001\/archderm.1983.01650320010007","article-title":"Association of chronic urticaria and angioedema with thyroid autoimmunity","volume":"119","author":"Leznoff","year":"1983","journal-title":"Arch Dermatol"},{"key":"R32-20250920","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1007\/BF03345696","article-title":"Serum thyroid autoantibodies in patients with idiopathic either acute or chronic urticaria","volume":"32","author":"Gangemi","year":"2009","journal-title":"J Endocrinol Invest"},{"key":"R33-20250920","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1111\/j.1365-2133.2005.06646.x","article-title":"Thyroid autoimmunity in chronic urticaria","volume":"153","author":"O'Donnell","year":"2005","journal-title":"Br J Dermatol"},{"key":"R34-20250920","first-page":"286","article-title":"Autoimmunity and the etiology of chronic urticaria","volume":"4","author":"Kaplan","year":"1999","journal-title":"Canad J Allergy Clin Immunol"},{"key":"R35-20250920","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1067\/mjd.2003.142","article-title":"Laboratory tests and identified diagnoses in patients with physical and chronic urticaria and angioedema: A systematic review","volume":"48","author":"Kozel","year":"2003","journal-title":"J Am Acad Dermatol"},{"key":"R36-20250920","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1111\/j.1398-9995.2005.00962.x","article-title":"EAACI\/GA2LEN\/EDF guideline: Definition, classification and diagnosis of urticaria","volume":"61","author":"Zuberbier","year":"2006","journal-title":"Allergy"},{"key":"R37-20250920","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1097\/00130832-200310000-00008","article-title":"Chronic idiopathic urticaria","volume":"3","author":"Greaves","year":"2003","journal-title":"Curr Opin Allergy Clin Immunol"},{"key":"R38-20250920","doi-asserted-by":"crossref","first-page":"2515","DOI":"10.2165\/00003495-200464220-00003","article-title":"Chronic urticaria: Aetiology, management and current and future treatment options","volume":"64","author":"Kozel","year":"2004","journal-title":"Drugs"},{"key":"R39-20250920","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1046\/j.1365-2133.2000.03664.x","article-title":"Randomised double blind study of cyclosporine in chronic idiopathic urticaria","volume":"143","author":"Grattan","year":"2000","journal-title":"Br J Dermatol"},{"key":"R40-20250920","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1007\/s12016-007-0038-3","article-title":"Chronic urticaria: Recent advances","volume":"33","author":"Greaves","year":"2007","journal-title":"Clin Rev Allerg Immunol"},{"key":"R41-20250920","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1046\/j.1365-2133.1998.02033.x","article-title":"Intravenous immunoglobulin in chronic urticaria","volume":"138","author":"O'Donnell","year":"1998","journal-title":"Br J Dermatol"},{"key":"R42-20250920","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1016\/j.jaci.2008.07.006","article-title":"Treatment of chronic autoimmune urticaria with omalizumab","volume":"122","author":"Kaplan","year":"2008","journal-title":"J Allergy Clin Immunol"}],"container-title":["Indian Journal of Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/00076423-200954030-00016","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T13:48:42Z","timestamp":1787838522000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/00076423-200954030-00016"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009,7]]},"references-count":42,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2009]]}},"URL":"https:\/\/doi.org\/10.4103\/0019-5154.55640","relation":{},"ISSN":["0019-5154","1998-3611"],"issn-type":[{"value":"0019-5154","type":"print"},{"value":"1998-3611","type":"electronic"}],"subject":[],"published":{"date-parts":[[2009,7]]},"assertion":[{"value":"2009-04-01","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2009-05-01","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}