Abstract
Thyroid autoimmunity is the most common organ-specific autoimmune disorder, which is characterized by the production of thyroid autoantibodies and lymphocytic infiltration into the thyroid. The majority cases of chronic urticaria have unknown (idiopathic) causes, with about 30–40 % possibly having an autoimmune substrate. Considering that autoimmune factors may be the common features of both thyroid autoimmunity and urticaria, it is likely that both entities may coexist within the same patient. A number of studies have investigated the association between thyroid autoimmunity and urticaria. However, most of these studies are relatively small sample size, the power achieved in those studies was not sufficient to detect whether there is an association between urticaria and thyroid autoimmunity. The aim of this study is to combine primary data from all relevant studies to produce reliable estimates of the associations between thyroid autoantibodies and urticaria. Literature databases were searched including Medline, Embase, Web of Science, Chinese Wanfang, and CBM databases from January 1980 to December 2013. A total of 14,203 urticaria cases and 12,339 non-urticaria controls were included in this study. From these data, the odds ratio (OR) with 95 % confidence interval (95 % CI) was calculated. The meta-analysis results showed that the prevalence of positive thyroid autoantibodies in patients with urticaria was higher than non-urticaria controls (TgAb: OR 6.55, 95 % CI 3.19–13.42, P < 0.00001, I 2 = 67 %; TmAb: OR 4.51, 95 % CI 2.78–7.33, P < 0.00001, I 2 = 47 %; TPOAb: OR 8.71, 95 % CI 6.89–11.01, P < 0.00001, I 2 = 20 %, respectively). The results of this meta-analysis suggested that patients with urticaria were more likely to have thyroid autoimmunity than the control groups.
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References
M. Szyper-Kravitz, I. Marai, Y. Shoenfeld, Coexistence of thyroid autoimmunity with other autoimmune diseases: friend or foe? Additional aspects on the mosaic of autoimmunity. Autoimmunity 38, 247–255 (2005)
E.M. Jacobson, Y. Tomer, The CD40, CTLA-4, thyroglobulin, TSH receptor, and PTPN22 gene quintet and its contribution to thyroid autoimmunity: back to the future. J. Autoimmun. 28, 85–98 (2007)
C. Balázs, The role of hereditary and environmental factors in autoimmune thyroid diseases. Orv. Hetil. 153, 1013–1022 (2012)
A. Kawashima, K. Yamazaki, T. Hara, T. Akama, A. Yoshihara, M. Sue, K. Tanigawa, H. Wu, Y. Ishido, F. Takeshita, N. Ishii, K. Sato, K. Suzuki, Demonstration of innate immune responses in the thyroid gland: potential to sense danger and a possible trigger for autoimmune reactions. Thyroid 23, 477–487 (2013)
P. Leru, Urticaria: an allergologic, dermatologic or multidisciplinary disease? Rom. J. Intern. Med. 51, 125–130 (2013)
M. Mandelli, L.G. Semeraro, L. Brunetti, P. Poli, M. Giovannini, A challenge for pediatrician: non allergic urticaria. Pediatr. Med. Chir. 35, 253–258 (2013)
A. Leznoff, R.G. Josse, J. Denburg, J. Dolovich, Association of chronic urticaria and angioedema with thyroid autoimmunity. Arch. Dermatol. 119, 636–640 (1983)
I. Turktas, N. Gokcora, S. Demirsoy, N. Cakir, E. Onal, The association of chronic urticaria and angioedema with autoimmune thyroiditis. Int. J. Dermatol. 36, 187–190 (1997)
B. Ryhal, R.S. De Mera, Y. Shoenfeld, J.B. Peter, M.E. Gershwin, Are autoantibodies present in patients with subacute and chronic urticaria? J. Investig. Allergol. Clin. Immunol. 11, 16–20 (2001)
W.B. Yang, J.C. Lin, W.M. Jiang, J.X. Li, To explore the relationship between autoimmune thyroid disease and chronic urticaria. Chin. J. Dermatovenerol. 16, 87–88 (2002)
Y.H. Su, Y. Wang, C. Yang, X. Shi, W.Y. Wei, H. Huang, X.L. Liu, Determination of thyroid function and thyroid autoantibodies in chronic urticaria patients and its clinical significance. Suzhou Univ. J. Med. Sci. 23, 250–251 (2003)
W.B. Yang, J.C. Lin, W.M. Jiang, Q. Liao, Detection of thyroid autoantibodies and its function in patients with chronic urticaria. Chin. J. Dermatol. 36, 660 (2003)
W.B. Yang, J.C. Lin, W.M. Jiang, J.X. Li, Study on the relationship between chronic idiopathic urticaria and thyroid autoimmunity. J. Pract. Med. 19, 244–245 (2003)
L. Verneuil, C. Leconte, J.J. Ballet, C. Coffin, D. Laroche, J.P. Izard, Y. Reznik, D. Leroy, Association between chronic urticaria and thyroid autoimmunity: a prospective study involving 99 patients. Dermatology 208, 98–103 (2004)
F. Cebeci, E. Topcu, N. Onsun, N. Kurtulmus, A. Uras, Autoimmune thyroiditis with chronic idiopathic urticaria. Deri. Hastaliklari. ve. Frengi. Arsivi. 38, 264–267 (2004)
A.G. Palma-Carlos, M.L. Palma-Carlos, Chronic urticaria and thyroid auto-immunity. Eur. Ann. Allergy Clin. Immunol. 37, 143–146 (2005)
F. Cebeci, A. Tanrikut, E. Topcu, N. Onsun, N. Kurtulmus, A.R. Uras, Association between chronic urticaria and thyroid autoimmunity. Eur. J. Dermatol. 16, 402–405 (2006)
T.C.M. Feibelmann, F.T. Goncalves, M.S. Daud, A.D.S. Jorge, S.A.O. Mantese, P.T. Jorge, Assessment of association between autoimmune thyroid disease and chronic urticaria. Arq. Bras. Endocrinol. Metab. 51, 1077–1083 (2007)
I.S. Aamir, S. Tauheed, F. Majeed, A. Atif, Serum antithyroid antibodies in female patients with chronic urticaria. J. Coll. Physicians Surg. Pak. 18, 498–501 (2008)
V. Nuzzo, L. Tauchmanova, P. Colasanti, A. Zuccoli, A. Colao, Idiopathic chronic urticaria and thyroid autoimmunity: experience of a single center. Derm. Endocrinol. 3, 255–258 (2011)
A.O. Al-Balbeesi, Significance of antithyroid antibodies and other auto-antibodies in Saudi patients with chronic urticaria. Possible parameters in predicting chronic over three years disease. J. Saudi Soc. Dermatol. Dermatol. Surg. 15, 47–51 (2011)
R. Confino-Cohen, G. Chodick, V. Shalev, M. Leshno, O. Kimhi, A. Goldberg, Chronic urticaria and autoimmunity: associations found in a large population study. J. Allergy Clin. Immunol. 129, 1307–1313 (2012)
K.S. Wan, C.S. Wu, The essential role of anti-thyroid antibodies in chronic idiopathic urticaria. Endocr. Res. 38, 85–88 (2013)
S. Yadav, A.J. Kanwar, D. Parsad, R.W. Minz, Chronic idiopathic urticaria and thyroid autoimmunity: perplexing association. Indian J. Dermatol. 58, 325–336 (2013)
A. Alpay, N.S. Tekin, I.Ö. Tekin, H.C. Altinyazar, R. Koca, S. Cinar, Autologous serum skin test versus autologous plasma skin test in patients with chronic spontaneous urticaria. Dermatol. Res. Pract. 2013, 1–6 (2013)
L.W. Sun, J. Li, E.X. Kang, C.Y. Han, L.P. Yan, W.S. Jin, X.J. Xia, The relationship between antibodies associated with chronic idiopathic urticaria and the onset of disease. Chin. J. Dermatol. 46, 390–393 (2013)
A. Kawashima, K. Tanigawa, T. Akama, A. Yoshihara, N. Ishii, K. Suzuki, Innate immune activation and thyroid autoimmunity. J. Clin. Endocrinol. Metab. 96, 3661–3671 (2011)
G. Di Lorenzo, M.S. Leto-Barone, S. La Piana, A. Seidita, G.B. Rini, Chronic spontaneous urticaria: an autoimmune disease? A revision of the literature. Clin. Exp. Med. 13, 159–164 (2013)
M. Rottem, Chronic urticaria and autoimmune thyroid disease: is there a link? Autoimmun. Rev. 2, 69–72 (2003)
M. Bagnasco, P.L. Minciullo, M. Schiavo, G. Saraceno, S. Gangemi, S. Benvenga, Urticaria and thyroid autoimmunity. Thyroid 21, 401–410 (2011)
S.C. Dreskin, K.Y. Andrews, The thyroid and urticaria. Curr. Opin. Allergy Clin. Immunol. 5, 408–412 (2005)
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This study would not have been possible without the participation of urticaria patients and non-urticaria controls. We would like to appreciate all of them.
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Pan, XF., Gu, JQ. & Shan, ZY. The prevalence of thyroid autoimmunity in patients with urticaria: a systematic review and meta-analysis. Endocrine 48, 804–810 (2015). https://doi.org/10.1007/s12020-014-0367-y
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DOI: https://doi.org/10.1007/s12020-014-0367-y