A study of autologous serum therapy in patients of chronic urticaria at a tertiary care center in western India

Rinkal Madhudiya; Vimesh Parmar; Deval Vora

doi:10.18203/issn.2455-4529.IntJResDermatol20242356

Authors

Rinkal Madhudiya Department of Dermatology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
Vimesh Parmar Department of Neonatology, All India Institute of Medical Sciences, Bhopal, MP, India https://orcid.org/0009-0005-4330-8579
Deval Vora Department of Dermatology, Shri M P Shah Medical College, Jamnagar, Gujarat, India

DOI:

https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20242356

Keywords:

Autologous serum skin test, Autologous serum therapy, Autoreactive chronic urticaria, Chronic urticaria, Total severity score

Abstract

Background: Chronic urticaria (CU) is a common and troublesome dermatosis for patients. Approximately 30-50% of patients with CU have an autoimmune basis for their condition, as shown by a positive skin test for ASST, this subgroup is known as Autoreactive chronic urticaria. autologous serum therapy (AST) is considered a potential curative for this auto-reactive subgroup. Our study aimed to find out the efficacy of AST in both ASST positive and ASST negative CU patients.

Methods: A cohort of 100 patients of CU were prospectively analyzed for incidence of ASST (+) patients out of total and efficacy of autologous serum injections for sequential 6 weeks in both ASST (+) and ASST (-) CU patients. The response of AST was recorded by the urticaria total severity scale (TSS) every week for 6 weeks and at 18 weeks.

Results: The mean baseline TSS in the ASST (+) group was 12.14±1.66 and in the ASST (-) group was 11.77±1.45 (p-value- 0.5). The mean TSS at 18 weeks in the ASST (+) group was 1.30±1.51 and in the ASST (-) group was 2.17±2.02 (p-value-0.151). At 18 weeks of treatment, complete clearance was present in 44.6% of the ASST (+) group and 31.4% in the ASST (-) group (p value-0.151).

Conclusions: AST can be considered as a first line of treatment, in patients of CU irrespective of the results of ASST, which is cost-effective and has long-lasting effects.

Metrics

Metrics Loading ...

References

Bajaj AK, Saraswat A, Upadhyay A, Damisetty R, Dhar S. Autologous serum therapy in chronic urticaria: Old wine in a new bottle. Indian J Dermatol Venereol Leprol. 2008;74:109-13.

Krupashankar DS, Shashikala K, Rama Madala. Clinical and investigative assessment of patients with positive versus negative autologous serum skin test: A study of 80 south Indian patients. Indian J Dermatol. 2012;57(6):434-8.

Godse KV. Autologous serum skin test in chronic idiopathic urticaria. Indian J Dermatol Venereol Leprol. 2004;70:283-4.

Hide M, Francis DM, Grattan CE, Hakimi J, Kochan JP,Greaves MW. Autoantibodies against the high affinity IgE receptor as a cause of histamine release in chronic urticaria. N Engl J Med. 1993;328:1599-604.

Staubach P, Onnen K, Vonend A, Metz M, Siebenhaar F, Tschentscher I, et al. Autologous whole blood injections to patients with chronic urticaria and a positive autologous serum skin test: A placebo-controlled trial. Dermatology. 2006;212:150-9.

Asero R, Ferrer M, Kocaturk E, Maurer M. Chronic spontaneous urticaria: The role and relevance of autoreactivity, autoimmunity, and autoallergy. J Allergy Clin Immunol Pract. 2023;11(8):2302-8.

Godse KV. Autologous serum skin test in chronic idiopathic urticaria. Indian J Dermatol Venereol Leprol. 2004;70:283-4.

Debbarman P, Sil A, Datta PK, Bandhyopadhyay D, Das NK, Autologus serum therapy in chronic urticaria: A promising complements to antihistaminics. Indian J Dermatol. 2014;59:375-82.

Nageswaramma S, Sarojini VL, Pujitha BB, Shirisha G, Bindu GS. Efficacy of Autologus serum therapy in chronic urticaria. ICV. 2015;77:83.