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Abstract：
Urticaria is defined as the sudden appearance of erythematous, itchy wheals of variable size, with or without angioedema (AE) (swelling of the deeper layers of the skin). Its classification depends on time course of symptoms and the presence of eliciting factors. When it lasts less than 6 weeks it is classified as acute urticaria (AU), and if the symptoms persist for more than 6 weeks, it is classified as chronic urticaria (CU). Current International Guidelines also classify CU as chronic spontaneous urticaria (CSU) and inducible urticarial, according to the absence or presence of environmental triggering factors. CSU is defined as urticaria and/or angioedema in which there is no evidence of a specific eliciting factor. CSU is associated with autoimmunity in 30-45% of the cases, sharing some immunological mechanisms with other autoimmune diseases, and is associated with autoimmune thyroid disease (ATD) in about 4.3%-57.4% patients. Several studies suggest that adequate therapy with anti-thyroid drugs or levothyroxine in early stages of ATD and CSU, may help to remit the latter; but there is still a lack of double-blind, placebo-controlled studies that support this hypothesis in patients without abnormal thyroid hormone levels. The objective of this review is to describe the pathophysiology of chronic spontaneous urticaria and its association with autoimmune thyroid disease.
摘要：
荨麻疹被定义为红斑的突然出现，可变大小的发痒的水团，有或没有血管性水肿（AE）（皮肤深层肿胀）。其分类取决于症状的时间过程和诱发因素的存在。当它持续少于6周时，它被归类为急性荨麻疹（AU），如果症状持续超过6周，它被归类为慢性荨麻疹（CU）。目前的国际指南还将CU分为慢性自发性荨麻疹（CSU）和诱导型荨麻疹，根据环境触发因素的存在或不存在。CSU定义为荨麻疹和/或血管性水肿，其中没有证据表明有特定的诱发因素。在30-45％的病例中，CSU与自身免疫有关，与其他自身免疫性疾病共享一些免疫机制，约4.3%-57.4%的患者与自身免疫性甲状腺疾病(ATD)相关。一些研究表明，在ATD和CSU的早期阶段，使用抗甲状腺药物或左甲状腺素进行适当的治疗。可能有助于汇出后者；但仍然缺乏双盲，安慰剂对照研究在甲状腺激素水平无异常的患者中支持这一假设。这篇综述的目的是描述慢性自发性荨麻疹的病理生理学及其与自身免疫性甲状腺疾病的关系。
