Autoimmunity is thought to be one of the most frequent causes of chronic urticaria. In about half of patients with chronic idiopathic hives, the explanation is that body’s immune system is, in a sense, overactive. The urticaria is “autoimmune”. The immune system is attacking the normal tissues of the body and causing hives as a result.
Various autoimmune or endocrine diseases have been associated with urticaria, including:
- systemic lupus erythematosus
- cryoglobulinemia – is part of a group of diseases that cause damage and inflammation of the blood vessels throughout the body (vasculitis).
- juvenile rheumatoid arthritis
- autoimmune thyroid disease (eg, Graves disease).
Urticaria is also known as hives.
Autoimmune Disorders and Urticaria
According to the American Osteopathic College of Dermatology, about half the cases of chronic idiopathic hives are due to immune systems that attack the body’s own tissues (also known as autoimmunity). Thyroid disease is the most commonly reported autoimmune condition in people with chronic hives, followed by rheumatoid arthritis and type 1 diabetes. A study published in September 2013 in the European Journal of Dermatology found that celiac disease is also associated with chronic hives.
However, says Anand, “we don’t know if the disease causes urticaria or if the person’s propensity to have an autoimmune reaction causes it. But if we don’t find any triggers when we test for allergens, then we look for an underlying infection or autoimmune disease.” Anand adds that treatment for that condition can help clear the hives.
Once the diagnosis of autoimmune hives has been made, the goal is then to select the best combination of medications to reduce the frequency of outbreaks.
Long-term, this autoantibody may go into remission and it may be reasonable to try periods off suppression medications every few month to see if they are still needed.
There has been a high incidence of autoantibody to thyroid glands reported among those with anti-Fc-receptor antibodies and it is suggested that yearly thyroid testing be done by the primary care physician. (Fc receptors are a class of cell surface receptors that bind to the Fc portion of antibodies to form immune complexes and recruit the complement and/or effector system to defend the body against pathogens.)
You may want to keep a journal to track your hives. This may help your doctor with your diagnosis.
- Your activities
- Any medications, herbal remedies or supplements you take
- What you eat and drink
- Where hives appear and how long it takes a welt to fade
- Whether your hives come with painful swelling
Chronic hives can go on for months and years. They can interfere with sleep, work and other activities. The following precautions may help prevent or soothe the recurring skin reactions of chronic hives:
- Wear loose, light clothing.
- Avoid scratching or using harsh soaps.
- Soothe the affected area with a bath, fan, cool cloth, lotion or anti-itch cream.
- Keep a diary of when and where hives occur, what you were doing, what you were eating, and so on. This may help you and your doctor identify triggers.
- Avoid known triggers.
- Apply sunscreen before going outside.