Chronic Hives Linked to Autoimmune Thyroid Disease
Thyroid Replacement, Antibiotics are Possible Treatments
The researchers concluded that thyroid autoimmunity may be associated with chronic urticaria in some patients who are euthyroid (normal TSH), and that treatment with thyroid hormone can result in remission of their urticaria. While the antithyroid antibodies demonstrated autoimmunity, their levels had no correlation to the urticaria's actvitity. The lower thyroid-stimulating hormone (TSH) level with treatment did have a direct relationship to the reduction of symptoms, however, leading the researchers to speculate that an inflamed thyroid gland may be releasing something that causes the urticaria.
Another potential treatment that has been discussed by researchers during the past decade is antibiotic therapy. This is due to some studies that have that shown that one common -- but usually overlooked -- cause of hives is infection with the Helicobacter pylori -- or H. pylori -- bacteria. This is the same bacteria that has been found to cause some stomach ulcers. This connection was discovered after it was observed that ulcer patients who had urticaria found that their urticaria cleared up after antibiotic therapy for the ulcer.
The researchers recommend that children with chronic hives be periodically tested for T4, TSH, and antithyroid antibodies, in order to detect thyroid abnormalities as early as possible. According to the researchers, thyroid autoimmunity and hypothyroidism may appear several years after onset of the hives.
Generally, this recommendation that thyroid and antibody testing be conducted in anyone who has chronic urticaria or hives, given the known connections.
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Levy Y, et. al. “Chronic urticaria: association with thyroid autoimmunity,” Arch Dis Child. 2003 Jun;88(6):517-9. Pubmed reference
Resolution of chronic urticaria in patients with thyroid autoimmunity. J Allergy Clin Immunol. 1995;96:901-5.
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