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Chronic Hives Linked to Autoimmune Thyroid Disease
Thyroid Replacement, Antibiotics are Possible Treatments

by Mary Shomon

July 7, 2003 -- According to Israeli researchers, children who have chronic hives – sometimes known by the technical term urticaria – have an increased risk of having autoimmune thyroid disease and hypothyroidism.

This finding confirms that the relationship in children is the same as what was known about adults – that urticaria is associated with thyroid autoimmunity.

For some patients with chronic urticaria, there is a link to autoimmune disease, and in particular, thyroid disease, as a significant percentage of patients with urticaria also have high levels of antithyroid antibody, even though they may not have clinical thyroid disease. In one study, ten patients with chronic urticaria who had normal thyroid levels (but seven of the ten had elevated antithyroid antibodies and three controls had no antithyroid antibodies) were treated with the synthetic thyroid drug levothyroxine.

While receiving the levothyroxine, the seven patients reported that their urticaria symptoms went away within 4 weeks. The three controls did not respond. In five patients, symptoms recurred after treatment was stopped; these symptoms again resolved after treatment was restarted.

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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.

Implications

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.

FOR MORE INFORMATION ON DEALING WITH AUTOIMMUNE DISEASE

Read my bestselling book, Living Well With Autoimmune Disease.



Sources:

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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