Cholinergic Urticaria - Causes, Symptoms, Diagnosis and Treatment
Cholinergic urticaria - A rare autoimmune kind of allergic urticaria. Clinically is characterized by acute (within an hour), minor rash pruritic vesicles with serous content on exposed skin. The rash tends to spread, accompanied by a prodrome. Diagnosis is based on history, clinical manifestations, provocative tests to acetylcholine, artificial stimulation of an allergic reaction, blood tests for allergens, consultation narrow specialists. Cholinergic urticaria treatment is to neutralize provoking factor correction and concomitant pathology.
Cholinergic urticaria
Urticaria - Acute allergic itching that occurs as an immune response to the irritant effect of acetylcholine produced by the patient's own body. In the structure of dermatological diseases at a fraction of the cholinergic urticaria accounts for about 7% of all the varieties of "nettle dermatoses". Within the group, only 50% of cases of disease have significantly autoimmune genesis, which is confirmed by a test with autosyvorotkoy (ASST), mechanisms of development of the remaining 50% is not fully elucidated. The pathological process has no age, gender, seasonal framework lacks endemicity. A feature of cholinergic urticaria is a possibility to control recurrence considering provoking factor. The urgency of the problem of Dermatology at the present stage is associated with a constant increase in the number of allergic dermatoses, which are the basis for the development of cholinergic urticaria, which significantly violates the patients' quality of life.
vegetative-vascular dystonia), increased sweating and stress. In this embodiment, the cholinergic urticaria is sufficient destruction of fat cells (the main effector cells of any of hives) of unknown origin. Cells begin to produce histamine and prostaglandins that promote inflammation and activating acetylcholine - a neurotransmitter nerve excitation, in response to which there is an immune response that is clinically manifested rash.
dyspepsia, increased salivation. Spontaneously the temperature rises, there is a malaise, aggravated comorbidities.
Severity depends on the clinical manifestations increase acetylcholine levels in the body. A distinctive feature of the clinic cholinergic urticaria is spontaneous enough to prompt resolution of cutaneous manifestations and other symptoms associated with the direct stimulation of the nervous system acetylcholine high, coupled with the progression of concomitant diseases (diseases of the gastrointestinal tract, endocrine disorders).
KLA, OAM, biochemical test for C-reactive protein, parasitological examination of feces analysis on helminth eggs, of nasopharyngeal swab at the beginning of infection, in combination with symptoms sufficient for diagnosing pathology dermatologist. This is confirmation of the cholinergic nature of the disease requires the use of special techniques. The most simple diagnostics via cholinergic urticaria precipitating factors as the patient lowered hands for 2-3 minutes in hot water (> 50 degrees), which immediately causes the cholinergic response. Provocative test is administered subcutaneously acetylcholine that for 20 minutes gives the symptoms of cholinergic urticaria. Skin test intradermal injection of autologous serum (ASST) relates to screening methods.
A blood test for antinuclear antibodies is performed to rule out other types of autoimmune urticaria. Based on the total number of data and IgE proteins involved in the development of allergy, eliminate chronic urticaria. Assess skin dermographism and its reaction to the UFO, perform pressure on the skin in order to exclude physical urticaria. In severe cases, due to the fact that cholinergic urticaria often occurs at fote systemic diseases, skin biopsy is performed, and thyroid ultrasound heart EFGDS and analysis on H. Pylori bacteria with the evaluation results by specialists. All analyzes are never prescribed simultaneously, a decision on whether the application of those or other methods accepted by the doctor. Cholinergic urticaria differentiated from other types of urticaria based on the results of diagnostic tests.
plasmapheresis, sometimes in combination with immunosuppressants. Outwardly prescribe medications containing belladonna. Prevention cholinergic urticaria is to eliminate precipitating factors. Forecast relatively favorable, taking into account the severity of allergy and its complications.