慢性蕁麻疹的致病機轉中，自體免疫扮有重要的角色。慢性蕁麻疹已被報告和自體免疫甲狀腺炎及數種風濕病有相關性。本研究的目的在於了解台灣慢性蕁麻疹病人的臨床表徵和自體抗體，並探討慢性蕁麻疹和風濕病及自體免疫甲狀腺疾病之間的相關性。我們回顧2008年9月至2009年8月，於彰化基督教醫院過敏免疫風濕科診斷為慢性蕁麻疹，共106位病人。我們就臨床表徵、自體抗體和並存的自體免疫疾病予以分析。女性和男性的比例為2.1：1。平均診斷年齡為36.5歲。血管性水腫、皮膚劃紋症和壓力誘發之疹塊分別發生於23.1%、26.7%和68.1%的病人。20.6%的病人具有抗甲狀腺抗體 (抗甲狀腺球蛋白抗體、抗微粒體抗體)。10.4%的病人具有抗核抗體，7.2%的病人具有SSA抗體，1.4%的病人具有SSB抗體。18.5%的病人其紅血球沉降速率升高。28位(26.4%)病人同時患有風濕病或自體免疫甲狀腺疾病二者之一。在16位合併風濕病的病人中，乾燥症和類風濕性關節炎共佔其中的一半。相較於沒有合併風濕病的病人，合併風濕病的病人其關節痛、高紅血球沉降速率和陽性抗核抗體的盛行率顯著較高( p 值分別為 <0.005、<0.05、<0.005 )。部分的慢性蕁麻疹和風濕病及自體免疫甲狀腺疾病有相關性。我們建議對慢性蕁麻疹病人進行自體免疫疾病的篩檢檢查。

Autoimmunity plays a major role in the pathogenesis of chronic urticaria (CU). CU has been reportedto be associated with autoimmune thyroiditis and several rheumatic diseases in the related literature. Thisstudy aims to determine the clinical and laboratory features of CU in Taiwan, and to detect the associationof CU with rheumatic diseases and thyroid autoimmunity. We reviewed the medical records of 106 patientswho were diagnosed with CU at Changhua Christian Hospital during the period of September 2008 - August2009. The female-to-male ratio was 2.1：1. The mean age at diagnosis was 36.5 years. Concomitantangioedema, dermographism and pressure-induced hive occurred in 23.1%, 26.7% and 68.1% of patients,respectively. Antithyroid antibodies (antithyroglobulin and/or antimicrosomal antibodies) presented in 20.6%of patients. Antinuclear antibodies (ANA), anti-SSA and anti-SSB antibodies presented in 10.4%, 7.2%and 1.4% of patients, respectively. Elevated erythrocyte sediment rate (ESR) was measured in 18.5%of patients. Twenty-eight patients (26.4%) had rheumatic diseases and/or thyroid autoimmunity. Of 16patients with rheumatic diseases, Sjogren's syndrome and rheumatoid arthritis accounted for the majority.Patients with rheumatic diseases had higher prevalence of arthralgia (p ＜0.005), ESR elevation (p ＜0.05)and ANA positivity (p ＜0.005) than patients without rheumatic diseases. A subgroup of CU has associationswith rheumatic diseases and thyroid autoimmunity. Screen tests for autoimmune diseases in CU patientsare recommended.