Chronic Spontaneous Urticaria Learning Zone
Transcript: CSU and autoimmune comorbidities
Marcus Maurer, MD, and Petra Staubach-Renz, MD
All transcripts are created from interview footage and directly reflect the content of the interview at the time. The content is that of the speakers and is not adjusted by Medthority.
We do want to touch a little bit on the other two groups of comorbidities. Now, autoimmune comorbidities, of course, are very common. What is your take on this? We say in the guideline, this should be question and answer driven, but we also say that we should now look for IgG on anti-TPO, a marker for Hashimoto, if you want, but also a biomarker for severe utricaria in all of our patients. I know that you see many children. How important are comorbidities and especially autoimmune comorbidities in children with chronic spontaneous utricaria? - Yeah, if you say children, you have to think about the parents and they always want to know why does or do my, or does my child have such problems or symptoms and they want to have a reason or they want to understand what's going on. And we are a centre for urticaria, so we are looking for autoimmune diseases like thyroid autoimmune diseases, and we are looking in the blood for this because the symptoms, very often, they do not have symptoms. And we also look for IgE, for example. And of course we look at the whole skin. Sometimes you can see vitiligo. I think in other countries more than in Germany, but we look for this and we sometimes wonder how often we can see it, even in children.
- Yeah, yeah, I have the same experience. I think for many years we underestimated the importance of looking for this, and I don't really know, but it's a lot. How many patients are diagnosed with that comorbid autoimmunity, be it rheumatoid arthritis or Hashimoto by their urticariologist, and you know, this is also important that we look at the whole patient, not just the wheal and not just the angioedema. First question here that we can sort of weave in. Do we have any tests to screen for comorbidities, for autoimmune comorbidities? - I think the blood is the only thing. - The blood is good, but I really want to stress that history taking in chronic spontaneous urticaria is essential. So, you know, Hashimoto is so prevalent that I always ask about sleep and digestion and hair, and you know, some of the things that- - Yeah. - Come with Hashimoto no, but...
- Yeah, but my recommendation for everyone who is handling the patients, we ask always to fill in a questionnaire before they come to my room. They have to send it, in our hospital, they have to send it to us. And then I check it in the beginning, and I know the questions. It's a time from three to five minutes, but the is much deeper, and they write everything they have or they had in the past. And it's really, it's better quality. That's my opinion and it takes not more time. It takes less time. - Look, we're getting so much feedback here. Thank you guys for being so active. I'll try to work this all in. Ellie says in Brazil, it's been a routine to check for Hashimoto and I strongly want to echo that. We also do that, we explore that by good history taking, but also by looking at auto antibodies and thyroid hormone levels. That is a good idea, simply because it is so common and then...
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