Autoimmune urticaria is a medical condition in which an individual experiences chronic hives or raised itchy welts, which are not caused by a specific allergen or other identifiable trigger. In this case, the hives could be related to an underlying autoimmune disorder, such as lupus or thyroid disease. Chronic hives are usually not fatal but can be debilitating. Symptoms are treated with daily use of antihistamines or other medications, in addition to efforts to treat underlying autoimmune diseases as appropriate.
Urticaria is the medical term for the presence of hives, which are red or pink welts that spontaneously arise on the skin. This occurs when the body releases a chemical called histamine that causes blood plasma to leak from the blood vessels in the skin. In some people, hives are triggered by conditions such as heat or stress. They can also be an allergic reaction to specific foods or certain medications, such as codeine, aspirin, or nonsteroidal anti-inflammatory drugs such as ibuprofen. Occasionally hives occur without an apparent trigger.
Chronic urticaria refers to hives that last longer than six weeks or that go away quickly but often recur. In autoimmune urticaria, episodes of hives do not appear to have a specific trigger and are thought to indicate the presence of an autoimmune disorder, in which the individual's body responds to itself as a threat. This condition is diagnosed through a combination of a complete medical history, a physical exam, and sometimes blood tests or skin tests.
Treatment of autoimmune urticaria generally consists of daily use of oral antihistamines to prevent the occurrence of hives. Doctors often recommend a non-sedating antihistamine such as loratidine (Claritin® brand) or fexofenadine (Allegra® brand) as a first line of defense. Other types of antihistamines, which can cause drowsiness, include diphenhydramine (Benadryl® brand name) and chlorpheniramine (Chlor-Trimeton® brand name). In some cases, doctors may recommend the use of other medications to control autoimmune urticaria, including ranitidine (brand name Zantac®), short-term use of an oral corticosteroid such as prednisone, or certain tricyclic antidepressants such as doxepin (brand name Zonalon ® ) to relieve itching.
In addition to autoimmune urticaria, hives can take many forms. A hive-like condition called angioedema involves swelling of the face, throat, or genitals that may itch or burn and can sometimes be life-threatening. Physical urticaria refers to hives that occur in reaction to vibration, heat, sun exposure, pressure, or other physical stimuli, but quickly resolve when the stimulus has ceased.