COAGULATION DEFECTS IN CHRONIC URTICARIA. M.A.Pérez-Gómez, R. López-Salgueiro, M. Díaz, R. Almero, A. Giner, F. España, D. Hernández

Allergy Department. Hospital Universitari i Politècnic La Fe, Valencia.

Patients with chronic urticaria (CU) show some alterations of the coagulation components. The role of these findings is still unknown, being the

expression of a pro-inflammatory effect or representing a defect in the coagulation cascade. The thrombin generation test (TGT) is a global assay

that measures the overall tendency of a plasma sample to form thrombin after the initiation of coagulation.

Patients with a history of swelling showed increased levels of thrombin compared with patients without it. This finding shows an increase in the

coagulation potential of patients with oedema, but the clinical relevance is still under evaluation.

BACKGROUND:

To perform TGT in plasma of patients actively suffering from CU and to find out if the results have a

relation with the type or severity of urticaria, the presence of comorbidities or with other analytical

parameters.

We performed an observational, descriptive study in 22

adult patients diagnosed with CU and 8 healthy

controls. All patients were informed and accepted to

participate. A broad spectrum of blood tests and the

autologous serum skin test (ASST) helped to classify

the urticaria as autoimmune, and rule out other

conditions. The severity of the disease was evaluated

by the questionnaire Urticaria Severity Score (USS).

Plasma was collected to analyze TG

There were not any statistically significant differences between the severity index and the results

of the TGT. However, we observed a tendency to a hypercoagulable pattern in patients with

severe CU (10/22). Patients with a history of oedema (50%), showed a higher thrombin peak-

height and an increased area under the curve. Patients with previous symptoms of oedema

showed higher levels of thrombine than patients without oedema. The difference was more

pronounced when compared with healthy controls. We couldn’t find any differences between

TGT and other analytical or clinical parameters.

OBJECTIVE:

METHOD:

RESULTS:

CONCLUSIONS

0

500

1000

1500

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2500

3000

1 2 3 4 5 6 7 8

ETP

PATIENTS

ETP IN CONTROLS

0

500

1000

1500

2000

2500

3000

1 2 3 4 5 6 7 8 9 10 11

ETP

PATIENTS

ETP IN PATIENT WITH OEDEMA

0

500

1000

1500

2000

2500

3000

1 2 3 4 5 6 7 8 9 10 11

ETP

PATIENTS

ETP IN PATIENT WITHOUT OEDEMA

23%

32%

45%

TYPE OF URTICARIA

Allergy

Autoimmune

Idiopathic

0

50

100

150

200

250

300

350

1 2 3 4 5 6 7 8 9 10 11

PEAK

PATIENTS

PEAK IN PATIENT WITH OEDEMA

55% 27%

14% 4%

URTICARIA SEVERITY SCORE mild

moderate

mod-sev

severe

0

50

100

150

200

250

300

350

1 2 3 4 5 6 7 8 9 10 11

PEAK

PATIENTS

PEAK IN PATIENT WITHOUT OEDEMA

0

50

100

150

200

250

300

350

1 2 3 4 5 6 7 8

PEAK

PATIENTS

PEAK IN CONTROLS

In relation to this presentation, I declare that there are no conflicts of interest

CONTROLS