Urticaria
Definition
Urticaria - the notion that covers a group of diseases, the main symptom of which is an urticarial element on the skin. With all the variety of etiological factor for all types of urticaria characterized by a common pathogenetic mechanism-increase vascular permeability of micro circulatory course and bed acute edema development in the area of surrounding the vessels. In case of spreed affection on subcutaneous and submucosal layers of dermis develops angioneurotic edema (Bannister's disease). According to flow can be acute and chronic (more than 6 weeks) case.
Rash is characterized by itch of varying intensity, complete reversibility of elements.
On the basis of etiological among the most frequent forms of urticaria mark out the following types:
Allergic
Idiopathic
Temperature
Demographic
Vibration
cholinergic
Contact
Another rash
unspecified urticaria
Angioneurotic edema (swelling Quincke's)
Survey
1. Mandatory laboratory studies:
Clinical analysis of blood;
An overall analysis of urine;
Biochemical analysis of blood (total protein, total bilirubin and direct), ALT, ACT, blood glucose, creatinine, uric acid);
RW, HIV;
Coprogramma.
This amount of mandatory testing is adequate for patients with allergic, contact, vibration, temperature urticaria forms.
In case of unspecified, idiopathic electrodermatogramic urticaria, it is recommend to include in the list of mandatory following of survey to identify the functional or organic violations:
Revmtests (ANF, AT to DNA, DRR cryoprecipitate);
Bacteriological study (excrements, material from the mucous oropharynx);
Coprocystoscopy;
Differential detection of AT to AG toxocariasis, echinococcus, opisthorchid flukes, trichina and (or) other parasites, given the regional pathology.
2. Allergological survey:
Allergologic anamnesis (including pharmacological and food);
Prick and scarification skin tests with atopic allergens and intradermal tests with infectious allergens;
Tests: cold (Duncan-test), the heat, with the rovings;
In patients with suspected urticaria, are available in this hospital tests in vitro or in vivo.
The second and third paragraphs of the survey are sick outside exacerbation urticaria and receive antihistamine and GMP drugs.
3. Mandatory instrumental studies.
Bicycle ergometry to exclude cholinergic urticaria.
In the case of idiopathic, unspecified, dermographism urticaria are following tool shed research for the purpose to find the functional and organic violations:
Ultrasound of the abdominal cavity;
EGDS;
ECG.
4 Further research tool.
R-grafia WGCs and PIP (for reasons).
5. Consultations of experts:
Allergist (optional)
In idiopathic, unspecified, demographic urticaria are hold further consultations: the gynecologist, rheumatology, dentist, ENT, parasitology, endocrinology and others (for reasons).
Additional instrumental and laboratory tests are appointed on the advice of consultants.
Description: The wide range of surveys with idiopathic, unspecified, demographic forms of urticaria can be justified with the urticaria reaction may be a symptom of various diseases such as autoimmune, parasitic, cancer, or the result of functional disorders of the gastrointestinal tract, chronic inflammatory diseases (disbacteriosis bowel , periodontitis, etc.).
