Clinical and pathogenetic relationship between chronic urticaria and morphofunctional modifications of the digestive tract

G. Patriarca, A. Venuti, C. Nuzzo, L. Lauriola, D. Schiavino, A. Romano, C. Rumi, G. Fais

Research output: Contribution to journalArticle

Abstract

Chronic urticaria is a syndrome on account both of the etiology and the pathogenesis, which has not yet been well defined. As regards the pathogenetic mechanisms, the hypothesis has been confirmed of a correlation between chronic urticaria and gastrointestinal diseases. In a previous series of investigations the authors have demonstrated that patients with chronic urticaria show a significant increase in serum pepsinogen levels. Studies were performed in 145 patients with chronic urticaria to establish a pathogenetic relationship between gastrointestinal disorders and chronic urticaria. In these patients the radiological, histological and endoscopic aspects of the digestive system were studied. Basal and histamine-induced acid secretion and serum levels of pepsinogen were investigated. X-ray examination of the digestive tract showed abnormal findings in 62 patients (gastroduodenitis, gastric or duodenal ulcer, gastric hypotonia). Gastroduodenal endoscopy revealed modifications in the gastroduodenal mucosa in 33.3% of the cases (gastroduodenitis, atrophic gastritis, gastric diverticulum, gastric polyp, duodenal polyp, pyloric erosion). Histological examinations revealed abnormal patterns in 75% of the cases (chronic nonspecific inflammation, intestinal metaplasia, eosinophil infiltration, mononuclear cell infiltration, mucosal oedema, mucosal atrophy). Gastric secretion of HCl was modified following histamine stimulation in 56.5% of the cases (hypersecretion and hyposecretion). Serum pepsinogen levels were considerably elevated. Patients with chronic urticaria presented morphological and functional modifications: there was an abnormal X-ray picture in 70.4% of the cases, endoscopic modifications in 33.3% and histopathological lesions in 75%. Gastric secretion of HCl was modified in more than 50% of the cases whereas serum pepsinogen showed a marked increase. On the basis of the results obtained, the authors discuss the possible role of morphological and functional disorders of the digestive system in the pathogenesis of chronic urticaria. The reabsorption of protein molecules not digested by the proteolytic enzymes could represent a contributing factor in the pathogenesis of this syndrome. The increase in pepsinogen is characterized by marked impairment of gastroduodenal function. Inflammation of faulty metabolism of the gastroduodenal mucosa may play an important role in the onset and persistence of urticaria.

Original languageEnglish
Pages (from-to)379-382
Number of pages4
JournalAllergologia et Immunopathologia
Volume6
Issue number5
Publication statusPublished - 1978

ASJC Scopus subject areas

  • Immunology and Allergy

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