Diseases that cause hives in adults
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Diseases That Cause Hives in Adults
Chronic Urticaria and Autoimmune Disorders
Chronic Urticaria (CU)
Chronic urticaria (CU) is a prevalent condition characterized by the spontaneous or inducible appearance of hives, angioedema, or both, lasting for at least six weeks. The pathophysiology of CU involves the release of histamine and other mediators from cutaneous mast cells, which can be triggered by various factors including specific immunoglobulin E (IgE), components of complement activation, and endogenous compounds1. Autoimmune phenomena are found in over 30% of CU patients, with common associations including thyroid autoimmunity and the presence of autoantibodies against the alpha-subunit of the basophil IgE receptor and IgE itself1 4.
Autoimmune Thyroiditis
Autoimmune thyroiditis is a significant underlying cause of CU. The treatment of thyroiditis with suppressive doses of thyroid hormone often results in the remission of CU symptoms1. This highlights the importance of screening for thyroid autoimmunity in patients presenting with chronic hives.
Systemic Lupus Erythematosus (SLE)
Systemic lupus erythematosus (SLE) is another autoimmune disorder linked to chronic spontaneous urticaria (CSU). Studies have shown a variable prevalence of CSU in SLE patients, ranging from 0% to 27.5% in adults4. The pathogenesis of both conditions involves IgG- and IgE-mediated autoreactivity, linking inflammation and autoimmunity with the activation of the complement and coagulation systems4.
Gut-Skin Axis and Microbiome Dysbiosis
Gut Microbiome and Chronic Urticaria
Emerging evidence suggests a significant role of the gut microbiome in the development of CU. Dysbiosis, or the imbalance of gut bacteria, has been associated with dermatologic conditions, including CU. Research indicates that CU patients often have a decreased abundance of beneficial bacteria such as Firmicutes and Bacteroidetes, and an increased abundance of Proteobacteria, which may enhance intestinal permeability and lead to inflammatory skin diseases2. This connection between gut health and skin conditions opens new avenues for potential treatments targeting the gut microbiome.
Psychiatric Disorders and Chronic Urticaria
Mental Health Impact
Chronic urticaria significantly affects the quality of life and has been linked to a higher risk of psychiatric disorders. The persistent itch and discomfort can lead to anxiety, depression, and other mental health issues, further complicating the management of the disease3.
Other Causes of Hives
Infections and Drugs
Infections and certain medications are also known triggers for hives. Immune complex production can lead to urticarial vasculitis, a condition where immune complexes deposit in the blood vessels, causing inflammation and hives1. Additionally, drugs such as nonsteroidal anti-inflammatory drugs (NSAIDs) and antibiotics can induce hives in susceptible individuals1.
Angioedema
Angioedema, which often accompanies urticaria, can occur due to various causes including ACE inhibitors, hereditary angioedema (HAE), and acquired angioedema (AAE). While angioedema can be self-limiting, it poses a risk of fatal asphyxiation if it involves the larynx8.
Conclusion
Hives in adults can be caused by a variety of diseases, with chronic urticaria being a common condition linked to autoimmune disorders, gut microbiome dysbiosis, infections, and certain medications. Understanding these underlying causes is crucial for effective management and treatment of hives, improving the quality of life for affected individuals.
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Most relevant research papers on this topic
Chronic urticaria: pathophysiology and etiology, or the what and why.
Chronic urticaria is a complex disease involving cutaneous mast cell release, with autoimmune factors playing a significant role in its pathophysiology and identifying treatable causes is crucial for effective management.
IDDF2020-ABS-0112 Gut-skin axis: decoding the link between the gut microbiome and hives
Chronic urticaria patients have a decreased abundance of certain gut bacteria, potentially leading to inflammatory skin diseases.
Systematic Review
Rigorous JournalPatients with chronic urticaria have a higher risk of psychiatric disorders: a population‐based study
Chronic urticaria patients are at a higher risk of developing psychiatric disorders, such as anxiety and depression, due to the itchy hives.
Rigorous JournalComorbidity and pathogenic links of chronic spontaneous urticaria and systemic lupus erythematosus – a systematic review
Chronic spontaneous urticaria and systemic lupus erythematosus may share common pathogenesis and comorbidity rates, with potential for targeted treatment options.
Systematic ReviewResearch Progress in Chronic Autoimmune Urticaria
Chronic autoimmune urticaria (CU) is an immune-mediated inflammatory disease that impairs patients' quality of life and is more common in adults than children, with a peak occurrence in the third to fifth decades of life.
Pathogenicity of Serratia marcescens Strains in Honey Bees
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Urticaria and angioedema
Urticaria and angioedema are common disorders, and managing them effectively requires understanding their causes, diagnosis, and treatment strategies.
Highly CitedPrevalence and Causes of Childhood Urticaria
Childhood urticaria is more prevalent than chronic urticaria, with infections, medications, and foods as common causes, and chronic autoimmune urticaria being more prevalent in children than adults.
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