Serum ferritin levels in chronic spontaneous urticaria in association with autologous serum skin test: A cross-sectional study

Abstract

BACKGROUND: Chronic spontaneous urticaria (CSU) is a common clinical condition presenting with wheals or along with angioedema. It has a complex pathogenesis having a considerable impact on quality of life. In patients with chronic spontaneous urticaria (CSU) exhibiting poor response to conventional treatments, the presence of hyposiderinemia suggests that oral iron therapy could potentially lead to resolution of the urticaria symptoms. OBJECTIVES: (1). To estimate serum ferritin levels in patients with CSU. (2) To assess the correlation between urticarial activity score, autologous serum skin test (ASST), and serum ferritin levels in CSU. MATERIALS AND METHODS: This prospective study enrolled 37 cases of clinically diagnosed CSU attending the dermatology outpatient department from December 2019 to November 2020 after Institutional Ethics Committee approval. ASST and serum ferritin level estimation were done on all patients. The severity of urticaria was calculated using the Urticaria Activity Score. Statistical analysis was done by frequency, standard deviation, and Chi-square test. RESULTS: Among ASST-positive patients, only 4 (19%) had low ferritin levels. No association was found between ASST and serum ferritin levels (P = 0.342). Mean serum ferritin levels in ASST-positive patients were high 91.34 ± 87.24 μg/L which was statistically significant compared to mean serum ferritin levels in ASST-negative patients 49.64 ± 46.91 μg/L. There was significant involvement of palms and soles in ASST-positive patients (P = 0.038). CONCLUSION: Although there was no significant correlation of serum ferritin levels with CSU, oral iron supplementation may be considered an add-on treatment in case of refractory urticaria.

Keywords

• autologous serum skin test
• chronic spontaneous urticarial
• serum ferritin