Rationelles diagnostisches Vorgehen bei der chronischen Urtikaria

The pathogenesis of 100 patients with chronic urticaria was carefully analysed. Helicobacter pylori (HP) serology was elevated in 47 % and gastral HP infection was found in 96 % of 27 patients who underwent gastroscopy with biopsies. Disappearance or significant improvement of urticarial symptoms occurred in 91 % of HP eradicated subjects but only in 50% of untreated HP-seropositive patients. Taken together the following causes were found: 43 focal infections, 35 idiopathic forms, 15 pseudoallergic reactions, five with thyroid antibodies, and two malignant diseases. Among focal infections 26 patients had HP gastritis, nine chronic ear-nose-throat focal infections, four infections with Epstein-Barr- or Cytomegalovirus, two dental infections and two yersiniosis. Thus, in chronic urticaria, assessment of the frequent HP infection should be included in the diagnostic schedule.