A Prospective Study for the Prevalence of Helicobacter Pylori Infection in Patients with Chronic Urticaria in Korea

Jang, Myoung Kuk; Kim, Jae Wang; Kim, Sang Seok; Seok, Sang Mee; Kim, Kwang Joong; Lee, Chong Ju

Abstract

BACKGROUND: Helicobacter pylori(H. pylori) infection is known to be strongly associated with varied dermatoses such as rosacea, vasculitic purpura, and Sweet's syndrome. Also, many antibiotics including amoxicillin, clarithromycin, and tetracycline have been used to ameliorate chronic urticaria. This recent knowledge posed the plausibility that H. pylori infection might be an underlying causative factor of chronic urticaria.
OBJECTIVE
This study was conducted to investigate the role of H. pylori infection in patients with chronic urticaria.
METHODS
Sixty-five subjects with chronic urticaria were examined for H. pylori infection with enzyme-linked immunosorbent assay for IgG/M against H. pylori and rapid urease test(CLO test) for endoscopically biopsied gastric mucosa. Amoxicillin or clarithromycin combined with omeprazole as a therapy was administrated to the 44 patients with positive test results for 4 weeks.
RESULTS
H. pylori infection was more frequently diagnosed in 44 of 65(67.7%) patients with chronic urticaria than in the control subjects(8.8%). After the completion of treatment for 4 weeks, specific IgG antibodies and a CLO test against H. pylori were negative in 28 of 38(73.7%) and 43 of 44(97.7%) patients respectively. At the post-treatment evaluation, 37 of 44(84.1%) patients with H. pylori-positive urticaria showed significant clinical remission of urticaria.
CONCLUSION
Eradication of H. pylori in patients with chronic urticaria was accompanied by clinical remission of urtication. There is substantial evidence that unexplained causes of chronic urticaria may be associated with H. pylori infection.