Chronic Hives Due to Vitamin D Deficiency

It seems that there is more and more research being published indicating that vitamin D deficiency leads to allergy exacerbation (and by supplementation, the severity can be reduced). Particularly problematic given so many people are vitamin D deficient as a possible byproduct of working indoors for so many of us (including physicians).

The most recent research out of Nebraska suggests that chronic urticaria in adults may be due to reduced vitamin D levels. In the small study, researchers compared 25 patients with chronic hives to 25 patients with nasal allergies. Researchers found patients with hives had significantly reduced levels of vitamin D, with nearly half of them considered to be vitamin D deficient.


References:
Reduced vitamin D levels in adult subjects with chronic urticaria. J Allergy Clin Immunol. 2010 Aug;126(2):413; author reply 413-4.

Low vitamin D status despite abundant sun exposure. J Clin Endocrinol Metab. 2007 Jun;92(6):2130-5. Epub 2007 Apr 10.

Serum vitamin D levels and severe asthma exacerbations in the Childhood Asthma Management Program study. J Allergy Clin Immunol. 2010 Jul;126(1):52-8.e5. Epub 2010 Jun 9.

Vitamin D in atopic dermatitis, asthma and allergic diseases. Immunol Allergy Clin North Am. 2010 Aug;30(3):397-409.

Serum vitamin D levels and severe asthma exacerbations in the Childhood Asthma Management Program study. J Allergy Clin Immunol. 2010 Jul;126(1):52-8.e5. Epub 2010 Jun 9.

Vitamin D in atopic dermatitis, asthma and allergic diseases. Immunol Allergy Clin North Am. 2010 Aug;30(3):397-409.

Strange But True Allergies People Suffer From (Sex, Kissing, Water, etc)

As shown on CBS news here, these things can cause an allergic reaction in the rare unfortunate individual:

1) Water can cause hives in some people (aquagenic urticaria)
2) Sunlight
3) Kissing (a person has recently eaten a food substance that the person being kissed is allergic too)
4) Sex (some women are allergic to seminal fluid)
5) Hops and barley can cause an allergic reaction
6) Low temperatures
7) Cell phones (due to Nickle content)
8) Pressure (too tight a belt, necktie, bra, etc)
9) Chocolate
10) Exercise (cholinergic urticaria)
11) Vibration (dental drill, lawn-mower, jackhammer, etc)
12) Allergy medications (or more precisely, the additives found within allergy medications)

See your local allergist if you suspect you have this!

H. Pylori Infection Can Cause Urticaria and Angioedema!

Thanks to a recent blog post by medical blogger, Dr. Ves Dimov, I was made aware of how H. Pylori (Helicobacter pylori) infection of the stomach can cause chronic (idiopathic) urticaria as well as angioedema and that eradication of H. Pylori thru antibiotics and acid suppression can significantly improve the problem!

For those who do not know what H. pylori is... It is a germ that is the most important cause of gastritis and peptic ulcer disease. It can be diagnosed by measurement of H. pylori-specific (IgA and IgG) antibodies, urea breath test, or upper endoscopy. And... this germ is now becoming implicated in causing problems beyond the digestive system like angioedema and urticaria.

In one study, 88% of infected patients in whom the bacterium was eradicated after therapy showed a total or partial remission of urticaria symptoms. Symptoms remained unchanged in all uninfected patients.

Another study documented the disappearance (67%) or improvement of urticaria (24%) in most antimicrobially treated patients after 3-12 weeks.

Triple therapy is considered to be the standard treatment for children and adults. A proton pump inhibitor combined with two antibiotics has been shown to be very effective in clearing H pylori from the stomach. The current recommendation is treatment with amoxicillin, clarithromycin, and a proton pump inhibitor (Prevpac) for 2 weeks. Triple therapy regimens that are effective in children include a proton pump inhibitor combined with clarithromycin and metronidazole or amoxicillin and metronidazole.

References:
Beneficial effects of Helicobacter pylori eradication on idiopathic chronic urticaria. Dig Dis Sci 1998 Jun;43(6):1226-9.
Prevalence of Helicobacter pylori-associated gastritis in chronic urticaria. Int Arch Allergy Immunol 1998 Aug;116(4):288-94.