Urticária crônica espontânea: manifestações clínicas, diagnóstico, patogênese e história natural

Abstract

Introduction: Chronic spontaneous urticaria (CSU) is defined by the presence of recurrent urticaria (also called hives or wheals), angioedema, or both for a period of six weeks or more. Objective: to discuss chronic spontaneous urticaria: clinical manifestations, diagnosis, pathogenesis and natural history. Methodology: Literature review of the Scielo, PubMed and VHL databases, from January to March 2024, with descriptors “chronic spontaneous urticaria”, “clinical manifestations” and “diagnosis”, articles from 2019 to 2024 (162 studies) were included. . studies with other criteria were excluded, with 05 articles in full. Results and Discussion: Chronic spontaneous urticaria (CCU) is defined by the presence of urticaria (urticaria), angioedema, or both for a period of six weeks or more. The diagnosis of CSU is made clinically based on the episodic appearance of characteristic urticarial lesions, with or without angioedema. A complete blood count with differential, a C-reactive protein (CRP) or erythrocyte sedimentation rate (ESR), and possibly a thyroid-stimulating hormone (TSH) level are suggested in diagnosis, although these labs are normal in most patients who do not present signs and symptoms of systemic disease. No specific trigger or etiology can be identified in 80 to 90 percent of adults and children with CSU if a careful history does not suggest one, although patients may be able to identify factors that worsen the disorder once it is present. The best developed hypotheses involve histamine releasing factors and defects in basophil signaling and/or function. Conclusion: UEC is a self-limiting disorder in the majority of patients, with an average disease duration of two to five years, although active UEC significantly impairs quality of life.