Histamine Release in Chronic Idiopathic Urticaria

Abstract

In their article describing autoantibodies against the high-affinity IgE receptor as a cause of histamine release in chronic urticaria, Hide et al. (June 3 issue)¹ state that the majority of patients with severe, chronic urticaria have an immediate wheal-and-flare response after intradermal injection of autologous serum. Have the authors investigated this phenomenon in patients with acute hives? If so, is chronic urticaria more likely to develop in patients with a positive reaction to their own serum? One of my patients with acute hives of unknown cause had a positive result on skin testing with autologous serum. When skin testing was repeated four weeks later, the results were still positive, even though her acute hives had disappeared within a few days and she had not taken medications for three weeks.