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master's thesis
Etiopatogeneza i liječenje kronične spontane urtikarije
Zagreb: University of Zagreb, School of Medicine, 2022. urn:nbn:hr:105:364232
Barišić, Ana
University of Zagreb
School of Medicine
Department of Dermatology

Institutional repository: Dr Med - University of Zagreb School of Medicine Digital Repository

Cite this document

Barišić, A. (2022). Etiopatogeneza i liječenje kronične spontane urtikarije (Master's thesis). Zagreb: University of Zagreb, School of Medicine. Retrieved from https://urn.nsk.hr/urn:nbn:hr:105:364232

Barišić, Ana. "Etiopatogeneza i liječenje kronične spontane urtikarije." Master's thesis, University of Zagreb, School of Medicine, 2022. https://urn.nsk.hr/urn:nbn:hr:105:364232

Barišić, Ana. "Etiopatogeneza i liječenje kronične spontane urtikarije." Master's thesis, University of Zagreb, School of Medicine, 2022. https://urn.nsk.hr/urn:nbn:hr:105:364232

Barišić, A. (2022). 'Etiopatogeneza i liječenje kronične spontane urtikarije', Master's thesis, University of Zagreb, School of Medicine, accessed 25 December 2024, https://urn.nsk.hr/urn:nbn:hr:105:364232

Barišić A. Etiopatogeneza i liječenje kronične spontane urtikarije [Master's thesis]. Zagreb: University of Zagreb, School of Medicine; 2022 [cited 2024 December 25] Available at: https://urn.nsk.hr/urn:nbn:hr:105:364232

A. Barišić, "Etiopatogeneza i liječenje kronične spontane urtikarije", Master's thesis, University of Zagreb, School of Medicine, Zagreb, 2022. Available at: https://urn.nsk.hr/urn:nbn:hr:105:364232

Metadata
TitleEtiopatogeneza i liječenje kronične spontane urtikarije
Title (english)Etiopathogenesis and treatment of chronic spontaneous urticaria
AuthorAna Barišić
MentorSuzana Ljubojević Hadžavdić (mentor)
Committee memberZrinka Bukvić Mokos (predsjednik povjerenstva)
Committee memberRomana Čeović (član povjerenstva)
Committee memberSuzana Ljubojević Hadžavdić (član povjerenstva)
GranterUniversity of Zagreb
School of Medicine
(Department of Dermatology)
Zagreb
Defense date and country2022-07-15, Croatia
Scientific / art field,
discipline and subdiscipline		BIOMEDICINE AND HEALTHCARE
Clinical Medical Sciences
Dermatovenerology
Abstract
Kronična urtikarija je bolest karakterizirana pojavom urtika i angioedema u razdoblju duljem od 6 tjedana. Prevalencija kronične spontane urtikarije kreće se između 1% i 2%, s prevalencijom od oko 1,3% kod žena i oko 0,8% kod muškaraca. Kod djece je prevalencija ispod 1% i ne postoji značajna razlika u spolu. Etiologija bolesti je nepoznata, a patogenetski mehanizam nastanka urtika i angioedema je degranulacija mastocita s otpuštanjem vazoaktivnih medijatora koji djeluju na krvne žile izazivajući vazodilataciju, kemotaksijom potiču migraciju upalnih stanica i djeluju na aferentna živčana vlakna izazivajući svrbež. U oko 50% slučajeva identificiran je i podležeći autoimunosni mehanizam aktivacije mastocita. Dva su tipa reakcija preosjetljivosti identificirana u kroničnoj autoimunoj urtikariji: u tipu I prisutna su autoantitijela IgE tipa, a u tipu II IgG-anti-IgE i IgG-anti-FcεRI protutijela. Klinička slika urtika i angioedema često je popraćena svrbežom i boli, ali mogu biti prisutni i opći simptomi. Bolest je prosječnog trajanja od 2 do 6 godina. U dijagnostici je prvi korak potvrda dijagnoze kroz uzimanje anamneze, fizikalni pregled i osnovne laboratorijske pretrage. Laboratorijske pretrage indicirane u dijagnostici su kompletna krvna slika, CRP, i ukupni IgE. Daljnji postupci su identifikacija komorbiditeta i faktora koji modificiraju aktivnost bolesti, te provođenje upitnika koji boduju aktivnost bolesti i utjecaj bolesti na kvalitetu života. Terapija prvog izbora za liječenje su antagonisti H1 receptora u standardnoj dozi, te povećanje doze do 4 puta u slučaju neodgovarajućeg odgovora na jednostruke doze. Treći korak je dodavanje monoklonalnog anti-IgE protutijela omalizumaba, a četvrti korak uključivanje imunomodulatornog lijeka ciklosporina u terapiju.
Abstract (english)
Chronic urticaria is a disease that manifests with wheals and angioedema that last longer than 6 weeks. Prevalence of CSU is between 1% and 2 %, with differences between genders: it is more prevalent in females, at around 1,3%, and in males the prevalence is about 0,8%. In pediatric population the prevalence is at around 1% without differences between sexes. Although the etiology of the disease is unknown, the main pathophysiological mechanism is degranulation of the mast cells, which release histamine and other mediators. Vasoactive mediators consequently dilate surrounding blood vessels, attract other immune cells through chemotaxis and stimulate afferent nerve fibers. In approximately 50% of cases there is an underlying autoimmune mechanism of mast cell activation. Two types of hypersensitivity reactions have been identified: type I with IgE autoantibodies and type II with IgG-anti-IgE i IgG-anti-FcεRI antibodies. Apart from wheals and angioedema, CSU may present with itching, burning and pain, or even general symptoms. Regression of urticaria usually occurs after 2 to 6 years. Regarding diagnostic procedures, the diagnosis is confirmed through patient's history, physical examination and the results of laboratory tests (complete blood count, serum IgE, CRP). Secondly, patient's comorbidities and disease modifying factors should be identified, as well as the disease activity and its impact on quality of life. First-line therapy for CSU are H1-receptor antagonists. The dose of the drug can be raised up to four times if single dose is not effective. In case of an inadequate response, omalizumab should be added on to the preexisting therapeutic regimen. Ciclosporin A should be considered if the disease is resistant to omalizumab.
Keywords
Keywords (english)
Languagecroatian
URN:NBNurn:nbn:hr:105:364232
Study programmeTitle: Medicine
Study programme type: university
Study level: integrated undergraduate and graduate
Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
Type of resourceText
File originBorn digital
Access conditionsOpen access
Terms of useLicence In copyright icon
Created on2023-01-02 11:00:03