Chronic Idiopathic Urticaria and Thyroid Disease

Patients with chronic idiopathic urticaria or angioedema are often frustrated by their symptoms and by the inability of their physician to uncover the cause of their affliction. Detailed histories, food diaries, “routine” laboratory studies, and advanced immunologic evaluations usually offer no further insight into the pathogenesis of the disorder. Recent advances in comprehending the etiology of chronic urticaria or angioedema have supported the notion that many cases may be an indication of an underlying autoimmune process. As discussed in this chapter, there is an increasing body of evidence to corroborate the theory that there is an association of some cases of chronic urticaria or angioedema with thyroid autoimmunity, and that a subset of these patients may respond therapeutically to the administration of thyroid hormone. Evaluating patients with chronic idiopathic urticaria or angioedema for thyroid autoimmunity should be part of their standard workup. Therapeutic use of thyroid hormone may be considered a therapeutic option in select patients who fail to respond to conventional therapy.