[CIS-PAGID] BEST REGARDS

[Berger, Melvin]

In many cases, increasing thyroid replacement so that the TSH is within normal limits or at the lower end of the normal range will cause resolution of the urticaria. I suggest to try this before any other expensive work up. 
 
Melvin Berger, M.D., Ph.D.
Adjunct Professor of Pediatrics and Pathology
Case Western Reserve University
Cleveland, OH 44106

________________________________

From: pagid-bounces at list.clinimmsoc.org on behalf of Dewton Vasconcelos
Sent: Thu 3/22/2012 3:27 PM
To: pagid at list.clinimmsoc.org
Subject: Re: [CIS-PAGID] BEST REGARDS


Dear Wilmer

Sometimes hypothyroidism due to Hashimoto's autoimmune thyroiditis is associated to urticaria, usually chronic urticaria. She is nowadays clearly hypothyroid (TSH moderately elevated).
In these cases, replacement of L-thyroxin usually induces remission of the cutaneous manifestations.

Best regards,

Dewton

Wilmer Cordova Calderon wrote: 

	DEAR DEWTON THIS LABORATORY RESULTS ARE SOME CONTRIBUTE TO THYROID ALTERATION. OTHER DISEASES ARE: NEGATIVE   


	CBC / Date 16/02/2012

	leukocytes / cells / microL 7630

	Neutrophils% / cells / microL 3490

	Lymphocytes% cells / microL 3060

	BASOPHILS 30

	monocytes 810 INCREASED SLIGHTLY

	eosinophils 220

	Hemoglobin. 12.8

	Hematocrit: 38.6

	ERYTHROCYTES 4290

	Platelets: 433

	Additional elements:

	Ig E 362.1 INCREASED 3 TIMES NORMAL

	OTHER REVIEWS

	PCR 1.1

	ESR 10

	ANTI Thyroglobulin 1298 INCREASED SEVERALY

	ANTI PEROXIDASE:  MAS 600 INCREASED SEVERALY

	TSH 25.76: INCREASED SEVERALY

	Parasitological: NEGATIVE

	Leucos URINE: GR  1 / C

	GLYCEMIA 95
	
	
	2012/3/22 Dewton Vasconcelos <dmvascon at usp.br>
	

		Dear Wilmer
		
		I'd suggest to look for common causes of urticaria, e.g., non steroid anti-inflammatory drugs, artificial colorants in foods, drugs, toothpaste etc., other drugs (basophil degranulators, angiotensin converter enzyme  inhibitors etc.).
		The infections are really common and it is important to rule out allergies (rhinosinusitis, asthma etc) and Samter's triad (AAS sensitivity, asthma and chronic eosinophilic non-allergic rhinitis).
		Look for IgA levels, as IgA deficiency is frequently associated to autoimmunity (thyroid and gut) and respiratory allergies.
		
		All the best,
		
		Dewton Vasconcelos
		University of São Paulo 


		Wilmer Cordova Calderon wrote: 

			THERE IS A PATIENT WOMAN 56 YEAR OLD  WITH  Acute Urticaria
			BACKGROUND DISEASES
			

			PTI 

			HYPERTHYROIDISM THEN (ACTUALLY) HIPOTHYROIDISM

			BRONCHITIS - TRACHEITIS TWICE A YEAR

			TONSILLITIS FIVE A YEAR

			SPLENECTOMY 14 YEAR OLD

			HYSTERECTOMY  39 YEAR OLD


			LABORATORY
			CBC / DATE
			Count / Date 16/02/2012
			No absolute leukocytes / cells / microL 7630
			Neutrophils% / cells / microL 3490
			Lymphocytes% cells / microL 3060
			BASOPHILS 30
			monocytes 810
			eosinophils 220
			Hemoglobin. 12.8
			Hematocrit: 38.6
			ERYTHROCYTES 4290
			Platelets: 433
			Additional elements:
			Ig E 362.1
			OTHER REVIEWS
			1.1 PCR
			ESR 10
			Thyroglobulin 1298
			PEROXIDASE ANTI MAS 600
			TSH 25.76
			Parasitological 3 METs NEG
			Leucos URINE EX 1 / C
			GLYCEMIA 95 
			IN ADDITION TO OTHER THYROID ASSESSMENT SHOULD BE ASSOCIATED PATHOLOGY TO EVALUATE?

			ATTE

			WILMER CÓRDOVA






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