Heparin and tranexamic Acid therapy may be effective in treatment-resistant chronic urticaria with elevated D-dimer : a pilot study
Articolo
Data di Pubblicazione:
2010
Citazione:
Heparin and tranexamic Acid therapy may be effective in treatment-resistant chronic urticaria with elevated D-dimer : a pilot study / R. Asero, A. Tedeschi, M. Cugno. - In: INTERNATIONAL ARCHIVES OF ALLERGY AND IMMUNOLOGY. - ISSN 1018-2438. - 152:4(2010 Apr), pp. 384-389.
Abstract:
Background : chronic urticaria (CU) patients often present activation of the coagulation cascade and fibrinolysis whose markers correlate with disease severity. Aim : we evaluated whether CU patients with elevated plasma D-dimer have a poor response to antihistamines, and anticoagulation and
inhibition of fibrinolysis may be beneficial in these patients. Methods : sixty-eight consecutive patients with CU were prescribed cetirizine 10 mg daily for 2 weeks; plasma D-dimer was measured. Non-responders were given cetirizine 30 mg daily for 1 week and subsequently, in case of failure, systemic steroids. Patients with persistent controlled CU and elevated D-dimer plasma levels were offered subcutaneous nadroparin 11,400 IU once a day and oral tranexamic acid 1 g three times a day for 2 weeks. Results : D-dimer levels were elevated in 14/68 (20.6%) patients (range 306–7,317 ng/ml; normal values ! 278 ng/ml) and were associated with a more severe disease. Twelve of 14 patients with elevated D-dimer
levels did not respond to antihistamine treatment (p = 0.0001). On the whole, 14 patients reported a poor or absent response to cetirizine 10 mg daily and only 1 of these
responded satisfactorily to cetirizine 30 mg daily. Eight patients with elevated D-dimer and whose disease was not satisfactorily
controlled by prednisone received nadroparin
and tranexamic acid. A marked improvement of symptoms was observed in 5/8 cases. Conclusion : our findings indicate that CU patients with elevated D-dimer often present a more severe disease with reduced response to antihistamines. Based on this short pilot study, some of these patients may benefit from treatment with nadroparin and tranexamic
acid
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
Anticoagulants; Antihistamines; Autoreactivity; Chronic urticaria; D-dimer; Heparin; Therapy
Elenco autori:
R. Asero, A. Tedeschi, M. Cugno
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