61 Chronic Urticaria With Sensitization to Anisakis Simple~,. Which Factors Contribute to Detectable Specific IgG4 Values? Francisco Vega de La Osada, Alvaro ...
S126 Abstracts
61 Which Chronic Urticaria With Sensitization to Anisakis Simple~, Factors Contributeto Detectable Specific IgG4 Values? Francisco Vega de La Osada, Alvaro Daschner, Bego~a Gonzdlez Leza Hospital University La Princess, Madrid, Spain In our area a high proportion of patients with chronic urticaria are sensitized to Anisakis simplex (A.s.). In order to elucidate a possible diagnostic value for specific IgG4, patients with chronic urticaria and with measurable specific IgE values (>0,7 kU/1, Cap-FEIA, Pharmacia, Uppsala, Sweden) were divided into two groups: Group A was comprised of 23 patients with detectable specific IgG4 against A.s. and in group B 21 patients were included without detectable IgG4. Both groups were compared with respect to age, specific IgG against A.s. and duration of symptoms (mean values, standard deviation (SD), t-test) as well as for total and specific IgE against A.s. (median values, interquartile range (IQR) and Mann-Whitney). Spearman correlation coefficients were calculated between the mentioned parameters. Chi-square-test was used to compare the prevalence of Helicobacter-pylori infection (positive breath test), anarnnestic data of rhinoconjunctivitis or asthma as well as the prevalence of a suspected previous history of acute gastro-allergic Anisakiasis (acute urticaria/angioedema, abdominal pain and or nausea after intake of raw or undercooked fish) in both groups. Mean age was 44,2 (SD 16,5) years in group A and 44,0 (SD 13,4) years in group B. IgG4 levels in group A ranged from 177-6405 (median 869) lag/l. Mean specific serum IgG was higher in group A than in group B (12,1, SD 10,5 mg/l versus 6,7, SD 4,0 mg/1; p=0,05). Mean duration of symptoms did not differ in group A (20,4, SD 28,3 months) compared to group B (27,2, SD 33,7 months). Total IgE was higher in group A than in group B (median 241, IQR 125-382 kU/1 versus 149, IQR 82-192 kU/1, p=0,02). Also specific IgE was higher in group A (29,8, IQR 14-53 versus 4,5, IQR 1,5-14,4; p=0,001). If all patients were studied, IgG4 values correlated with total IgE (Rho 0,35; p=0,02), specific IgE (Rho 0,49; p=0,001 ) and specific IgG (Rho 0,51; p0,7 kU/l. In the control group 10
J ALLERGY CLIN IMMUNOL JANUARY 2002
patients were included with chronic urticaria without detectable specific IgE against A.s. Measurement of specific IgG and IgG4 against A.s. was performed with CAP-FEIA. Mean values were compared for age, time interval, and specific IgG. Median values were obtained for total IgE, specific IgE and specific IgG4. Spearman Correlation Coefficients were calculated between all mentioned parameters. Mean age was 44,2 (SD 10,5) years in group A and 44,1 (SD 12) years in group B (group C: 37,1; SD 17,4 years). Mean time interval was 8,5 (SD 4,0) months in group A and 6,8 (SD 3,2) months in group B (group C: 8,3; SD 3,5 months). Mean specific IgG was higher in group B than group A (23,4, SD 24 versus 6,2, SD 3,4 mg/1; p=0,004). Mean specific IgG in the control group did not differ significantly from group A (4,8, SD 2,8 rag/l). Median total IgE was higher in group B than in group A (418, IQR 301-922 versus 156, IQR 41-209 kU/1; p = 0,02). Median specific IgE was higher in group B than in group A (51,9, IQR 24,398,4 versus 4,9, IQR 1,6-23 kU/1; p =0,02). All patients except one in group B showed measurable specific IgG4 values (median 1872; IQR 940-7775 lag/l). Only two patients of group A ( 177 and 522 lag/l) and one patient in the control group (221 lag/l) displayed positive IgG4 values. IgG4 correlated with total lgE (Rho 0,41, p=0,02), specific IgG (Rho 0,73, p
