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Chronic Recurrent Urticaria and the functional condition of the liver


Author: Doina Barba
Degree:doctor of medicine
Speciality: 14.00.05 - Internal Diseases (with specification: Pulmonology, Gastroenterology, Hepatology, Nephrology, Functional Diagnostics and Endoscopy)
Year:2005
Scientific adviser: Vlada-Tatiana Dumbrava
doctor habilitat, professor, State University of Medicine and Pharmacy "Nicolae Testemitanu"
Scientific consultant: Ludmila Luss
doctor habilitat, professor
Institution:
Scientific council:

Status

The thesis was presented on the 27 April, 2005
Approved by NCAA on the 23 June, 2005

Abstract

Adobe PDF document0.20 Mb / in romanian

Thesis

CZU 616.514-036.12-036.87:612.35

Adobe PDF document 2.15 Mb / in romanian
140 pages


Keywords

recurrent chronic urticaria, chronic hepatitis, laboratory hepatic syndromes, the immune and allergic status, Polyoxidonium

Summary

A complex and profound investigation was performed in 104 patients with Chronic Recurrent Urticaria (CRU), which have been assisted in the clinics of Allergology and Hepatology of State University of Medicine and Pharmacy “Nicolae Testemitanu". The clinical symptomatology of the characteristic liver function, the immune parameters and the allergic condition in case of different forms of CRU; either of allergic origin or associated with chronic hepatitis have been examined on the base of some comparative estimations. It has been registered in CRU the major frequent cases associated with different hepatic diseases (61,5% cases, increasingly of HBV and HCV etiology). The causative and provocative factors of CRU differ essentially: the allergic urticaria is induced through allergens, while CRU accompanied by HC is caused by exacerbation of the main disease, dietetic errors, consumption of drugs and others.

The immune status of the patients with allergic CRU shows a lot of immune changes, such as disbalance of the T-lymphocytes population with the quantitative diminuation of the T- and B- suppresser cells, elevation of the concentration of the lymphocytes B and IgM, IgE serum. The activation and disbalance of the T-cellular segment, the growth of the serum lymphocytes B, IgG, the reduction of the immunoregulator index and emphasis of the index leuco/T-lymphocytes have been registered in the associated variants, having announced the condition of immunoreactive deficiency and more significant immune alterations than in patients with allergic urticaria.

The proves that represent the hepatic function of the patients with allergic CRU have pointed out disturbances by some parameters of the cytolytic (AST), cholestatic (total and the conjugated bilirubine), hepatodepressive (the total protein, urea, globulins, prothrombinic index) syndromes which are included within the limits of the normative oscillations and probably they explain the functional reaction of the hepatitis in the inflammatory process (the phenomen on of the “irate liver”).

The parameters of AST, ALT, the level of the total and the conjugated bilirubine, total protein, globulins, prothrombinic index, fibrinogen, trigliceride alter considerably in case of the patients with CRU combined with HC.

The traditional treatment in patients with allergic urticaria related to the efficiency of the clinical and laboratory indices in 75% cases, but in patients with CRU combined with HC has been in 48,4% cases, according to a low evolution of the syndrome, with persisting for the rezidual phenomens and resistance to the therapy.

The complex treatment, when being supplemented with immunomodulator medication in case of patients with allergic CRU (Polioxidoniu) succeeds in 92,8% cases, but in patients with associated disease about 90,1%, proves the optimising use of the immunomodulator medication for the complex treatment of CRU.