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Autologous Serum Skin Test and Autologous Whole Blood Injections to Patients with Chronic Urticaria: A Retrospective Analysis
Jonathan Te-Peng Tseng Woan-Ruoh Lee Sheng-Shan Lin Chun-Hung Hsu Hung-Hsu Yang Kuo-Hsien Wang Hsiou-Hsin Tsai Tsung-Hsien Tsai
Dermatol Sinica 27: 27-36, 2009

Background: Chronic urticaria (CU) is defi ned as widespread short-lived (< 24 h) itching maculopapular
skin lesions with or without angioedema for more than 6 weeks for which a predominant
physical cause must be excluded. The autologous serum skin test (ASST) has been shown
to result in immediate hypersensitivity-type skin reactions in a subpopulation of CU patients and
autologous whole blood (AWB) injection has been used as one of treatment modalities.
Objective: To evaluate the relationship of a panel of laboratory examinations to the positivity of
ASST and to evaluate the effi cacy of AWB injection in the treatment of ASST (+) and ASST (–)
CU patients.
Methods: A retrospective chart review was performed on CU patients who were subjected to
ASST and received AWB injection therapy. We assessed the therapeutic effects of 8 weekly
AWB injections in ASST (+) and ASST (–) CU patients by using urticaria activity score (UAS).
Results: Thiry-seven patients were analysed. There was no signifi cant differences in number of
patients, sex distribution, age, smoking vs. non-smoking, exacerbation of uricarial symptoms
due to stress, and UAS between ASST (+) and ASST (–) CU patients at baseline. All patients
presented normal complete blood count/differential count, and ANA. Anti-microsomal antibody
was positive in 3/15 (20.0%) ASST (+) patients and in 2/22 (9.0%) ASST (–) patients (P = 0.6).
The 8-week course of AWB injection was well tolerated. ASST (+) patients, but not ASST (–)
patients, showed signifi cantly reduced CU activity.
Conclusion: 8 of the 9 ASST (+) patients with CU responded to treatment with AWB injection.
Only 2 of the 8 ASST (–) patients showed response to the treatment. Others were having no effects
or exacerbation of the urticarial symptoms. Further studies utilizing larger number of patients,
longer follow-up periods, and different amount of autologous serum injection may better
defi ne the clinical effi cacy of autologous serum injection for the treatment of chronic urticaria
with positive ASST.

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