Table 4.
Levothyroxine in the treatment of CU (15 years to date)∗
| Author | Comments |
|---|---|
| Kim et al.35 | 184 patients with CU, 23.4% with ATAbs and 14.1% with thyroid dysfunction, were treated with levothyroxine. Only 2/10 patients with HT showed improvement in urticaria. 8 patients presented hyperthyroidism, of which 5 had GD. No patient showed improvement in urticaria after treatment with antithyroid drugs. |
| Magen et al.45 | 44 cases with CSU and hypothyroidism compared with 44 CSU and euthyroid controls. They were administered l-thyroxine for 53 ± 19 days. After the treatment, all subjects were euthyroid, the UAS score decreased without showing any relationship with the ASST result. After 3–6 months of treatment, no significant difference was found in the euthyroid controls. |
| Temboury et al.46 | A 13-year-old male with recurrent CU and hypothyroidism, increased TGAbs, and TPOAbs (4440 U/ml). 50 μg thyroxine treatment was administered. Patient showed improvement of the CU, until finally becoming asymptomatic. |
| Kiyici et al.17 | 15 patients with CSU and positive ATAbs, were divided into 2 treatment groups: 1) Levothyroxine and desloratadine 5 mg/day, 2) Desloratadine 5 mg/day. All patients showed significant improvement in pruritus and severity of the hives, but there was no difference in other clinical symptoms or in the levels of antibodies. In group 1 the levels of IFN-γ and TNF-α increased after treatment with levothyroxine compared to basal levels. (p = 0.05) |
| Aversano, et al.25 | 20 women with CSU and AT with positive ATAbs received l-thyroxine until suppression of TSH. In 16 of them there was a decrease in symptoms of urticaria at 12 weeks (p < 0.0001), and ATAbs levels (p = 0.001). |
| Levy et al.47 | 187 patients with CSU for more than 7.5 years. Among female patients (n = 97) 1 had Hashimoto's thyroiditis, 2 had hypothyroidism. They were given levothyroxine 100 μg/day. None of the 3 showed remission of the disease when starting levothyroxine. |
CU: chronic urticaria. HT: Hashimoto's thyroiditis. GD: Grave's disease. CSU: chronic spontaneous urticaria. UAS: urticaria activity score. ASST: autologous serum skin test. ATAbs: anti-thyroid autoantibodies, TGAbs: anti-thyroglobulin antibodies. TPOAbs: anti-thyroid peroxidase antibodies. IFN-γ: interferon gamma. TNF-α: tumor necrosis-alpha. AT: autoimmune thyroiditis. TSH: Thyroid stimulating hormone.