Efficacy of autologous serum therapy in positive and negative autologous serum skin test patients in chronic urticaria in a tertiary care centre.

Abstract

Autologous serum therapy (AST) has been a recent therapeutic choice for a variety of chronic diseases such as allergic, inflammatory, infectious, and autoimmune disorders. However, evidence were not convincing of the beneficial effects of autologous serum therapy in treatment of Chronic urticaria (CU). CU is a common dermatological condition that is very disturbing to the patient as well as to the physician. A new observation was made about the abnormal type 1 reactions to intradermal autologous serum injections in some CU patients. This has led to the new subgroup of autoimmune chronic urticaria. The autologous serum skin test (ASST) is an intradermal test result in immediate hypersensitivity-type skin reactions in a subpopulation of CU patients and it's giving promising evidence of therapeutic and diagnostic benefit. Autologous whole blood injection has already been used as one of the old treatment modalities for chronic urticaria. The objectives of this study/reasearch are to analyse the efficacy of autologous serum therapy in patients with chronic urticaria and compare its results in ASST(+) and ASST(-) chronic urticaria patients. Approximately 5 mL of patients' blood was drawn in a plain vacutainer and centrifuged at 3000 r.p.m. for 10 min, separated 2.5 mL serum injected deep intramuscularly into gluteus muscle. Injections were repeated every week for about 9 weeks and a repeat follow up at 20 weeks was done. Out of a total of 20 patients, excellent improvement in terms of decrease in Urticaria assessment severity score was seen in 6 patients; whereas, 10 patients showed partial response, 2 patients showed no response and 2 patients lost the follow up. 10 patients with ASST(+) and 6 patients of ASST(-) showed little improvement in urticaria severity score. AST therapy is a cost-effective adjuvant modality to reduce the severity of symptoms of chronic urticaria. In some patients it's giving long term remission period and it decreases the updosing of antihistamines.