Revista Paulista de Pediatria
Print version ISSN 0103-0582
Rev. paul. pediatr. vol.31 no.2 São Paulo June 2013
http://dx.doi.org/10.1590/S0103-05822013000200021
CASE REPORT
Recurrence of chronic urticaria caused by reinfection by Helicobacter pylori
Recidiva de urticaria crónica decurrente de reinfección por Helicobacter pylori
Dayanne Melo V. BrusckyI; Luiz Alexandre R. da RochaI; Aldo José F. CostaII
IResidência em Alergia e Imunologia Clínica pelo Hospital das Clínicas da UFPE (HC-UFPE); Alergologista e Imunologista do Centro de Pesquisas em Alergia e Imunologia do HC-UFPE, Recife, PE, Brasil
IIDoutor em Nutrição pela UFPE; Alergologista e Imunologista do Centro de Pesquisas em Alergia e Imunologia do HC-UFPE, Recife, PE, Brasil
IIDoutor em Nutrição pela UFPE; Alergologista e Imunologista do Centro de Pesquisas em Alergia e Imunologia do HC-UFPE, Recife, PE, Brasil
ABSTRACT
OBJECTIVE: To describe a case of chronic urticaria in a female adolescent associated with Helicobacter pyloriinfection, confirmed in two different occasions, with improvement of urticaria after the antibacterial treatment.
CASE DESCRIPTION: A 13-year-old female patient sought medical care with chronic urticaria and epigastric pain unresponsive to medical treatment. Laboratorial tests for further investigation were normal except for the upper gastrointestinal endoscopy with biopsy showing moderate chronic active gastritis associated with Helicobacter pylori. After specific and appropriate treatment, the patient had remission of the symptoms. A new upper gastrointestinal endoscopy to control the treatment after nine months was normal. After five years, the patient returned with recurrence of urticaria and epigastric pain. She was taking antihistamines, without any improvement. It was again submitted to screening protocol for chronic urticaria with normal results. She was submitted to upper gastrointestinal endoscopy, which showed positive urease test. The patient started a new treatment for Helicobacter pylori with disappearance of chronic urticaria and epigastric pain within seven days.
COMMENTS: The reported case suggests a causal relationship between the positive diagnosis of Helicobacter pylori and the occurrence of chronic urticaria, showing the remission of symptoms after the institution of effective therapy for this agent. Chronic urticaria is a disease of complex etiology, and although controversial, there is growing evidence of Helicobacter pylori involvement with extraintestinal diseases, including chronic urticaria.
CASE DESCRIPTION: A 13-year-old female patient sought medical care with chronic urticaria and epigastric pain unresponsive to medical treatment. Laboratorial tests for further investigation were normal except for the upper gastrointestinal endoscopy with biopsy showing moderate chronic active gastritis associated with Helicobacter pylori. After specific and appropriate treatment, the patient had remission of the symptoms. A new upper gastrointestinal endoscopy to control the treatment after nine months was normal. After five years, the patient returned with recurrence of urticaria and epigastric pain. She was taking antihistamines, without any improvement. It was again submitted to screening protocol for chronic urticaria with normal results. She was submitted to upper gastrointestinal endoscopy, which showed positive urease test. The patient started a new treatment for Helicobacter pylori with disappearance of chronic urticaria and epigastric pain within seven days.
COMMENTS: The reported case suggests a causal relationship between the positive diagnosis of Helicobacter pylori and the occurrence of chronic urticaria, showing the remission of symptoms after the institution of effective therapy for this agent. Chronic urticaria is a disease of complex etiology, and although controversial, there is growing evidence of Helicobacter pylori involvement with extraintestinal diseases, including chronic urticaria.
Key-words: urticaria; Helicobacter pylori; adolescent.
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